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Territorial Scope of Policy Coverage | Area |
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Area of Coverage | Area 1 - Worldwide Area 2 - Worldwide excluding USA Area 3 - Asia5 |
Outside Area of Coverage | Emergency treatment only |
5 cases within Hong Kong & Macau restricted to semi-private room for Plan A & B only
Basic Coverage
Basic Cover - Hospital Services | Plan A | Plan B | Plan C | Plan D6 |
---|---|---|---|---|
Annual Deductible Options | NIL | NIL | NIL / US$5,000 / US$8,000 | NIL / US$5,000 / US$8,000 |
Overall Annual Limits | US$180,000 | US$380,000 | US$2,500,000 | US$5,000,000 |
- Hospital Charges
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Hospital Charges Fully covered Fully covered Fully covered Fully covered - Room and Board
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Room and Board US$200 per day US$500 per day Fully covered
Up to Standard Private Room Level ChargeFully covered
Up to Standard Private Room Level Charge - Intensive Care Unit
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Intensive Care Unit US$750 per day US$1,100 per day Fully covered Fully covered - Companion Bed
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Companion Bed
Accompanied dependent child below age 20Fully covered Fully covered Fully covered Fully covered - Oncology Treatment
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Oncology Treatment Fully covered Fully covered Fully covered Fully covered - Day Case Treatment
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Day Case Treatment
Maximum per policy yearUS$6,000 Fully covered Fully covered Fully covered - Renal Dialysis
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Renal Dialysis
Maximum per policy yearUS$10,000 US$20,000 Fully covered Fully covered - Local Ambulance Services
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Local Ambulance Services Fully covered Fully covered Fully covered Fully covered - Local Transport
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Local Transport
On the day of discharge from confinement
Single trip following confinement of 7 days or moreFully covered Fully covered Fully covered Fully covered - Organ Transplant
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Organ Transplant
Maximum per policy year
Excluding donor costs if chargeable to the Insured MemberUS$75,000 US$100,000 Fully covered Fully covered - Pre and Post-hospitalisation Treatment
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Pre and Post-hospitalisation Treatment
Outpatient expenses incurred within 30 days before admission and 90 days following hospital dischargeFully covered Fully covered Fully covered Fully covered - Advanced Diagnostic Scanning
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Advanced Diagnostic Scanning Fully covered Fully covered Fully covered Fully covered - Emergency Ward Treatment
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Emergency Ward Treatment Fully covered Fully covered Fully covered Fully covered - Nursing at Home
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Nursing at Home
Incurred start date within 30 days from discharge up to 182 days per policy yearN.A. US$100 per day Fully covered Fully covered - Emergency Dental Treatment
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Emergency Dental Treatment
Maximum per policy yearUS$10,000 US$20,000 Fully covered Fully covered - Psychiatric Treatment
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Psychiatric Treatment
Maximum per policy yearN.A. Fully covered Fully covered Fully covered - Surgical Appliances7
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Specified Items
Maximum per policy year- Pace maker
- Artificial cardiac valve
- Metallic or artificial joint for joint replacement
- Prosthetic ligaments for replacement or implantation between bones and
- Prosthetic intervertebral disc
N.A. US$2,500 for both specified and non-specified items sharing the same limit Fully covered Fully covered Non-specified Items
Maximum per policy yearN.A. US$2,500 for both specified and non-specified items sharing the same limit US$5,000 US$5,000 - Hospital Cash
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Hospital Cash
Maximum 120 days per policy year
Hospital cash will be payable for the following:- Resident patient in the general ward of government hospital (Hong Kong & Macau only)
- Outpatient endoscopic procedures and
- Co-ordination of benefits
US$100 per day US$100 per day US$150 per day US$250 per day - Complications of Pregnancy
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Complications of Pregnancy
Maximum per policy yearN.A. N.A. Fully covered Fully covered - Private Nursing
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Private Nursing
Maximum 45 days per policy yearN.A. N.A. Fully covered Fully covered - Rehabilitation Benefit
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Rehabilitation Benefit
Maximum per policy year
Covers expenses in a rehabilitation centre within 90 days after discharge from hospitalN.A. N.A. Fully covered Fully covered - Hospice or Palliative Care Benefit
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Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Hospice or Palliative Care Benefit
Covers confinement in a registered hospice for care and nursing service following a diagnosis of terminal illness confirmedN.A. N.A. US$50,000
