Protect your health Preserve your success · against the prevailing health risks of modern times,...
Transcript of Protect your health Preserve your success · against the prevailing health risks of modern times,...
**Important Notice: Please be advised that following approval by the Hong Kong
Insurance Authority, the FWD Group (“FWD”) has acquired MetLife Limited and
Metropolitan Life Insurance Company of Hong Kong Limited (together, the
“Companies”). MetLife is therefore no longer affiliated with the Companies and no
longer responsible for matters related to the activities and insurance policies of the
Companies. FWD will provide more information on the Companies’ new names
and brand at a later date.
**重要通知:請注意,經香港保險業監管局批准,富衛集團(“富衛”)已收購大
都會人壽保險有限公司及美商大都會人壽保險香港有限公司(統稱“該等公司”)。
大都會人壽因此不再與該等公司有關聯關係,亦不再負責該等公司之活動及保單有
關的事宜。富衛將在稍後提供有關該等公司新名稱及新品牌的更多資訊。
MetLife Health-on-the-Peak Medical Plan
Protect your healthPreserve your success
MetLife Limited Customer Service Centre: Level 57, Hopewell Centre, 183 Queen’s Road East, Wan Chai, Hong Kong
Tel: (852) 2199 1000 Fax: (852) 8101 3977 www.metlife.com.hk(This brochure is for distribution in Hong Kong only.)
Insurance Companyof the Year
Digital Innovationof the Year
This product is an individual indemnity hospital insurance product and is available as a basic plan or an optional rider attachable to your basic plan. This brochure is tailored for the basic plan, MetLife Health-on-the-Peak Medical Plan. Please note that the information in this brochure does not contain the full terms of the policy and is intended for reference only. Please refer to the policy provisions of MetLife Health-on-the-Peak Medical Plan for full terms including but not limited to definitions, detailed terms, conditions and exclusions.
If you wish to learn more about the optional rider version of this product, please refer to the rider leaflet and policy provisions of MetLife Health-on-the-Peak Medical Benefit for more details.
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MetLife Health-on-the-Peak Medical PlanEssential Health Protection to Preserve Your Success
Thanks to technological advances, many twists and turns in life are now treatable hiccups in the hands of top-notch medical experts. To help you preserve your success with total peace of mind, MetLife Health-on-the-Peak Medical Plan (the “Plan”) is uniquely designed with the following essential features to back up your health protection:
Comprehensive Coverage to Secure the Best CareWe all know that superior care and treatment can make all the difference when facing health issues. To ensure that you have access to top-quality and advanced medical services, the Plan offers you 3 Plan Level options with different geographical coverage, providing you with an annual coverage of up to HK$25,000,000, subject to a lifetime limit of up to HK$60,000,000.
Maximum Benefit Limit (HKD)Geographical Coverage Area Worldwide Worldwide excluding the
United States of America Asia1
Annual Limit $25,000,000 $20,000,000 $10,000,000Lifetime Limit $60,000,000 $50,000,000 $25,000,000
Room Type Standard PrivateRoom
Standard PrivateRoom
StandardSemi-Private Room
From Pre-hospitalization to Post-hospitalizationYou can enjoy the high coverage without worrying about maxing out the item-by-item limits which typically occurs with ordinary medical insurance plans. Medical costs from pre-hospitalization, confinement, and surgery to post-hospitalization are covered under the Plan, including surgical fees, medical devices, pre-/post-hospitalization out-patient consultations, post-hospitalization home nursing and more.
Advanced Cancer Treatments also CoveredThanks to medical advances, many new cancer treatments are in place. To reinforce protection against the prevailing health risks of modern times, our Plan not only covers conventional cancer treatments like chemotherapy and radiotherapy but also advanced cancer treatments including target therapy, hormonal therapy, immunotherapy, proton therapy and specially approved medication2.
Being committed to backing up your health protection all the way, post-hospitalization alternative treatments (physiotherapy, acupuncture, chiropractic treatment, osteopathy, traditional Chinese medicine treatment, occupational therapy, speech therapy and homeopathy) and other extended benefits (kidney dialysis, organ and bone marrow transplants, HIV treatment and reconstructive surgery, etc.) are also within the coverage of the Plan.
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Case Study (All figures below are hypothetical and for illustrative purposes only)
Mr. Chan is covered by MetLife Health-on-the-Peak Medical Plan with the annual deductible option of HK$40,000 and has not made any claim this year. He needs to have a nasal polyp removed. As this is a minor operation, to save the time and hassle of in-patient treatment, he has opted for day case surgery which costs HK$15,000.
Under MetLife Health-on-the-Peak Medical Plan, a lower special annual deductible of HK$2,500 applies to Mr. Chan’s case, instead of the standard annual deductible (i.e. HK$40,000 for Mr. Chan’s policy). With other medical plans in the market, the standard annual deductible typically applies to both in-patient and day case surgeries, and Mr. Chan would have to pay HK$15,000.
But in this case, Mr. Chan only has to pay HK$2,500 and the rest is covered by the Plan, saving him HK$12,500.
Lower Special Annual Deductible of HK$2,500Total cost of the surgery HK$15,000Payable by Mr. Chan HK$2,500Covered by the Plan HK$12,500
Deductible Arrangements that Best Suit Your NeedsThe Plan comes with 3 annual deductible options, which are HK$0, HK$10,000 and HK$40,000. The options allow you to choose the annual amount that would be covered by you or your other insurance plans before you can claim under this Plan. This way you can select the right level of protection you need based on your existing coverage and budget. With a higher deductible amount, the premiums for the Plan would be lower. When you retire and are no longer covered by your company’s group medical benefit, you may choose to exercise the privilege to opt for a lower annual deductible at the age of 55 or 65 without having to provide any proof of insurability3.
