1. MEDICAL INSURANCE PLAN

2. Benefits (hK$)
Details of the Plan
Annual Deductibles Options Nil, HK$2,000, HK$5,000
Geographical Area Options Worldwide, North America Exclusion
Claims Processing Hong Kong
0-65 (New Applications)
Age Limits & Renewals
Expiry Age 100
Additions Immediate After Birth
Currency HK$
hosPitalisation
age < 75 age 75+
annual limit $10 Million Per Year $5 Million Per Year
hospitalisation & out-patient surgery
Room and Board including general nursing care Private Room up to $4,500 per Day Semi-Private Room up to $2,000 per Day
Maximum 90 Days
Parental Accommodation (added bed, same room) Fully Covered Fully Covered
Theatre fees; X-rays; laboratory tests; medicines Fully Covered 30% of Surgeon’s Fees
and drugs; blood and plasma; surgical appliances;
rental of wheel chairs; standard prosthetic devices
Intensive Care (Room and Board including general Fully Covered Maximum $8,000 per Day
nursing care) Maximum 90 Days
Surgeon’s Fees including pre- and post-surgical $200,000 per Year $160,000 per Year
services
Anaesthetist Fees as charged 30% of Surgeon’s Fees 30% of Surgeon’s Fees
Professional Fees including physician, specialist, Fully Covered $20,000 per Year
radiologist, physiotherapist, and pathologist fees
Kidney Dialysis Fully Covered $120,000 per Year
oncology
Treatment for cancer received as an In-patient, Fully Covered $120,000 per Year
Day-patient or Out-patient
organ transplant
Transplant of kidney, heart, liver, bone marrow, $800,000 per Disability $800,000 per Disability
lung or cornea
Complications of Pregnancy
In-patient treatment necessary as a direct result of Hospitalisation and Out-patient surgery Hospitalisation and Out-patient
a Complication of Pregnancy sub-limits apply surgery sub-limits apply
Private nursing
In-hospital, when certified medically necessary by Fully Covered Maximum $500 per Day
an attending physician Maximum 30 Days
evacuation and emergency Benefits
Worldwide emergency assistance including Maximum of $4,000,000 per event Maximum of $4,000,000 per event
evacuation and repatriation
Local Ambulance to hospital Fully Covered Fully Covered
Mortal Remains $120,000 $60,000
life Cover
Life Cover $10,000 $10,000
Note: All limits and monetary amounts shall in all instances be HK$
01

3. emergency Room treatment
Emergency room treatment Fully Covered Fully Covered
accidental Damage to teeth
Treatment received in a dental surgery or in an Fully Covered $15,000 per Year
Emergency room in a Hospital
Pre-hospitalisation Benefits
Coverage for treatment directly related to the $8,000 per Disability per year $5,000 per Disability per year
medical condition requiring hospitalisation For treatment incurred within 30 days prior For treatment incurred within 30 days
to hospital admission prior to hospital admission
Pre-Hospitalisation Benefits are separate and Pre-Hospitalisation Benefits are
distinct from optional out-patient benefit separate and distinct from optional
out-patient benefits
Post-hospitalisation Benefits
Coverage for normal follow-up treatment after Fully Covered $4,500 per year
hospitalisation Maximum $450 per visit
For treatment incurred within 90 days after
Physicians and specialists office visits For treatment incurred within 90 days
discharge from hospital after discharge from hospital
Physiotherapist, chiropractor, and acupuncturist
when certified necessary by an attending physician Post-Hospitalisation Benefits are separate Post-Hospitalisation Benefits are
and distinct from optional out-patient separate and distinct from optional
Prescribed medicines, dressings, x-rays, diagnostic benefits out-patient benefits
laboratory tests, and surgical appliances
oPtional out-Patient Benefits
age < 75 age 75+
annual limit $40,000 per year $40,000 per year
Physicians and specialists consultations Fully Covered Fully Covered
Prescribed Medicines Fully Covered $20,000 per year
Physiotherapy and chiropractic treatment upon $7,500 per year $5,000 per year
referral Maximum $500 per visit Maximum $500 per visit
Imaging and Lab Tests Fully Covered Fully Covered
Chronic Conditions Fully Covered $20,000 per year
Traditional Chinese Medicine $4,000 per year $2,000 per year
Maximum $400 per visit Maximum $200 per visit
oPtional Dental Benefits
annual limit $5,700 per year for Routine and $12,000 per year for Major Restorative
Routine Dental Treatment • Examinations
• Tooth cleaning
• Normal composite fillings
• Inlay (excluding gold inlays)
• Onlay (excluding gold onlays)
• Sealant
• Extractions
Major Restorative Dental Work • Removal of impacted, buried or unerupted teeth
• Removal of roots
• Root Canal Treatment
• Removal of solid odontomes
• Apicectomy
• New or repair of Bridge Work (excluding gold bridge work)
• New or repair of Crowns (excluding all gold crowns)
• New or repair of Upper and Lower Dentures
Note: All limits and monetary amounts shall in all instances be HK$
02

