CIGNA HEALTHFIRST CHOICE
MEDICAL PLAN
Trouble-free hospitalization and cancer protection insurance plan that works for you
Total convenience
CASHLESS HOSPITALIZATION
Cancer Treatment and Dialysis Benefit
UP TO HK$160,000
PLAN BENEFITS
Cigna HealthFirst Choice Medical Plan saves you from hassle at times when you need to be hospitalized. The plan covers not only your hospitalization expenses, but also common expenses such pre-admission and post-hospitalization treatment, cancer treatment, dialysis and more, enhancing your chances for speedy recovery. With cashless hospitalization at any Hong Kong network hospital, you can get the hospital admittance.
Cashless Hospitalization
Cigna will settle payment directly with the hospital in HK on your behalf – saving you the hassle of paying a deposit and making a claim. All you need to do is to fill in a form to arrange pre-approval in advance. Leaving you free to focus on your recovery.
Cancer treatment and dialysis
Benefit up to HK$160,000 per year
Covers MRI, CT Scan and PET Scan, whether carried out in hospital or in a clinic
Simplified application process
Just answer a few simple health questions to enroll the plan
COVERAGE DETAILS
PLAN TYPE, POLICY TERM AND PREMIUM STRUCTURE OF BASIC PLAN
HOSPITALIZATION AND SURGICAL BENEFITS
EXCLUSIVE PRIVILEGES
ISSUE AGE
COVERAGE AMOUNT
CIGNA LIFELONG PREVENTIVE PROGRAM
PLAN TYPE, POLICY TERM AND PREMIUM STRUCTURE OF BASIC PLAN
- This product is a standalone individual policy. The basic plan provides hospitalization benefits which can be added with optional benefits of outpatient or other medical protection. The policy provides indemnity benefits and contains no cash value.
- 1 year and Annually Renewable.
- The plan provides a protection period of 1 year and guaranteed renewable up to age 100 of person insured, with payment period until the end of protection period. Premiums will increase with age and are subject to annual adjustment at policy renewal.
HOSPITALIZATION AND SURGICAL BENEFITS
Room & board benefits of up to HK$3,200 per day, max. 270 days per policy year
No annual limit before age 65
Cover surgical, anaesthetist's and operation theatre expenses
Worldwide coverage
Pre-admission and post-hospitalization treatment, and MRI, CT Scan and PET Scan services at clinics are also covered
EXCLUSIVE PRIVILEGES
10% discount on first year’s premium
Health reward of up to 15% premium discount at renewal for no claim record
1st year 30% premium discount for child (from 15 days to age 17) if enroll together with his/ her parent
ISSUE AGE
From 15 days to age 75
COVERAGE AMOUNT
For detailed coverage amount of each Hospital and Surgical Benefits and Recommended Additional Benefits, please click here
CIGNA LIFELONG PREVENTIVE PROGRAM
A free annual influenza vaccination and body check
Discounts on vaccinations and health check plans
RECOMMENDED ADDITIONAL BENEFITS
OUTPATIENT BENEFITS
3 different levels of cover for your visits to General Practitioner, Specialist, Chinese Herbalist, Chinese Bonesetter, Acupuncturist, Physiotherapist, Home Consultation, etc.
SUPPLEMENTARY MAJOR MEDICAL BENEFIT
Additional benefit of up to HK$575,000 per year to cover your inpatient medical expense.
DENTAL BENEFITS
Coverage includes scaling and polishing, oral examinations, extractions, fillings, X-ray, root canal fillings, etc.
ILLUSTRATIONS
Cigna HealthFirst Choice Medical Plan
Patrick, age 41, non-smoker
Cigna HealthFirst Choice Medical Plan
At age 41, Patrick is discovered to have a 5cm malignant tumor inside his stomach during a PET scan at a clinic.
He is advised to undergo total gastrectomy surgery followed by chemotherapy. Patrick submits a form and successfully applies for cashless hospitalization. His subsequent operation is successful and he remains hospitalized for two weeks. After 12 chemotherapy treatments - 6 in the hospital and the remainder in private clinics - he gradually recovers.
How did Choice Medical Plan help Patrick?
- Cashless hospitalization was easily arranged
- His chemotherapy expenses are covered under "Cancer Treatment and Dialysis" benefit and the miscellaneous hospital charges during hospitalization can be covered under "Other Medical Expenses" benefit, subject to the maximum limit of his plan
- The cost of PET scan conducted in a clinic is covered
| Items | Amount covered (HK$) | Maximum Limit (HK$) |
Hospital Room & Board | $22,400 ($1,600 x 14 days) | 1,600 per day |
|---|---|---|
Surgical Expenses (complex)1 | $60,000 | $65,000 |
Anaesthetist's Expenses (complex) | $16,0002 | $16,000 |
Operation Theatre Expenses (complex) | $15,000 | $16,600 |
Other Medical Expenses (including outpatient PET scan) | $20,500 | $21,500 |
Cancer Treatment and Dialysis (Chemotherapy) | $102,000 ($8,500 x 12 times) | $120,000 |
| Total amount reimbursed: | HK$235,900 |
Remark:
- For the classification of operations, please refer to the Simplified Schedule of Operations of the policy provisions.