Nowadays, day case surgeries are increasingly prevalent. As such, the Plan not only covers day case surgeries, but also applies a lower special annual deductible of HK$2,500 or less which saves you money.
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Guaranteed Yearly Renewable for Protection up to the Age of 100When it comes to medical protection, having comprehensive coverage is not enough. Rather, it is the guarantee that you can enjoy such coverage throughout your lifetime that really counts. If the Plan continues to be available for renewal, your policy under the Plan is guaranteed renewable every year for protection up to the age of 100.
Value-add Services to Upgrade Your Health
Cashless Arrangement4 and Second Medical Opinion5 - During the course of treatment, you may need to take time to rest and recover. To save time and spare you the hassle, the Plan provides you with the cashless arrangement service4. Through this service, we handle the settlement of covered medical expenses directly with the hospital, assuming you have completed a simple application process prior to your visit. In specific cases where you need to consult more than one source on a confirmed diagnosis of designated diseases, we can also arrange a free second medical opinion service5 for you.
24-hour Worldwide Emergency Assistance Service5 - True protection follows wherever you go. Under the Plan, the 24-hour Worldwide Emergency Assistance Service5 is available for you to seek emergency assistance while you are traveling abroad.
You deserve the best care.Protect your health with
MetLife Health-on-the-Peak Medical Plan today!
Plan Summary
Issue Age 5 – 65 years old (Age last birthday)
Product Type Individual Indemnity Hospital Insurance
Plan Type Basic Plan
Policy Currency Hong Kong Dollar
Policy Term Guaranteed Yearly Renewable up to age 100 of the insured person
Premium Payment Term Up to age 100 of the insured person
Premium Structure Yearly renewable and non-guaranteed
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Benefit Schedule
Maximum Benefit Limit (HKD)
Plan Level Global Plan Multinational Plan Oriental Plan
Geographical Coverage Area WorldwideWorldwide excluding the United States of
AmericaAsia1
Annual Limit $25,000,000 $20,000,000 $10,000,000
Lifetime Limit $60,000,000 $50,000,000 $25,000,000
Room Type Standard Private Room
Standard Private Room
StandardSemi-Private Room
Annual Deductible Options (Applies to Medical Reimbursement Benefits only)
$0 $10,000 $40,000 $0 $10,000 $40,000 $0 $10,000 $40,000
Day Case Surgery Annual Deductible(Applies to Day Case Surgery Benefit only)
$0 $2,500 $2,500 $0 $2,500 $2,500 $0 $2,500 $2,500
MEDICAL REIMBURSEMENT BENEFITSI. Confinement Benefitsa. Hospital Room and Board Benefit Full cover
b. Physician’s Visit Full cover
c. Specialist’s Visit6 Full cover
d. Companion Bed Benefit Full cover
e. Intensive Care Benefit6 Full cover
f. Miscellaneous Hospital Expenses Full cover
g. Private Nursing Benefit6Full cover
(maximum 30 days per policy year) (following i) surgery or ii) discharge from admission to Intensive Care Unit)
h. Psychiatric Treatment Benefit7 Full cover(maximum 45 days per policy year)
II. Surgical Benefitsa. Surgical Fee Full cover
b. Anaesthetist’s Fee Full cover
c. Operating Theatre Fee Full cover
d. Day Case Surgery Benefit Full cover
e. Medical Devices Full cover for specified items8
III. Pre- and Post-hospitalization Benefits
a. Pre-hospitalization Out-patient Benefit6Full cover
(maximum 1 general physician consultation and 1 specialist consultation per day)(within 30 days prior to confinement or day case surgery)
b. Post-hospitalization Out-patient Benefit6Full cover
(maximum 1 visit per day) (within 60 days after discharge from confinement or day case surgery)
c.
Post-hospitalization Alternative Treatment Benefit6 (which covers traditional Chinese medicine treatment, chiropractic treatment, acupuncture, homeopathy, osteopathy, physiotherapy, occupational therapy and speech therapy)
$30,000 per policy year (maximum $800 per visit and 1 visit per day)
(within 90 days after discharge from confinement or day case surgery)
d.Post-hospitalization Home Nursing Benefit6
Full cover(maximum 30 days per policy year) (within 90 days after discharge from confinement
following i) surgery or ii) admission to Intensive Care Unit)
e. Rehabilitation Benefit6 $50,000 per policy year(within 90 days after discharge from confinement)
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Remarks 1. Asia covers Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, Hong Kong, India, Indonesia, Japan, Kazakhstan,
Kyrgyzstan, Laos, Macau, Mainland China, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan and Vietnam.
2. Specifically approved medication means medication which is not registered with the Department of Health in Hong Kong but which is:(i) approved by and registered with the regulatory authority for pharmaceutical products in the United States of America or
Europe or Japan; (ii) imported into Hong Kong from United States of America, Europe or Japan for treatment of the insured person’s cancer under
the Import License (Form 3) granted by Department of Health in Hong Kong, provided that pre-approval is obtained from MetLife Limited before application for the Import License (Form 3) is filed with the Department of Health in Hong Kong;
(iii) Medically Necessary for treatment of the insured person’s cancer and recommended by a specialist in the relevant field in writing; and
(iv) consumed by the insured person in Hong Kong.3. This can only be exercised once per lifetime of the insured person and within 31 days immediately before the policy anniversary
date starting from 3rd policy anniversary on or immediately following the insured person’s 55th or 65th birthday.4. MetLife Limited has engaged Medical Administrators International (Hong Kong) Limited (“MAI”) to provide the relevant services.