Lifetime benefit limitUS$100,000
Lifetime benefit limit - HIV/AIDS Treatment (3 years waiting period)
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 HIV/AIDS Treatment (3 years waiting period) N.A. N.A. US$75,000
Lifetime benefit limitUS$150,000
Lifetime benefit limit - Congenital Conditions
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Congenital Conditions N.A. N.A. US$25,000
Lifetime benefit limitUS$50,000
Lifetime benefit limit - Final Tribute Cost
-
Basic Cover - Hospital Services Plan A Plan B Plan C Plan D6 Final Tribute Cost
Maximum per Insured MemberUS$2,000 US$2,000 US$5,000 US$5,000
6 Must be taken in conjunction with outpatient benefits
7 For the appliances of stents for percutaneous transluminal coronary angioplasty and intraocular lens for cataract surgery, such cost of appliances will be paid under Hospital charges
Extended Plan Benefits
Extended Benefits | Plan A | Plan B | Plan C | Plan D6 |
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- For Insured Members aged below 18
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Extended Benefits Plan A Plan B Plan C Plan D6 Increased Overall Annual Limit
Under Hospital Services, if Insured Member was diagnosed with one of the following diseases which was not a Pre-existing Condition or Congenital Condition: Bacterial Meningitis, Kawasaki Disease or CancerIncrease by 50% Increase by 50% Increase by 50% Increase by 50% Increased Benefit Limit
Emergency Dental Treatment under Hospital Services, where an Accident took place on school premises where the Insured Member is a full-time studentIncrease by 100% Increase by 100% Increase by 100% Increase by 100% Overseas Learning Programme
Maximum per policy year
Expenses incurred for applicable treatments under Outpatient Services, during the time the Insured Member is engaged as a participant in an overseas learning program arranged by the schoolUS$500 US$500 US$1,000 US$2,000 Vaccination
Maximum per policy yearUS$150 US$150 US$150 US$150 - For Overseas Emergency Services
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Extended Benefits Plan A Plan B Plan C Plan D6 Includes Emergency Medical Evacuation and Repatriation, Repatriation of Mortal Remains, Compassionate Visit and Return of Dependent Child/Children Not available for Insured Members aged 70 or above
Fully covered Fully covered Fully covered Fully covered
Optional Coverage
Optional Coverage - Outpatient Services | Option 1 (Eligible for Plan A or Plan B Hospital Services applicant) |
Option 2 (Eligible for Plan A or Plan B Hospital Services applicant) |
Eligible for Plan C or Plan D6 Hospital Services Applicant |
---|---|---|---|
Overall Annual Limits | US$5,000 | US$10,000 | Subject to Hospital Services Overall Annual Limit |
- General Physician Services
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantGeneral Physician Services Fully covered Fully covered Fully covered - Specialist Services
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantSpecialist Services Fully covered Fully covered Fully covered - Chinese Physician
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantChinese Physician
Maximum per policy yearUS$500 US$800 US$1,000 - Physiotherapy and Chiropractic Treatment8
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantPhysiotherapy and Chiropractic Treatment8
Maximum per policy yearUS$1,500 US$2,500 US$3,000 - Laboratory and X-ray Services8
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantLaboratory and X-ray Services8 Fully covered Fully covered Fully covered - Prescribed Drugs8
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantPrescribed Drugs8 Fully covered Fully covered Fully covered - Hormone Replacement Therapy8
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantHormone Replacement Therapy8
Maximum per policy yearUS$1,000 US$2,000 US$2,000 - Medical Appliances
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantMedical Appliances Fully covered Fully covered Fully covered - Hearing Aids
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services ApplicantHearing Aids
Maximum per policy yearUS$750 US$750 US$750 - Wellness and Optical Services
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services applicantWellness and Optical Services
Maximum per policy year
Routine medical check-up
Vaccination
Hearing Test
Eye exam & corrective vision aidsUS$500 US$750 US$750 - Complementary/Alternative Treatment
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services applicantComplementary/Alternative Treatment
Maximum per policy yearUS$1,000 US$1,000 US$1,000 - Psychiatric Treatment
-
Optional Coverage - Outpatient Services Option 1
(Eligible for Plan A or Plan B
Hospital Services applicant)Option 2
(Eligible for Plan A or Plan B
Hospital Services applicant)Eligible for Plan C or Plan D6
Hospital Services applicantPsychiatric Treatment
Maximum per policy yearUS$2,500 US$2,500 US$2,500
6 Must be taken in conjunction with outpatient benefits
8 Referred by General Physician/Specialist in writing is required
Dental Care (Eligible for Optional Outpatient Services applicant only) |
Eligible for Plan A or Plan B Hospital Services applicant |
Eligible for Plan C or Plan D6 Hospital Services Applicant |
---|---|---|
Overall Annual Limit | US$1,200 | US$2,000 |
- Oral examination, scaling and polishing
-
Dental Care
(Eligible for Optional Outpatient Services applicant only)Eligible for Plan A or Plan B