4. PReMiuMs (hK$)
hosPitalisation
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
0 8,694 7,738 6,782 7,060 6,295 5,530
1 8,694 7,738 6,782 7,060 6,295 5,530
2 8,694 7,738 6,782 7,060 6,295 5,530
3 8,694 7,738 6,782 7,060 6,295 5,530
4 8,694 7,738 6,782 7,060 6,295 5,530
5 8,694 7,738 6,782 7,060 6,295 5,530
6 7,951 7,082 6,213 6,466 5,770 5,075
7 7,951 7,082 6,213 6,466 5,770 5,075
8 7,951 7,082 6,213 6,466 5,770 5,075
9 7,951 7,082 6,213 6,466 5,770 5,075
10 7,951 7,082 6,213 6,466 5,770 5,075
11 7,951 7,082 6,213 6,466 5,770 5,075
12 7,951 7,082 6,213 6,466 5,770 5,075
13 7,951 7,082 6,213 6,466 5,770 5,075
14 7,951 7,082 6,213 6,466 5,770 5,075
15 7,951 7,082 6,213 6,466 5,770 5,075
16 7,951 7,082 6,213 6,466 5,770 5,075
17 7,951 7,082 6,213 6,466 5,770 5,075
18 7,951 7,082 6,213 6,466 5,770 5,075
19 7,980 7,059 6,136 6,489 5,752 5,014
20 8,010 7,037 6,061 6,513 5,734 4,954
21 8,039 7,013 5,985 6,537 5,716 4,893
22 8,068 6,990 5,911 6,560 5,697 4,834
23 8,285 7,176 6,066 6,733 5,846 4,958
24 8,509 7,367 6,225 6,912 5,999 5,085
25 8,738 7,564 6,389 7,096 6,156 5,217
Note: All limits and monetary amounts shall in all instances be HK$
03

5. hosPitalisation
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
26 8,975 7,766 6,558 7,285 6,318 5,351
27 9,218 7,975 6,732 7,479 6,485 5,490
28 9,468 8,189 6,910 7,679 6,656 5,633
29 9,536 8,259 6,982 7,734 6,712 5,691
30 9,605 8,330 7,055 7,789 6,769 5,749
31 9,674 8,402 7,129 7,845 6,826 5,808
32 9,744 8,474 7,203 7,900 6,884 5,868
33 9,814 8,547 7,279 7,957 6,942 5,928
34 10,194 8,874 7,555 8,260 7,205 6,149
35 10,589 9,216 7,842 8,577 7,478 6,379
36 11,001 9,572 8,142 8,907 7,763 6,619
37 11,430 9,942 8,454 9,250 8,059 6,869
38 11,877 10,328 8,779 9,608 8,369 7,130
39 12,194 10,617 9,041 9,862 8,600 7,339
40 12,519 10,915 9,310 10,123 8,839 7,555
41 12,855 11,222 9,588 10,392 9,085 7,778
42 13,200 11,538 9,876 10,668 9,339 8,009
43 13,555 11,864 10,173 10,953 9,600 8,247
44 13,878 12,145 10,412 11,212 9,826 8,440
45 14,210 12,435 10,660 11,479 10,059 8,639
46 14,550 12,731 10,913 11,752 10,298 8,843
47 14,899 13,036 11,173 12,033 10,543 9,053
48 15,257 13,349 11,440 12,321 10,795 9,268
49 16,107 14,129 12,151 13,003 11,421 9,838
50 17,006 14,958 12,909 13,724 12,086 10,447
51 17,957 15,837 13,715 14,487 12,791 11,094
52 18,963 16,769 14,575 15,295 13,540 11,784
53 20,027 17,758 15,489 16,149 14,334 12,519
Note: All limits and monetary amounts shall in all instances be HK$
04