MetLife Limited shall not be liable for any matters in respect of the services provided and reserves the right to revise the details of the services or withdraw the services from time to time without prior notice. The approval of the Cashless Arrangement Service is subject to the terms and conditions of MAI and the acceptance of the "Letter of Guarantee" by the hospitals. If the hospital expenses incurred have exceeded the eligible claim amount, the shortfall has to be borne by the policyowner or insured person.
5. The Second Medical Opinion Service and 24-hour Worldwide Emergency Assistance Service is provided by Inter Partner Assistance Hong Kong Ltd. and Aspire Lifestyles (HK) Limited respectively. MetLife Limited shall not be liable for any matters in respect of the services provided and reserves the right to revise the details of the services or withdraw the services by giving no less than 1 month’s prior written notice.
6. Written recommendation from a registered attending physician is required.7. Written recommendation from a registered specialist in psychiatry is required. 8. Specified items include pace maker, stents for Percutaneous Transluminal Coronary Angioplasty, intraocular lens, artificial cardiac
valve, metallic or artificial joints for joint replacement, prosthetic ligaments for replacement or implantation between bones, prosthetic intervertebral disc; and prosthetic device implanted during surgery and/or replacement of any other body organ or part inside the insured person’s body which is Medically Necessary.
9. If the insured person commits suicide within the first 13 months from the issue date or the latest reinstatement date of the insurance policy of the Plan, no Life Benefit shall be payable. If there is any due and unpaid levy, such amount will be deducted from the Life Benefit payable.
MEDICAL REIMBURSEMENT BENEFITS (CONTINUED) Maximum Benefit Limit (HKD)IV. Extended Benefits
a.Cancer Treatment Benefit6
(includes chemotherapy, target therapy, radiotherapy, hormonal therapy, immunotherapy, proton therapy and specifically approved medication2)
Full cover
b. Kidney Dialysis Benefit6 Full cover
c.Organ and Bone Marrow Transplant Benefit
Full cover
d. Accidental Out-patient Treatment Benefit Full cover(within 24 hours after accident)
e. Accidental Dental Treatment Benefit Full cover(within 2 weeks after accident)
f. HIV / AIDS Treatment Benefit $800,000 per life(once per lifetime)
g. Reconstructive Surgery Benefit6 $200,000 per life (within 12 months from the date of accident or date of mastectomy)
h. Hospice and Palliative Care Benefit6 $200,000 per life(once per lifetime)
i. Pregnancy Complications Benefit6 Full cover
LIFE BENEFITa. Life Benefit9 $60,000
OTHER SERVICESa. Cashless Arrangement Service4
b. Second Medical Opinion Service5
c. 24-hour Worldwide Emergency Assistance Service5
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Key Product RisksGeneral ExclusionsThe Plan will not cover conditions that result from any of the following events:(i) Pre-existing Condition;(ii) intentionally self-inflicted injury, or attempted suicide, while sane or insane;(iii) any treatment as a result of nuclear contamination or as a result of the insured person’s participation in war (whether it is
declared or not), invasion, act of foreign enemies, hostilities, strike, riot and/or civil commotion, civil war, rebellion, revolution, insurrection, terrorist acts, military or usurped power;
(iv) any act of the insured person contrary to the law of the country or territory in which the act is committed;(v) any congenital anomaly or inherited disorder or developmental disorders which has manifested or was diagnosed before the
insured person attains age 16;(vi) pregnancy (including child birth, miscarriage, or abortion), surrogacy or foetal surgery and complication resulting therefrom or
relating thereto, unless such occurrence is covered by Pregnancy Complications Benefit, birth control, infertility treatment or assisted reproduction;
(vii) any elective surgery or treatment, cosmetic surgery or treatment, plastic or reconstructive surgery or treatment, unless such surgery or treatment is covered by Reconstructive Surgery Benefit;
(viii) dental care and treatment unless such occurrence is covered by Accidental Dental Treatment Benefit;(ix) scuba diving or engaging in or taking part in any kind of race other than on foot, mountaineering involving the use of ropes or
guides by the insured person;(x) the insured person being under the influence of alcohol or drugs unless, in the case of drug consumption, it is proved that
such drug was taken in accordance with proper medical prescription or treatment;(xi) the insured person being in a state of insanity or psychiatric or psychological disturbance or any mental or nervous disease or
disorder unless such occurrence is covered by Psychiatric Treatment Benefit;(xii) sexual problem or sex changes, any sexually transmitted disease which is classified as a venereal disease in the International
Classification of Diseases (ICD) and testing for sexually transmitted diseases, infection with Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations, derivations or variations, AIDS Related Complex (ARC) and complications resulting therefrom or relating thereto unless such occurrence is covered by HIV / AIDS Treatment Benefit;
(xiii) routine preventive health checks and vaccinations;(xiv) prostheses, orthotic devices, corrective devices and medical appliances not required for a surgical operation (unless such
medical appliances and medical devices are covered by medical devices of the Surgical Benefits);(xv) experimental drugs and treatment which have not been approved by the government, relevant authorities and recognized
medical association in the locality (unless such drug is a specifically approved medication);(xvi) consumption of any of the following traditional Chinese medicines: (i) agaricus blazei murill, (ii) antelope horn powder, (iii)
antler, (iv) cordyceps, (v) cubilose, (vi) donkey-hide gelatin, (vii) ganoderma, (viii) all kinds of ginseng, (ix) hippocampus, (x) moschus, (xi) pearl powder and (xii) placenta hominis;
(xvii) the organ transplantation cost incurred in connection with identifying and procuring a replacement organ or organ donation as the donor, all associated transportation costs and administrative costs;
(xviii) treatment of sleep disorders including insomnia, snoring or sleep apnoea (except for the treatment of sleep apnoea which is life threatening as confirmed by the attending physician and approved by MetLife Limited in advance);
(xix) treatment of obesity (including morbid obesity), weight control program or bariatric surgery (except when bariatric surgery is Medically Necessary as confirmed by the attending physician and approved by MetLife Limited in advance);
(xx) bank charges, expenses incurred for the provision of medical and hospital bills, certificates, documentation, information or other evidence as required by MetLife Limited;
(xxi) any confinement or stay, surgery, medical treatment, services and/or supplies for which compensation or reimbursement is payable under any law, medical program, or insurance policy provided by any governments, companies or other insurance providers; and
(xxii) any confinement or stay, surgery, medical treatment, investigation, services and/or supplies which are not Medically Necessary; or any charges which exceed the Reasonable and Customary charges.