Hospital Services applicantEligible for Plan C or Plan D6
Hospital Services ApplicantOral examination, scaling and polishing
Twice per policy yearFully covered Fully covered - Dental Treatment (6 months waiting period)
-
Dental Care
(Eligible for Optional Outpatient Services applicant only)Eligible for Plan A or Plan B
Hospital Services applicantEligible for Plan C or Plan D6
Hospital Services ApplicantDental Treatment (6 months waiting period) - Intra oral x-ray
- Impaction
- Emergency treatment to relief dental pain (palliative)
- Fillings
- Medication/Drugs
- Root canal treatment
- Extraction (including wisdom tooth)
- Periodontal treatment
Fully covered Fully covered - Major Restorative Dental Treatment (12 months waiting period)
-
Dental Care
(Eligible for Optional Outpatient Services applicant only)Eligible for Plan A or Plan B
Hospital Services applicantEligible for Plan C or Plan D6
Hospital Services ApplicantMajor Restorative Dental Treatment (12 months waiting period) - Dentures, crowns and bridges
- Inlays
- Implants (surgical implant placement/implant abutments)
80% reimbursement Fully covered - Orthodontic Treatment (12 months waiting period)
-
Dental Care
(Eligible for Optional Outpatient Services applicant only)Eligible for Plan A or Plan B
Hospital Services applicantEligible for Plan C or Plan D6
Hospital Services ApplicantOrthodontic Treatment (12 months waiting period) For dependent child aged below 1850% reimbursement 50% reimbursement
Maternity Care (Eligible for Plan C or Plan D6 Hospital Services applicant) |
|
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First policy year overall annual limit | NIL |
Second policy year overall annual limit | US$5,000 |
Third policy year and thereafter overall annual limit | US$10,000 |
The above annual benefit will be counted from the Commencement Date of Maternity Date
Notes
- Major Exclusions
-
The following treatments, conditions, activities, items and their related expenses are excluded from the plan and the insurer shall not be liable for the items listed below:
- Pre-existing conditions (refer to the General Provisions & Conditions)
- Birth defect and congenital illnesses unless otherwise explicitly provided and endorsed in the Schedule
- Infertility, contraception or sterilisation or inducing pregnancy unless otherwise explicitly provided and endorsed in the Policy or Schedule
- Treatment not undertaken by or on the recommendation of a physician
- Chinese herbs and/or tonic medicine such as but not limited to bird’s nest, lingzhi, ginseng, cordceps sinensis, agaricus blazei murill, sika deer antler, etc
- Drug purchased without physician’s prescription
- Addictive conditions/disorders, like abuse of drug or alcohol
- Self-inflicted injury or suicide
- Treatment which is not medically necessary or treatment of an optional nature
- Elective cosmetic surgery
- Injuries resulting from war, invasion, acts of foreign enemies, hostilities or warlike operations, civil war, rebellion, revolution, insurrection, civil commotion, or participating in an illegal act including resultant imprisonment
- Racing of any form other than on foot, and all professional sports
- Treatment of sexually transmitted diseases
- Alternative treatment, such as aroma therapy & naturopathy unless otherwise explicitly provided and endorsed in the Schedule
- Treatment for bodily injury or sickness incurred while serving as a member of police or military forces
For the full list of exclusions, please refer to the policy terms and conditions.
1 If the Insured Member has remained in the USA for more than 185 days at the time of incurring the covered medical expenses, all benefits payable under the Policy which takes place in the USA shall be reduced by at least forty percent (40%) of relevant reimbursable charges, subject always to the Policy’s terms and conditions, but in no event shall such reimbursement exceed the limits stated in the Schedule. Area of coverage: Asia – please refer to the area of coverage, Asia under the territorial scope of policy coverage
2 Not available for Insured members aged 70 and above
3 Insured member needs to follow the required procedures to enjoy the cashless hospitalisation arrangement. Please refer to the Policy and our website for more details on the requirements and arrangements. Insured members need to reimburse Liberty for the deductible, if any, as well as the shortfall which included medical expenses that are not eligible for claims
4 Upon application approval, we will guarantee Policy is renewable up to age 100 irrespective of your health condition or claims record. Policy renewal at each anniversary is guaranteed at the pool level when the benefits and premium rates are revised, subject to the payment of premium and the availability of the product, and the chosen plan option at renewal. For details, please refer to the insurance consultant and the Policy
The plan is subject to the terms, conditions, and exclusions of the relevant policy contract. Liberty Insurance reserves the final right to approve any application. This product brochure contains general information only and the information shown is for information purposes only. Please refer to the Policy and Policy Schedule for details of coverage, terms, and conditions.
If there is any inconsistency or ambiguity between the English version and the translated version, the English version shall prevail.