International Healthcare Plans for China Valid from 1st April 2018 INDIVIDUAL POLICIES. Table of Benefits

Transcription

1 International Healthcare Plans for China Valid from 1st April 2018 INDIVIDUAL POLICIES Table of Benefits

2 REASONS TO CHOOSE US Flexible modular cover ability to combine multiple plans Direct settlement for in-patient, out-patient and dental treatment in China, plus access to our global network of over 714,500 medical providers worldwide Exceptional cover for chronic and congenital conditions Freedom to choose your preferred doctors and hospitals Comprehensive cover for Out-patient plans (full refund for medical practitioner fees and prescription drugs, generous cover for alternative treatment and physiotherapy) 24/7 Helpline and Emergency Assistance services Ability to accept a wide range of preexisting conditions Opportunity to transfer cover to an equivalent Allianz Partners international healthcare plan without underwriting if relocating outside China, where available POLICY TERMS AND CONDITIONS This Table of Benefits provides an outline of the cover we provide under each plan. Cover is subject to our policy terms and conditions, as detailed in our Individual Benefit Guide, which is issued to members upon policy inception. Details of our pre-authorization process can also be found in this guide, which is available on our website: CORE PLANS Core Plan Benefits Diamond Plus Diamond Prime Diamond Care Maximum plan benefit in CNY 18,900,000 9,450,000 4,200,000 In-patient benefits Treatments and costs marked with an asterisk (*) require pre-approval through submission of a Treatment Guarantee Form. Hospital accommodation* Private room Private room Semi-private room Intensive care* a a a Prescription drugs and materials* In-patient and day-care treatment only. Prescription drugs are those which legally can only be purchased when you have a doctor s prescription a a a Surgical fees, including anaesthesia and theatre charges* a a a Physician and therapist fees* In-patient and day-care treatment only a a a Surgical appliances and materials* a a a

3 Core Plan Benefits Diamond Plus Diamond Prime Diamond Care Diagnostic tests* In-patient and day-care treatment only a a a Organ transplant* a a 84,000 Psychiatry and psychotherapy* In-patient and day-care treatment only a 65,000 N/A Accommodation costs for one parent staying in hospital with an insured child under 18* a a a Emergency in-patient dental treatment a a a Other benefits Day-care treatment* a a a Kidney dialysis* a a a Out-patient surgery* a a a Nursing at home or in a convalescent home* Immediately after or instead of hospitalisation Rehabilitation treatment* In-patient, day-care and out-patient treatment; must commence within 14 days of discharge after the acute medical and/or surgical treatment ceases 35,000 25,000 N/A 35,000 20,000 10,000 Local ambulance a a 2,000 Emergency treatment outside area of cover For trips of a maximum period of six weeks Max. 42 days Max. 42 days N/A Medical evacuation* Where necessary treatment is not available locally, we will evacuate the insured person to the nearest appropriate medical centre* a a a Where ongoing treatment is required, we will cover hotel accommodation costs* a a a Evacuation in the event of unavailability of adequately screened blood* a a a If medical necessity prevents an immediate return trip following discharge from an in-patient episode of care, we will cover hotel accommodation costs* Max. 7 days Max. 7 days Max. 7 days Medical repatriation* Where the necessary treatment is not available locally, you can choose to be medically repatriated to your home country instead of the nearest appropriate medical centre* a a N/A Where ongoing treatment is required, we will cover hotel accommodation costs* a a N/A Repatriation in the event of unavailability of adequately screened blood* a a N/A If medical necessity prevents an immediate return trip following discharge from an in-patient episode of care, we will cover hotel accommodation costs* Max. 7 days Max. 7 days N/A Expenses for one person accompanying an evacuated person* 25,000 25,000 25,000 Expenses for one person accompanying a repatriated person* 25,000 25,000 N/A Travel costs of insured family members in the event of an evacuation* Travel costs of insured family members in the event of a repatriation* N/A Repatriation of mortal remains* 85,000 85,000 N/A Travel costs of insured family members in the event of the repatriation of mortal remains* N/A Travel costs of insured members to be with a family member who is at peril of death or who has died 12,500 per lifetime 12,500 per lifetime N/A