Product Limitations1. Your policy will terminate when the aggregate benefits paid (except Life Benefit) under all insurance policies (including this
policy), whether in force or not, covering the insured person that are subject to respective lifetime limits and issued by the MetLife Limited have reached the lifetime limit which corresponds to your chosen Plan Level.
2. Cover for specific items will take effect from the following dates:
ItemsCoverage Effective Date
(after the issue date or the latest reinstatement dateof the insurance policy of the Plan, whichever is later)
Accidental Injury ImmediatelySickness 30 days
Pregnancy Complications 300 daysOrgan and Bone Marrow Transplant 1 year
HIV / AIDS Treatment 5 years
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3. MetLife Limited shall reimburse Reasonable and Customary charges for the actual expenses incurred for Medically Necessary Confinement or stay, surgery, medical treatment, services and/or supplies up to the relevant maximum benefit limits as shown in the Benefit Schedule.
Reasonable and Customary means the level of charges for confinement or stay, surgery, medical treatment, services and/or supplies received by the insured person that are Medically Necessary, which does not exceed the usual level of charges for such confinement or stay, surgery, medical treatment, services and/or supplies in the locality where the charges are incurred. Please refer to the Policy Provisions for the definition of Medically Necessary.
Confinement means an admission of the insured person to a hospital or mental or psychiatric hospital that is recommended by a physician for medical service and as an in-patient as a result of a Medically Necessary condition in relation to a covered injury or covered sickness for a period of no less than 6 consecutive hours. No minimum period is required for confinement in connection with any emergency treatment in a hospital, as a result of an emergency for the performance of a surgical procedure or other medical service in a hospital, or where a confinement commences and ends on 2 different dates. Confinement shall be evidenced by a daily room charge invoiced by the hospital or mental or psychiatric hospital and the insured person must stay in the hospital or mental or psychiatric hospital continuously for the entire period of confinement.
4. If the insured person is confined in a room of a class above the room type which corresponds to the chosen Plan Level on any days of a confinement, the below adjustment factor shall be multiplied to any amount that can be claimed under the Confinement Benefits and Surgical Benefits for such confinement:
Room Type of the ConfinementRoom Type of the Confinement
Standard Semi-Private Room Standard Private Room
Standard Semi-Private Room Not applicable Not applicable
Standard Private Room 50% Not applicable
Any room with amenities upgraded beyond a Standard Private Room 25% 25%
Please refer to the Policy Provisions for the definition of Standard Semi-Private Room and Standard Private Room.
5. If the insured person changes his or her principal location of residence to a Designated Country, where such Designated Country is within the Geographical Coverage Area which corresponds to the chosen Plan Level, commencing from the date of such change, in respect of any confinement or stay, surgery, medical treatment, services and/or supplies for the covered injury and covered sickness which takes place in such Designated Country being the principal location of residence, any amount that can be claimed under Medical Reimbursement Benefits therein shall be reduced to 75% of the Medical Reimbursement Benefits payable. Designated Country refers to any country below or a country covered in any below region:
i. Western Europe (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Vatican City);
ii. Australia;
iii. New Zealand; and
iv. Canada.
6. If both product limitations no. 4 and 5 are applicable, any amount that can be claimed under Confinement Benefits and Surgical Benefits shall be multiplied by both 75% and the adjustment factor while any amount that can be claimed under Pre- and Post-Hospitalization Benefits and Extended Benefits shall be reduced to 75% of the amount payable.
7. If your chosen Plan Level is the Global Plan, any amount that can be claimed under Medical Reimbursement Benefits shall be reduced to 50% of the amount payable if:i. the insured person’s principal location of residence is the United States of America at the time of any confinement or stay,
surgery, medical treatment, services and/or supplies received by the insured person in the United States of America; and/orii. the confinement, stay, surgery, medical treatment, services and/or supplies received by the insured person in the United
States of America are not pre-approved by MetLife Limited unless such confinement, surgery, medical treatment, services and/or supplies are incurred solely for emergency purpose due to an accident.
8. If both product limitations no. 4 and 7 are applicable, any amount that can be claimed under Confinement Benefits and Surgical Benefits shall be multiplied by both 50% and the adjustment factor while any amount that can be claimed under Pre- and Post-Hospitalization Benefits and Extended Benefits shall be reduced to 50% of the amount payable.