6. hosPitalisation
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
54 20,184 17,898 15,613 16,277 14,449 12,621
55 20,344 18,042 15,741 16,409 14,568 12,726
56 20,506 18,188 15,869 16,543 14,688 12,833
57 20,671 18,336 16,000 16,679 14,811 12,942
58 20,840 18,487 16,135 16,819 14,937 13,055
59 22,750 20,234 17,717 18,352 16,339 14,325
60 24,835 22,145 19,454 20,024 17,873 15,720
61 27,120 24,247 21,372 21,859 19,560 17,260
62 29,620 26,552 23,483 23,865 21,411 18,956
63 32,354 29,081 25,808 26,060 23,441 20,823
64 35,016 31,470 27,925 28,197 25,361 22,524
65 37,902 34,061 30,220 30,515 27,442 24,370
66* 40,990 36,829 32,668 32,988 29,659 26,331
67* 43,017 38,650 34,283 34,619 31,126 27,632
68* 45,145 40,563 35,980 36,333 32,667 29,000
69* 47,381 42,572 37,763 38,133 34,285 30,438
70* 49,717 44,670 39,624 40,012 35,975 31,937
71* 52,183 46,887 41,591 41,998 37,761 33,524
72* 54,777 49,219 43,661 44,089 39,642 35,196
73* 57,504 51,672 45,839 46,288 41,622 36,955
74* 60,370 54,249 48,129 48,599 43,703 38,806
75* 63,367 56,943 50,520 51,014 45,875 40,736
76* 66,534 59,793 53,052 53,570 48,178 42,785
77* 69,866 62,792 55,717 56,262 50,602 44,943
78* 73,368 65,944 58,520 59,091 53,152 47,213
79* 77,048 69,257 61,467 62,066 55,833 49,601
80* 80,876 72,700 64,525 65,153 58,613 52,072
Note: All limits and monetary amounts shall in all instances be HK$
*The premiums for age 66 or above are listed for renewal only.
05

7. hosPitalisation
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
81* 84,939 76,359 67,779 68,439 61,575 54,711
82* 89,208 80,204 71,201 71,893 64,690 57,487
83* 93,695 84,246 74,797 75,524 67,965 60,406
84* 98,410 88,494 78,578 79,341 71,408 63,476
85* 103,308 92,902 82,496 83,296 74,971 66,646
86* 108,507 97,587 86,667 87,507 78,770 70,034
87* 113,969 102,509 91,049 91,931 82,763 73,594
88* 119,717 107,690 95,664 96,589 86,968 77,346
89* 125,756 113,135 100,514 101,485 91,388 81,292
90* 132,023 118,778 105,533 106,552 95,956 85,361
91* 138,687 124,787 110,888 111,957 100,838 89,718
92* 145,705 131,118 116,532 117,654 105,985 94,316
93* 153,085 137,778 122,470 123,648 111,402 99,156
94* 160,859 144,795 128,731 129,967 117,116 104,264
95* 168,879 152,022 135,164 136,461 122,974 109,488
96* 177,457 159,766 142,075 143,436 129,283 115,130
97* 186,419 167,854 149,288 150,716 135,864 121,012
98* 195,795 176,312 156,829 158,328 142,741 127,155
99* 205,634 185,188 164,742 166,315 149,958 133,601
100* 215,793 194,337 172,880 174,531 157,365 140,200
Note: All limits and monetary amounts shall in all instances be HK$
*The premiums for age 66 or above are listed for renewal only.
06