4 Core Plan Benefits Diamond Plus Diamond Prime Diamond Care CT and MRI scans In-patient and out-patient treatment a a a PET* and CT-PET* scans In-patient and out-patient treatment a a a Oncology* In-patient, day-care and out-patient treatment a a a - Purchase of a wig, prosthetic bra or other external prosthetic device for cosmetic purposes Complications of pregnancy* In-patient and out-patient treatment In-patient cash benefit (per night) Where treatment has been received free of charge Emergency out-patient treatment Where these benefit amounts are reached, any additional costs may be reimbursed within the terms of any separate Out-patient Plan Emergency out-patient dental treatment Where these benefit amounts are reached, any additional costs may be reimbursed within the terms of any separate Dental Plan 1,680 per lifetime 1,680 per lifetime 1,680 per lifetime a a N/A 1,000 max. 25 nights 1,000 max. 25 nights 500 max. 25 nights 6,500 5,500 N/A 6,500 N/A N/A Palliative care* a a 50,000 Long term care* a max. 90 days per lifetime a max. 90 days per lifetime 50,000, max. 90 days per lifetime Congenital conditions* 4,000,000 per lifetime 3,000,000 per lifetime 1,000,000 per lifetime Benefits marked with a aare covered in full, subject to the Maximum Plan Benefit. * Require pre-approval. DEDUCTIBLES APPLICABLE TO THE OUT-PATIENT PLAN AND/OR HEALTH AND WELLBEING PLAN To reduce your Out-patient Plan and/or Health and Wellbeing Plan premium, simply select a deductible from the lists below and read across to find the relevant premium discount. Our premiums are expressed in whole numbers (i.e. without any cents or pence etc.), therefore, percentages may be slightly higher or lower than those stated below. Please note that deductibles do not apply to treatment received at a public hospital. Where a deductible is selected, it is payable per person, per out-patient consultation 1. Optional Out-patient Plan/Health and Wellbeing Plan Deductibles No deductible Discount on Diamond Plus and Prime 0% premium discount 200 deductible 5% premium discount 400 deductible 10% premium discount Optional Out-patient Plan/Health and Wellbeing Plan Deductibles Discount on Diamond Care deductible 5% premium discount 1 Deductibles apply only to the following: Medical practitioner consultation Specialist consultation Psychiatry and psychotherapy consultation Dietician consultation Vaccinations consultation Health and wellbeing check consultation 2 Please note that a mandatory deductible of 200 applies to the Diamond Care Out-patient Plan. You can choose to increase it to 400 if you wish to obtain a discount.

5 OUT-PATIENT PLANS OPTIONAL The following Out-patient Plans can be purchased with our Core Plans. They cannot be bought separately. Please note that the Diamond Plus Outpatient Plan can only be purchased with the Diamond Plus Core Plan. Out-patient Plan Benefits Diamond Plus Diamond Prime Diamond Care Maximum plan benefit in CNY No limit 75,000 45,000 Medical practitioner fees and prescription drugs Prescription drugs are those which legally can only be purchased when you have a doctor s prescription a a a Specialist fees a a 10,000 Diagnostic tests a a 10,000 Vaccinations 10,000 4,000 1,000 Chiropractic treatment, osteopathy, homeopathy, Chinese herbal medicine, acupuncture and podiatry Max. 12 sessions per condition for chiropractic treatment and max. 12 sessions per condition for osteopathic treatment, subject to the benefit limit Prescribed physiotherapy Initially limited to 12 sessions per condition; limit also applies to prescribed and nonprescribed physiotherapy sessions, where combined a 11,000 8,000 a 11,000 8,000 - Non-prescribed physiotherapy 5 visits 5 visits 5 visits Prescribed speech therapy, oculomotor therapy and occupational therapy* a 11,000 5,000 Psychiatry and psychotherapy 18 month waiting period applies 30 visits 20 visits N/A Prescribed medical aids a 21,000 N/A Prescribed glasses and contact lenses including eye examination 2,000 1,500 N/A Dietician fees 4 visits N/A N/A * Require pre-approval. HEALTH AND WELLBEING PLAN OPTIONAL The following Health and Wellbeing Plan can be purchased with any of the Core Plans. It cannot be bought separately. Health and Wellbeing Plan Benefits Health and wellbeing checks including screening for the early detection of illness or disease Checks are limited to: Physical examination Blood tests (full blood count, biochemistry, lipid profile, thyroid function test, liver function test, kidney function test) Cardiovascular examination (physical examination, electrocardiogram, blood pressure) Neurological examination (physical examination) Cancer screening - Annual pap smear - Mammogram (every two years for women aged 45+, or earlier where a family history exists) - Prostate screening (yearly for men aged 50+, or earlier where a family history exists) - Colonoscopy (every five years for members aged 50+, or 40+ where a family history exists) - Annual faecal occult blood test Bone densitometry (every five years for women aged 50+) Well child test (for children up to the age of six years, up to a maximum of 15 visits per lifetime) BRCA1 and BRCA2 genetic test (where a direct family history exists) Diamond 6,000