9. If the chosen Plan Level is the Multinational Plan or Oriental Plan, no benefits are payable under the Medical Reimbursement Benefits for any confinement or stay, surgery, medical treatment, services and/or supplies in a country outside the Geographical Coverage Area of the chosen Plan Level unless such country is not the principal location of residence of the insured person and the confinement, surgery, medical treatment, services and/or supplies that are incurred solely for emergency purposes due to an accident within 30 days of entry to such country.
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10. Pre-existing Condition means any injury or sickness: (i) which existed or was existing; (ii) where its cause existed or was existing; (iii) where the insured person had knowledge of the injury or sickness, signs or symptoms of the sickness; (iv) where any laboratory test or investigation showed the presence of the injury or sickness; or (v) which the insured person suffered or was suffering from;
prior to the policy issue date (if the policy has not been reinstated) or the reinstatement effective date (if the policy has been reinstated), whichever is later.
11. Requirement for obtaining pre-approval:(i) Bariatric surgery or treatment of sleep apnoea must be confirmed as Medically Necessary by the attending physician and
approved by MetLife Limited in advance. (ii) Specifically approved medication must be recommended in writing by a registered specialist in the relevant field and approved
by MetLife Limited in advance before the relevant application is filed with the Department of Health in Hong Kong. (iii) (Only applicable to Global Plan) The confinement, stay, surgery, medical treatment, services and/or supplies received by the
insured person in the United States of America needs to be pre-approved by MetLife Limited unless such confinement or surgery are incurred solely for emergency purpose caused by an accident, otherwise, any amount that can be claimed under Medical Reimbursement Benefits shall be reduced to 50% of the amount payable.
Premium Adjustment and Benefit RevisionPremium shall be determined by reference to the last birthday of the insured person upon renewal on each policy anniversary date. The premium rate is non-guaranteed and may be increased. MetLife Limited reserves the right to adjust the rate of premium from time to time by giving you not less than 1 month’s prior written notice.
MetLife Limited has the absolute discretion and right to revise the benefit structure (including but not limited to annual deductible, day case surgery annual deductible and benefit limits), benefits, restrictions, terms and conditions and premium rates under the Plan on each renewal by giving not less than 1 month’s prior written notice to the policyowner. Any revision and adjustment will apply to your policy automatically on policy renewal.
Any revision and adjustment to the premium and/or benefit will reflect the past experience and long-term assumptions of a number of factors in respect of the relevant policies including but not limited to (a) medical cost inflation; (b) expected changes in medical trends and practices; (c) operating expenses; (d) policy persistency; (e) cost of claim; and (f) performance of the investment of the assets.
Non-payment of PremiumYou should pay premium(s) on time and according to the selected premium payment schedule while the policy is in force. If you do not pay the premium within 60 days of the premium due date, the policy will be terminated and the insured person will lose the coverage.
Policy Renewal and Changes to Plan LevelIf the Plan continues to be available for renewal and all premiums have been paid, the renewal of your policy is guaranteed without further production of health evidence required on each policy anniversary date before the insured person's age exceeds age 99, subject to the premium rate, benefit structure and terms and conditions that applies at the time of renewal.
If MetLife Limited decides to no longer offer the Plan to all policyowners who are already enrolled, MetLife Limited will endeavor to enroll the insured person in another medical plan available at that time.
If the chosen Plan Level is the Global Plan, MetLife Limited has absolute discretion to revise the Plan Level of your policy from Global Plan to Multinational Plan at any time if the principal location of residence of the insured person has changed to the United States of America.
Existence and Duration of Right of CancellationWhile the Plan is in force, you may surrender or terminate the Plan at any time by sending a written request to us.
Implication on Pre-existing Conditions and Other Implications When Switching from One Policy to AnotherIf you want to switch to another medical policy from your existing medical plan, there would likely be changes in the premium rate, coverage, exclusions, as well as terms and conditions which you are subject to. In particular, you should pay attention to whether the new plan covers the Pre-existing Conditions.
Claims ProcedureIf you wish to make a claim, you must notify us within 30 days of the date of the event which may give rise to claim, and send us the completed prescribed claim forms and written proofs in support of the claim within 90 days from the date of such event. You can get the prescribed claim form by calling our Customer Service Hotline (852) 8102 1332 or by downloading from our website at http://www.metlife.com.hk.
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Full DisclosureYou should make full and frank disclosure of all material facts, including without limitation health conditions, in response to the questions asked when applying for the Plan. Non-disclosure may render the policy voidable at the sole and absolute discretion of MetLife Limited and the benefits provided under the policy may become immediately repayable to MetLife Limited and MetLife Limited reserves the right to recover from the policyowner any costs related to the policy.
Double InsuranceIf you are covered by more than one indemnity hospital insurance plan, you should be aware that any actual amounts reimbursed by other insurance policies will be deducted from the benefit payable under this Plan. Such amounts will count towards the annual deductible and/or the day case surgery annual deductible (if applicable) if (i) you submit the relevant documents such as receipts and claims settlement letter issued by the other insurance providers to MetLife Limited and (ii) the relevant claim would have been payable under this Plan.
Credit RiskThe Plan is underwritten by MetLife Limited. The benefits payable under your policy are subject to the credit risk of MetLife Limited. If MetLife Limited is unable to satisfy the financial obligations of the policy of the Plan, insured person may lose the coverage and you may lose the premium paid.