8. hosPitalisation Plus oPtional out-Patient
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
0 18,537 16,164 13,879 14,935 13,036 11,208
1 18,537 16,164 13,879 14,935 13,036 11,208
2 18,537 16,164 13,879 14,935 13,036 11,208
3 18,537 16,164 13,879 14,935 13,036 11,208
4 18,537 16,164 13,879 14,935 13,036 11,208
5 18,537 16,164 13,879 14,935 13,036 11,208
6 16,899 14,742 12,665 13,625 11,898 10,236
7 16,899 14,742 12,665 13,625 11,898 10,236
8 16,899 14,742 12,665 13,625 11,898 10,236
9 16,899 14,742 12,665 13,625 11,898 10,236
10 16,899 14,742 12,665 13,625 11,898 10,236
11 16,899 14,742 12,665 13,625 11,898 10,236
12 16,899 14,742 12,665 13,625 11,898 10,236
13 16,899 14,742 12,665 13,625 11,898 10,236
14 16,899 14,742 12,665 13,625 11,898 10,236
15 16,899 14,742 12,665 13,625 11,898 10,236
16 16,899 14,742 12,665 13,625 11,898 10,236
17 16,899 14,742 12,665 13,625 11,898 10,236
18 16,899 14,742 12,665 13,625 11,898 10,236
19 16,238 14,053 11,941 13,096 11,347 9,658
20 15,632 13,423 11,284 12,610 10,842 9,132
21 15,073 12,843 10,684 12,164 10,380 8,652
22 14,560 12,313 10,139 11,753 9,956 8,216
23 14,846 12,556 10,339 11,982 10,150 8,377
24 15,141 12,805 10,544 12,218 10,350 8,540
25 15,441 13,061 10,754 12,459 10,553 8,709
26 15,750 13,322 10,970 12,705 10,763 8,881
27 16,066 13,590 11,192 12,957 10,977 9,058
Note: All limits and monetary amounts shall in all instances be HK$
07

9. hosPitalisation Plus oPtional out-Patient
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
28 16,390 13,865 11,418 13,216 11,197 9,239
29 16,629 14,087 11,623 13,408 11,374 9,404
30 16,874 14,313 11,833 13,604 11,556 9,572
31 17,122 14,545 12,049 13,804 11,741 9,744
32 17,377 14,782 12,268 14,006 11,930 9,920
33 17,636 15,024 12,494 14,215 12,123 10,100
34 18,304 15,589 12,962 14,748 12,577 10,475
35 18,998 16,178 13,448 15,304 13,048 10,864
36 19,719 16,791 13,955 15,882 13,538 11,269
37 20,469 17,427 14,481 16,482 14,047 11,691
38 21,249 18,088 15,028 17,106 14,577 12,129
39 21,827 18,616 15,508 17,569 14,999 12,513
40 22,420 19,161 16,003 18,044 15,435 12,909
41 23,032 19,721 16,514 18,533 15,885 13,319
42 23,660 20,299 17,044 19,036 16,348 13,743
43 24,306 20,895 17,591 19,554 16,825 14,182
44 24,892 21,397 18,012 20,023 17,227 14,520
45 25,493 21,913 18,445 20,506 17,641 14,867
46 26,109 22,441 18,889 20,999 18,066 15,224
47 26,741 22,983 19,344 21,506 18,501 15,590
48 27,388 23,539 19,811 22,026 18,947 15,965
49 28,625 24,674 20,846 23,017 19,857 16,794
50 29,922 25,869 21,940 24,057 20,815 17,672
51 31,284 27,127 23,095 25,149 21,823 18,598
52 32,714 28,452 24,318 26,296 22,886 19,579
53 34,216 29,847 25,609 27,500 24,005 20,615
54 34,857 30,399 26,078 28,015 24,450 20,993
Note: All limits and monetary amounts shall in all instances be HK$
08