6 MATERNITY PLANS OPTIONAL The Diamond Plus Maternity Plan can only be purchased with the Diamond Plus Core Plan. Please note that an Out-patient Plan must be selected in conjunction with the Maternity Plan. Maternity Plans are available to couples and families i.e. a spouse/partner must also be insured under the policy. Maternity Plan Benefits Routine maternity* In-patient and out-patient treatment. Complications of childbirth* In-patient treatment. Diamond Plus Maternity Plan 63,000 per pregnancy 126,000 per pregnancy * Require pre-approval. DENTAL PLANS OPTIONAL Diamond Plus Dental Plan can only be purchased if both the Diamond Plus Core Plan and Diamond Plus Out-patient Plan have been selected. Diamond Prime Dental Plan can be purchased with any of the Core Plans. Neither Dental Plan can be bought separately. Dental Plan Benefits Diamond Plus Diamond Prime Maximum plan benefit in CNY No limit 15,000 Dental treatment 100% refund 80% refund Dental surgery 100% refund 80% refund Periodontics 80% refund 80% refund Orthodontic treatment and dental prostheses 65% refund, up to 45,000 50% refund AREA OF COVER Allianz China General Insurance Company Ltd. offers a choice of three options in relation to geographical cover. The chosen area of cover will be specified in the Insurance Certificate. Worldwide, which provides cover anywhere in the world Worldwide excluding USA Greater China, which provides cover for treatment in China, Hong Kong, Macau and Taiwan

7 HIGH COST PROVIDERS Members can select the medical provider of their choice. However, please be aware that treatment received at the below listed providers (High Cost Providers) will automatically include a 20% co-payment, which applies in addition to any other co-payment or deductible that applies to your policy. Should you wish to have unrestricted access to High Cost Providers, the 20% co-payment can be removed by paying a 30% surcharge on your premium (please note that it is not possible to remove the 20% co-payment on the Diamond Health and Wellbeing plan, if selected). HIGH COST PROVIDER LIST 3 : All Locations All United Family Hospitals and Clinics All Parkway Health Clinics, including the Gleneagles Medical and Surgical Centre Raffles Medical Clinics (formerly known as International SOS Clinics) China Shanghai East International Medical Centre Shanghai Red Leaf Women s Hospital Institute for Western Surgery New York Dental Clinic International Medical Center (IMC) Beijing Hong Kong Hong Kong Adventist Hospital Matilda International Hospital Hong Kong Sanatorium & Hospital Hong Kong Baptist Hospital Singapore All Parkway facilities, including Mount Elizabeth Hospitals and Gleneagles Hospitals 3 The above list is subject to change. The latest list of high cost providers can be found on our website: Allianz MyHealth CN app The pioneering Allianz MyHealth CN app has been developed to give you easy and convenient access to your cover, no matter where you are. Access the following features from your mobile device: MY CONTACTS MY POLICY MY CLAIMS SYMPTOM CHECKER Access our 24/7 multilingual Helpline and local emergency numbers Access your policy documents and your Membership Card on the go Submit your claims in 3 simple steps and view your claims history For a quick and easy evaluation of your symptoms OTHER SERVICES Look up the local equivalent names of brand name drugs and translate common ailments into one of 17 languages Allianz MyHealth CN app is administered via our sister company, Allianz Partners. All personal data within the Allianz MyHealth CN app is encrypted for data protection, plus most features are accessible even when offline. For more information, please visit:

8 Talk to us, we love to help! If you have any queries, please do not hesitate to contact us: Helpline From inside mainland China: From outside mainland China: (+ 86) Allianz China General Insurance Company Ltd. Shanghai Branch Unit 1408, 14F Shanghai Tower No.501 Middle Yincheng Road, Pudong New Area Shanghai , People s Republic of China Allianz China General Insurance Company Ltd. is the insurer and the inside mainland China administrator of this policy. The company is registered in China and regulated by the China Insurance Regulatory Commission. Registered Office: Unit 01-05, 11 & 12, 34th Floor, Main Tower, Guangzhou International Finance Center, 5 Zhujiang Xilu, Tianhe District, Guangzhou, Guangdong, P.R. China. Registered No AWP Health & Life SA, acting through its Irish Branch, is engaged by the insurer for the administration of the insurance policy outside mainland China. AWP Health & Life SA is a limited company governed by the French Insurance Code. Registered in France: No RCS Bobigny. Irish Branch registered in the Irish Companies Registration Office, registered No.: , address: 15 Joyce Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland. Allianz Partners is a registered business name of AWP Health & Life SA. DOC-TOB-AZCN-IND-EN-0218