Foreign Exchange RiskYou should be aware that any transaction which is denominated in a currency other than that of your home currency is subject to foreign exchange risks.
Inflation RiskThe benefits under the policy of the Plan may not be sufficient for the increasing protection needs in the future as the future cost of living may be higher than now due to the effects of inflation.
Important Notes● MetLife Limited reserves the right to accept or reject any application for MetLife Health-on-the-Peak Medical Plan.● MetLife Health-on-the-Peak Medical Plan is an insurance plan with no savings element. All premiums pay for the insurance and
related costs.● If you are not happy with your policy, you have the right to cancel it within the Cooling-off Period and obtain a refund of any
premiums paid and any levy paid provided that you have not made any claims under the policy. A written notice signed by you together with the policy must be received by the Customer Service Centre of MetLife Limited at Level 57, Hopewell Centre, 183 Queen's Road East, Wan Chai, Hong Kong within the Cooling-off Period (that is, 21 days after the delivery of the policy or the issue of a Notice informing you/your representative about the availability of the policy and the expiry date of the Cooling-off Period, whichever is earlier). If you cancel the policy after the expiration of the Cooling-off Period, you may not obtain a refund of any premiums paid.
● MetLife Limited is the insurance underwriter of the Plan, and is solely responsible for all content, approvals, coverage and benefit payment. MetLife Limited is a wholly-owned subsidiary of MetLife, Inc. in Hong Kong and operates under the "MetLife" brand. MetLife Limited is a company incorporated and registered as a private company limited by shares under the applicable laws in Hong Kong.
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年繳保費表(港元)- 全球計劃Annual Premium Table (HKD) - Global Plan
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female5-17 14,750 14,440 11,800 11,550 6,930 6,780
18 14,930 14,660 11,950 11,730 7,010 6,890
19 15,130 14,890 12,110 11,910 7,110 6,990
20 15,320 15,200 12,250 12,160 7,200 7,150
21 15,550 15,590 12,440 12,470 7,310 7,330
22 16,040 16,080 12,830 12,860 7,540 7,560
23 16,550 16,590 13,240 13,270 7,780 7,800
24 17,050 17,080 13,640 13,670 8,010 8,030
25 17,630 17,590 14,100 14,070 8,280 8,260
26 18,220 18,090 14,570 14,470 8,560 8,510
27 18,820 18,600 15,060 14,880 8,840 8,740
28 19,260 19,090 15,400 15,270 9,050 8,970
29 19,710 19,600 15,770 15,690 9,260 9,210
30 19,820 20,230 15,860 16,190 9,310 9,510
31 20,170 21,050 16,140 16,840 9,480 9,890
32 20,550 21,860 16,440 17,490 9,660 10,280
33 20,970 22,720 16,780 18,180 9,860 10,680
34 21,270 23,560 17,020 18,850 10,000 11,080
35 21,590 24,290 17,270 19,430 10,140 11,410
36 22,060 25,050 17,650 20,040 10,360 11,770
37 22,520 25,840 18,020 20,670 10,580 12,150
38 23,010 26,640 18,410 21,320 10,820 12,520
39 23,480 27,450 18,780 21,960 11,040 12,900
40 24,050 28,300 19,240 22,640 11,300 13,300
41 24,710 29,410 19,760 23,530 11,610 13,820
42 25,400 30,670 20,320 24,540 11,940 14,420
43 26,250 31,910 21,000 25,530 12,340 14,990
44 27,260 33,180 21,810 26,540 12,810 15,590
45 28,680 34,440 22,940 27,550 13,480 16,190
46 30,180 35,690 24,140 28,550 14,190 16,780
47 31,840 36,960 25,470 29,570 14,960 17,370
48 33,600 38,220 26,880 30,580 15,790 17,970
49 35,480 39,490 28,380 31,590 16,670 18,560
50 37,800 40,740 30,240 32,590 17,770 19,150
A2
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female51 40,530 42,300 32,420 33,840 19,050 19,890
52 43,800 43,890 35,040 35,110 20,580 20,630
53 47,460 45,470 37,970 36,370 22,300 21,370
54 51,860 47,040 41,490 37,630 24,370 22,110
55 56,270 49,160 45,010 39,330 26,450 23,110
56 60,980 51,660 48,780 41,330 28,670 24,280
57 65,870 54,820 52,690 43,860 30,950 25,770
58 70,920 58,590 56,730 46,870 33,330 27,540
59 76,110 63,020 60,890 50,420 35,770 29,620
60 82,430 68,050 65,940 54,440 38,750 31,980
61 90,290 74,680 72,230 59,750 42,440 35,100
62 100,370 82,850 80,290 66,280 47,180 38,930
63 112,960 92,310 90,360 73,850 53,090 43,390
64 125,570 101,760 100,450 81,410 59,020 47,830
65 138,170 111,220 110,530 88,980 64,940 52,270
66* 149,990 117,730 119,990 94,190 70,500 55,340
67* 162,580 124,150 130,060 99,320 76,410 58,350
68* 175,180 130,550 140,140 104,430 82,330 61,360
69* 187,790 136,370 150,230 109,100 88,260 64,090
70* 193,770 142,790 155,010 114,230 91,070 67,120
71* 199,760 148,030 159,810 118,420 93,890 69,570
72* 205,740 153,290 164,590 122,630 96,690 72,050
73* 211,710 158,530 169,370 126,820 99,510 74,510
74* 217,710 163,780 174,160 131,020 102,320 76,980
75* 223,690 169,010 178,950 135,210 105,140 79,430
76* 234,840 178,930 187,880 143,150 110,380 84,090
77* 247,540 188,250 198,030 150,600 116,340 88,480
78* 259,670 197,580 207,730 158,070 122,040 92,860
79* 271,790 207,470 217,430 165,970 127,740 97,510
80* 283,920 216,790 227,140 173,440 133,440 101,890
81* 288,630 223,670 230,910 178,940 135,660 105,130
82* 293,140 230,950 234,510 184,760 137,770 108,550
83* 296,360 237,380 237,090 189,900 139,290 111,570
84* 298,820 243,660 239,050 194,930 140,450 114,520
85-99* 300,990 252,010 240,800 201,610 141,470 118,440
* 只供續保。* For renewal only.