10. hosPitalisation Plus oPtional out-Patient
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
55 35,517 30,969 26,563 28,547 24,910 21,384
56 36,196 31,556 27,060 29,095 25,382 21,786
57 36,896 32,160 27,573 29,659 25,870 22,200
58 37,618 32,782 28,102 30,242 26,373 22,629
59 40,750 35,641 30,692 32,752 28,665 24,705
60 44,145 38,751 33,522 35,472 31,158 26,974
61 47,836 42,145 36,624 38,432 33,878 29,462
62 51,845 45,842 40,020 41,645 36,843 32,186
63 56,197 49,872 43,738 45,134 40,074 35,167
64 59,250 52,602 46,149 47,584 42,266 37,103
65 62,533 55,539 48,742 50,220 44,625 39,188
66* 66,025 58,659 51,494 53,016 47,123 41,392
67* 68,302 60,699 53,297 54,847 48,765 42,844
68* 70,683 62,832 55,185 56,763 50,482 44,364
69* 73,174 65,064 57,160 58,768 52,278 45,955
70* 75,768 67,387 59,215 60,853 54,148 47,609
71* 78,495 69,831 61,378 63,047 56,116 49,353
72* 81,352 72,392 63,645 65,349 58,181 51,184
73* 84,345 75,077 66,023 67,761 60,346 53,102
74* 87,479 77,888 68,515 70,286 62,614 55,115
75* 90,747 80,819 71,110 72,918 64,975 57,208
76* 94,188 83,907 73,848 75,693 67,469 59,422
77* 97,797 87,147 76,721 78,606 70,086 61,746
78* 101,578 90,543 79,734 81,659 72,831 64,184
79* 105,540 94,102 82,893 84,860 75,709 66,742
80* 109,653 97,793 86,165 88,175 78,688 69,384
81* 114,004 101,703 89,636 91,691 81,851 72,196
82* 118,563 105,802 93,276 95,377 85,168 75,147
Note: All limits and monetary amounts shall in all instances be HK$
*The premiums for age 66 or above are listed for renewal only.
09

11. hosPitalisation Plus oPtional out-Patient
Worldwide North American Exclusion
AGE Nil $2K $5K Nil $2K $5K
Deductible Deductible Deductible Deductible Deductible Deductible
83* 123,344 110,100 97,093 99,243 88,648 78,243
84* 128,355 114,606 101,097 103,297 92,298 81,491
85* 133,553 119,275 105,240 107,492 96,070 84,841
86* 139,054 124,224 109,639 111,945 100,080 88,411
87* 144,822 129,413 114,250 116,613 104,286 92,155
88* 150,878 134,863 119,097 121,518 108,706 96,093
89* 157,229 140,579 124,182 126,663 113,343 100,226
90* 163,811 146,497 129,437 131,982 118,131 104,484
91* 170,792 152,783 135,031 137,641 123,235 109,033
92* 178,132 159,394 140,917 143,595 128,606 113,824
93* 185,836 166,337 147,099 149,849 134,249 118,859
94* 193,937 173,639 153,606 156,430 140,191 124,164
95* 202,288 181,155 160,288 163,188 146,280 129,587
96* 211,200 189,190 167,450 170,431 152,822 135,430
97* 220,500 197,572 174,917 177,980 159,639 141,515
98* 230,216 206,327 182,714 185,865 166,753 147,863
99* 240,400 215,504 190,886 194,127 174,210 154,516
100* 250,906 224,956 199,285 202,622 181,860 161,324
Note: All limits and monetary amounts shall in all instances be HK$
*The premiums for age 66 or above are listed for renewal only.
oPtional Dental Plan
HK$3,200 per person
If a deductible was selected for a medical plan, the selected deductible does not apply to the Dental Plan.
10

12. head office
Globalhealth asia limited
Suite 1401-3, Chinachem Hollywood Centre,
1-13 Hollywood Road, Hong Kong
telephone: (852) 2526 - 0918
facsimile: (852) 2526 - 0769
email: globalhealthuniversal@globalhealthasia.com
Web: www.globalhealthuniversal.com