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PortaProtection PortaProtection allows existing members of AXA group medical insurance schemes 1, and their dependents or immediate family to continue enjoying peace of mind from a comprehensive medical protection plan 2. The plan features lifetime coverage and worldwide protection. Existing members of our group medical insurance schemes can enjoy guaranteed acceptance and no underwriting is required when applying for PortaProtection. So feel free to enhance coverage for yourself and your family to suit different needs. 2
Medical protection on the move Continuity of your existing group medical benefits Whether you are moving from one employer to another or planning to retire, you will still be able to maintain the comprehensive medical coverage which you used to enjoy. No underwriting is required 3 and guaranteed acceptance 4,5 Any existing members of our group medical insurance schemes from 15 days old up to age 64 can enjoy guaranteed acceptance, with no requirement for a medical questionnaire or screening Coverage for pre-existing conditions 6 Unlike most other individual health insurance plans, PortaProtection covers pre-existing conditions for any existing members of our group medical insurance schemes who have been continuously insured for at least 12 consecutive months either under our group medical insurance schemes or PortaProtection. Lifelong protection and guaranteed renewal You will enjoy lifetime guaranteed annual renewal of your PortaProtection irrespective of your health condition. Be rest assured that wherever life takes you, you will continue to benefit from comprehensive medical protection 3
Medical protection on the move Comprehensive reimbursement of medical expenses 7 PortaProtection enables you to obtain the medical treatment of your choice by providing you with comprehensive reimbursement protection of actual medical expenses, including hospital room & board, intensive care, surgery, hospital expenses and outpatient surgery, etc. Design your own medical plan with flexibility 7 Select 1 out of 9 different levels of hospital and surgical benefits, either traditional or lump sum Enjoy free top-up cancer/dialysis treatment with protection corresponding to the hospital and surgical benefits level you have chosen Optional out-patient benefits with 4 different levels for you to choose from 4
PortaProtection at a glance Benefit period Issue age Eligibility (subject to the conditions stated in section Enrolment Guidelines below) Existing members of our group medical insurance schemes members of our group medical insurance schemes Whole of life 15 days old 64 years old Under age 65 Non-existing members of our group medical insurance schemes 15 days old - 64 years old, and dependents 8 or immediate family including spouse, child(ren), parents and siblings of existing members of our group medical insurance schemes Nationality Policy renewability Premium structure Effective date for coverage Policyholders must be holders of Hong Kong identity cards at the time of application Guaranteed renewal Yearly adjusted based on attained age The first day of a month 9, 10 5
Enrolment Guidelines Existing members of our group medical insurance schemes Must be submitted either: within 30 days after joining our group medical insurance scheme; or within 30 days after policy anniversary date of our group medical insurance scheme 11 ; or within 30 days prior to the termination of their membership 12 in our group medical insurance scheme Non-existing members of our group medical insurance schemes Can be submitted at any time 6
Remarks 1. Group medical insurance scheme(s) refer to selected group medical insurance schemes provided by AXA General Insurance Hong Kong Limited or AXA China Region Insurance Company Limited. 2. Subject to age limitation and eligibility. Please refer to sections PortaProtection at a glance and Enrollment Guidelines of this leaflet for details. 3. No underwriting is required for eligible existing group medical insurance members who can enjoy guaranteed acceptance. Health declaration is required for eligible non-existing group medical insurance members and subject to underwriting approval. Exclusions may apply. 4. Application will not be accepted if any applicant has cancelled a PortaProtection policy previously. 5. Premium rates are not guaranteed. AXA reserves the right to review and adjust the premium rates across each particular risk classes on each policy anniversary of PortaProtection Policy. 6. Except for any exclusions relevant to existing members stated under our group medical insurance schemes or the PortaProtection plan 7. Please refer to sections Traditional Hospital and Surgical Benefits, Lump Sum Hospital and Surgical Benefits, Free Top Up Cancer/Dialysis Treatment and Out-patient Benefits of this leaflet for details. 8. Dependent children aged from 15 days to 17 years old must apply together with their parent. 9. The effective date for coverage under PortaProtection will be the first day of a month. In the event an application is not submitted on the first day of the month, the effective date for coverage under PortaProtection will be the first day of the following month. Likewise, if the member s last day of coverage in our group medical insurance scheme is not the last day of a month, the effective date for PortaProtection will be the first day of the month in which the membership is terminated in our group medical scheme in order to ensure continuous coverage 10. If the applicant happens to be hospitalised before the day the benefit would otherwise become effective, his/her PortaProtection benefits will only commence on the first day after he/she is discharged from the hospital. 11. Subject to the successful renewal of the group medical insurance scheme for at least 1 year 12. Such termination of membership cannot be a result of non-renewal of our group medical insurance schemes. 7
8 Traditional Hospital & Surgical Benefit - 1
9 Traditional Hospital & Surgical Benefit - 2
10 Lump Sum Hospital & Surgical Benefit
Free Top Up Cancer/Dialysis Treatment Free Top up Cancer / Renal Dialysis Treatment in lump sum coverage (Apply to In-patient & Out-patient settings) Chemotherapy treatment or radiotherapy treatment or rental dialysis treatment performed in outpatient setting shall also be covered Insured Person needs to receive chemotherapy / radiotherapy / renal dialysis treatment & his traditional or lump sum benefits have been exhausted, the Company will pay this top up benefit up to the limits, or maximums 11
12 Out-patient Benefits (Optional Plan)
13 Annual Premium 10% discounted
14 Monthly Premium
Eligibility illustration Brothers, their Spouse & Child Apply in one application & in same plan Can apply at any time subject to corporate member is in-force Subject to Underwriting Parents Parents Apply in one application & in same plan Can apply at any time subject to corporate member is in-force Subject to Underwriting Brothers, their Spouse & Child Corporate Members Spouse & Child Sisters, their Spouse & Child Apply in one application & in same plan Can apply at any time subject to corporate member is in-force Subject to Underwriting Sisters, their Spouse & Child Spouse & Child of Corporate Members: Dependent child (below 18 years old) should apply in one application & in same plan with one parent If they are corporate members: They can apply (i) with 30 days after they join the AXA group medical scheme; (ii) 30 days after policy anniversary date before age 65; (iii) 30 days before cease employment. If they are non-corporate members: Can apply at any time subject to corporate member is in-force Subject to Underwriting
Eligibility illustration - Newly Join Member Effective date: Oct or Nov 1 Member Join date Group Medical Policy Anniversary date 30 days 30 days Sep 15 Oct 15 Nov 1 Jul 1 Enrollment Period
Eligibility illustration - Resignation / retirement Group Medical Policy Anniversary date Effective date: Nov 1 Member Last employment date 30 days 30 days Jul 1 Jul 30 Oct 15 Nov 15 Jul 1 If the member s last day of coverage in our group medical scheme is not the last day of a month, the effective date will be the 1 st day of the month in which the membership is terminated in our group medical scheme in order to ensure continuous coverage. Enrollment Period
Eligibility illustration - Age 65 Effective date: Nov 1 or Dec 1 30 days Age 65 Birthday Group Medical Policy Anniversary date Not accepted Nov 15 Dec 15 Jul 1 Member must be under age 65 at the effective date in order to ensure continuous coverage. Enrollment Period