年繳保費表(港元)- 全球計劃Annual Premium Table (HKD) - Global Plan
B1
年繳保費表(港元)- 環宇計劃 Annual Premium Table (HKD) - Multinational Plan
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female5-17 9,830 9,620 7,860 7,700 4,620 4,530
18 9,950 9,780 7,960 7,820 4,680 4,600
19 10,080 9,920 8,060 7,940 4,740 4,660
20 10,210 10,130 8,170 8,110 4,800 4,770
21 10,360 10,400 8,300 8,320 4,870 4,880
22 10,700 10,720 8,560 8,580 5,030 5,040
23 11,040 11,060 8,830 8,840 5,190 5,200
24 11,360 11,390 9,090 9,110 5,340 5,360
25 11,750 11,730 9,400 9,390 5,520 5,510
26 12,140 12,050 9,710 9,640 5,700 5,670
27 12,550 12,390 10,040 9,910 5,900 5,830
28 12,830 12,730 10,270 10,190 6,030 5,990
29 13,140 13,060 10,510 10,450 6,170 6,140
30 13,210 13,490 10,560 10,790 6,210 6,340
31 13,440 14,040 10,750 11,240 6,320 6,590
32 13,700 14,570 10,960 11,660 6,440 6,850
33 13,980 15,140 11,180 12,120 6,570 7,120
34 14,190 15,710 11,350 12,570 6,670 7,380
35 14,400 16,190 11,520 12,960 6,760 7,610
36 14,700 16,710 11,760 13,370 6,910 7,850
37 15,020 17,220 12,010 13,780 7,060 8,100
38 15,340 17,760 12,270 14,210 7,210 8,350
39 15,660 18,290 12,530 14,640 7,360 8,600
40 16,030 18,860 12,830 15,090 7,540 8,860
41 16,470 19,600 13,180 15,690 7,740 9,210
42 16,940 20,440 13,550 16,360 7,960 9,610
43 17,500 21,270 14,010 17,020 8,220 10,000
44 18,170 22,120 14,530 17,700 8,540 10,400
45 19,120 22,960 15,300 18,380 8,990 10,790
46 20,120 23,790 16,100 19,040 9,460 11,180
47 21,220 24,630 16,980 19,710 9,980 11,580
48 22,400 25,480 17,910 20,390 10,530 11,980
49 23,660 26,320 18,920 21,060 11,120 12,370
50 25,200 27,150 20,160 21,720 11,840 12,760
B2
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female51 27,020 28,200 21,610 22,560 12,690 13,250
52 29,200 29,250 23,360 23,400 13,720 13,740
53 31,640 30,300 25,310 24,240 14,870 14,240
54 34,570 31,360 27,660 25,100 16,240 14,740
55 37,520 32,770 30,010 26,220 17,630 15,400
56 40,660 34,440 32,530 27,550 19,110 16,190
57 43,910 36,540 35,130 29,230 20,640 17,180
58 47,270 39,060 37,820 31,250 22,220 18,350
59 50,740 42,010 40,590 33,610 23,850 19,740
60 54,950 45,370 43,950 36,300 25,830 21,330
61 60,190 49,780 48,150 39,830 28,290 23,390
62 66,910 55,230 53,530 44,180 31,450 25,960
63 75,310 61,540 60,250 49,230 35,400 28,930
64 83,720 67,830 66,970 54,260 39,340 31,880
65 92,120 74,140 73,690 59,310 43,290 34,850
66* 99,990 78,490 79,990 62,790 47,000 36,890
67* 108,380 82,770 86,710 66,210 50,940 38,900
68* 116,780 87,030 93,430 69,630 54,880 40,910
69* 125,190 90,910 100,150 72,720 58,840 42,720
70* 129,170 95,190 103,340 76,160 60,710 44,740
71* 133,170 98,680 106,530 78,940 62,590 46,380
72* 137,160 102,200 109,730 81,750 64,470 48,040
73* 141,140 105,680 112,920 84,550 66,340 49,680
74* 145,140 109,180 116,110 87,340 68,220 51,310
75* 149,120 112,680 119,300 90,140 70,090 52,960
76* 156,570 119,290 125,250 95,430 73,580 56,070
77* 165,030 125,510 132,030 100,400 77,560 58,990
78* 173,110 131,710 138,500 105,370 81,360 61,910
79* 181,200 138,320 144,960 110,650 85,170 65,010
80* 189,280 144,520 151,430 115,620 88,970 67,920
81* 192,420 149,110 153,940 119,290 90,440 70,080
82* 195,430 153,960 156,350 123,170 91,850 72,370
83* 197,580 158,260 158,070 126,610 92,860 74,380
84* 199,220 162,440 159,370 129,950 93,630 76,350
85-99* 200,660 168,010 160,520 134,410 $94,310 78,960
* 只供續保。* For renewal only.
年繳保費表(港元)- 環宇計劃 Annual Premium Table (HKD) - Multinational Plan
C1
年繳保費表(港元)- 環亞計劃Annual Premium Table (HKD) -Oriental Plan
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female5-17 6,380 6,250 5,100 5,000 3,000 2,940
18 6,470 6,350 5,180 5,080 3,050 2,980
19 6,550 6,450 5,240 5,160 3,080 3,030
20 6,650 6,580 5,310 5,270 3,130 3,100
21 6,730 6,760 5,390 5,410 3,160 3,180
22 6,950 6,960 5,570 5,570 3,270 3,280
23 7,170 7,180 5,730 5,740 3,370 3,370
24 7,390 7,400 5,910 5,920 3,480 3,480
25 7,630 7,620 6,110 6,100 3,590 3,580
26 7,890 7,840 6,310 6,280 3,710 3,690
27 8,160 8,050 6,530 6,450 3,830 3,780
28 8,340 8,270 6,670 6,620 3,920 3,890
29 8,540 8,490 6,830 6,790 4,010 3,990
30 8,590 8,770 6,870 7,010 4,030 4,120
31 8,750 9,120 6,990 7,300 4,120 4,280
32 8,900 9,470 7,120 7,580 4,190 4,450
33 9,090 9,840 7,280 7,880 4,270 4,620
34 9,220 10,210 7,370 8,170 4,340 4,800
35 9,360 10,520 7,490 8,420 4,400 4,950
36 9,560 10,860 7,640 8,680 4,490 5,100
37 9,770 11,190 7,810 8,960 4,590 5,260
38 9,960 11,540 7,970 9,230 4,680 5,430
39 10,170 11,900 8,140 9,510 4,780 5,600
40 10,420 12,250 8,340 9,810 4,890 5,750
41 10,710 12,740 8,570 10,190 5,030 5,990
42 11,000 13,290 8,800 10,640 5,180 6,250
43 11,380 13,830 9,100 11,070 5,340 6,500
44 11,800 14,390 9,440 11,510 5,540 6,760
45 12,430 14,920 9,940 11,940 5,840 7,010
46 13,070 15,470 10,460 12,370 6,140 7,270
47 13,790 16,010 11,030 12,810 6,480 7,530
48 14,550 16,560 11,640 13,250 6,840 7,780
49 15,370 17,100 12,300 13,680 7,220 8,040
50 16,380 17,650 13,100 14,120 7,700 8,300
C2
年齡 Age (上次生日年齡)
(Age last birthday)
每年自付額(港元)Annual Deductible (HKD)$0
(門診手術之每年自付額:$0)(Day Case Surgery
Annual Deductible: $0)
$10,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
$40,000(門診手術之每年自付額:$2,500)
(Day Case SurgeryAnnual Deductible: $2,500)
男性 Male 女性 Female 男性 Male 女性 Female 男性 Male 女性 Female51 17,560 18,330 14,050 14,670 8,250 8,620
52 18,970 19,020 15,180 15,210 8,910 8,940
53 20,560 19,710 16,440 15,770 9,660 9,260
54 22,470 20,390 17,980 16,320 10,560 9,590
55 24,380 21,290 19,510 17,030 11,460 10,010
56 26,430 22,390 21,150 17,910 12,420 10,520
57 28,540 23,760 22,830 19,010 13,410 11,170
58 30,720 25,390 24,580 20,310 14,440 11,930
59 32,980 27,300 26,390 21,840 15,500 12,830
60 35,710 29,480 28,570 23,580 16,780 13,860
61 39,120 32,360 31,300 25,890 18,390 15,210
62 43,490 35,900 34,800 28,720 20,440 16,870
63 48,950 39,990 39,170 31,990 23,010 18,800
64 54,410 44,090 43,530 35,270 25,580 20,730
65 59,870 48,180 47,900 38,550 28,140 22,650
66* 65,000 51,020 52,000 40,810 30,540 23,980
67* 70,460 53,800 56,360 43,040 33,120 25,280
68* 75,900 56,570 60,720 45,260 35,680 26,590
69* 81,380 59,090 65,100 47,270 38,250 27,770
70* 83,970 61,880 67,180 49,500 39,470 29,090
71* 86,570 64,140 69,260 51,310 40,690 30,150
72* 89,160 66,420 71,330 53,140 41,910 31,220
73* 91,740 68,700 73,400 54,960 43,110 32,290
74* 94,340 70,960 75,470 56,760 44,340 33,350
75* 96,930 73,240 77,540 58,590 45,560 34,420
76* 101,770 77,530 81,420 62,020 47,830 36,440
77* 107,270 81,570 85,820 65,260 50,420 38,340
78* 112,520 85,620 90,020 68,490 52,890 40,240
79* 117,780 89,900 94,230 71,930 55,360 42,250
80* 123,030 93,930 98,430 75,150 57,820 44,150
81* 125,080 96,930 100,070 77,540 58,790 45,560
82* 127,030 100,090 101,620 80,070 59,700 47,040
83* 128,430 102,870 102,740 82,300 60,360 48,350
84* 129,490 105,590 103,590 84,470 60,860 49,620
85-99* 130,420 109,210 104,340 87,370 61,300 51,320
* 只供續保。* For renewal only.
年繳保費表(港元)- 環亞計劃Annual Premium Table (HKD) -Oriental Plan
HK-
MK
T-A
G/C
DC
/IA
-ME1
PB0
6-0
719