- The actual anaesthetist's expense is HK$19,000. Due to the eligible maximum limit under his current plan level is HK$16,000, the amount covered under this item will be HK$16,000. For the rest of the items, since the actual expenses do not exceed the maximum limit, the entire amount can be covered.
FAQS
Application
How to enroll in Cigna HealthFirst Choice Medical Plan (“Choice”) ?
You may submit your application through our website, or by calling Cigna on 8200 8017, or contact your insurance brokers for details.
If you are an existing Cigna policyholder, you may apply through the MyCigna HK app or our online customer portal.
What do I need to be able to buy online now?
Before you start your online purchase, please make sure you have below information ready:
- Your HKID no.
- the HKID no. of any family members you wish to cover
- your basic contact information
- the height, weight, and medical history details of you or any family members you wish to cover
- your credit card information
How can I pay?
You can pay online with your credit card. We accept VISA and Mastercard. If you wish to pay using a different method, please call our hotline on 8200 8017
What can I do if I encounter problems on the online application?
Just sit back and relax. If you have entered your contact number in the application process, our Cigna representatives will contact you within 2 days. You may also call 8200 8017 for enquiry.
If I am already covered by other Cigna policy, could I be still enrolled in Choice?
If you are already covered under "Cigna HealthFirst Medical Plan Series" policy, including "Cigna HealthFirst Elite Medical Plan", "Cigna HealthFirst Choice Medical Plan" ,"Cigna HealthFirst DiaMedic Plan", or any other insurance policies that fall under "Cigna HealthFirst Medical Plan Series" , "Cigna VHIS Series" and "Cigna Cathay Premier Health Plan" products, you may call 8200 8017 to discuss setting up a new Choice policy. If you accept the underwriting results and the new coverage details, we will arrange for you to migrate from your old policy to the new Choice policy. If you are already covered under a different Cigna plan, you may enroll in Choice and enjoy coverage under both policies.
Coverage
What’s the area of coverage for Choice?
The coverage under the Hospital and Surgical Benefits is worldwide. The Optional Insurance Benefits are limited to Hong Kong coverage, except for medical expenses related to an Emergency which are covered worldwide.
What are the annual limits and lifetime limits for benefits of Choice?
There’s unlimited lifetime claims for Choice. There no annual limit until age 65. For age of 65 or above, the annual limit ranges from HK$175,000 to $700,000, depending on the plan level chosen.
Is there any optional benefits on top of the basic benefits of Choice?
Choice’s core coverage is focused on hospital and surgical coverage. However, there are various optional benefits for Choice customers to extend coverage to enhance your protection:
- Supplementary Major Medical Benefit:
Additional benefit of up to HK$575,000 per year to cover your inpatient medical expense. - Outpatient Benefits:
For your visits to General Practitioner, Specialist, Chinese Herbalist, Chinese Bonesetter, Acupuncturist, Physiotherapist, Home Consultation, etc. - Dental Benefit:
Coverage includes scaling and polishing, oral examinations, extractions, fillings, X-ray, root canal fillings, etc.
Discounts
Any premium discount for Choice?
There are various premium discount type available currently, they are
- First year premium 10% discount for new policies
- Child discount: 1st year 30% premium discount for child (from 15 days to age 17) if at least one parent is also covered under Choice
- No claim premium discount: Up to 15% premium discount at renewal
Premium Adjustment
Would premium be adjusted upon renewal?
Cigna reserves the right to revise the premium of the policy on the anniversary date or upon renewal. Factors leading to premium adjustment may include but are not limited to our overall experience in claims and expenses incurred by and /or in relation to this product. However, we will not adjust your premium based on your own health status or personal claims record.
Renewal
Would I be rejected for renewal for the change of my health conditions?
The basic benefits and optional insurance benefits will be effective for an initial period of 12 months and thereafter guaranteed and automatically renewable for successive periods of 12 months each provided that Cigna continue to issue new policy(ies) under the Basic Benefits and respective Optional Insurance benefits (if applicable) of Choice, and upon payment of the premium at time of renewal. This means any change in your health won’t have any impact on your eligibility to renew your policy.
Claims
Any limitation on claims for hospitalization in mainland China?
For treatment in mainland China, the Hospital must be of Tier 3 Class A or above or included on our list of designated private Hospitals as advised from time to time, otherwise no benefit shall be payable.
How to claim?
Please login to our customer portal at www.mycigna.com.hk or download our MyCigna HK app from the app store or Google Play store.
Written notification of a claim must be given to the Company within 30 days after the occurrence of the event giving rise to the claim. Such notification shall include information sufficient to identify the Person Insured and the nature of the claim.
When submitting a claim through MyCigna HK please have the below documents ready.
- You will need to have your doctor completing an Accident or Medical Expenses Doctor Form(sample):
- Receipt from your treatment
- Statement of charges from the hospital/Hospital Invoice or Bill/Hospital charges breakdown list
- Hospital Discharge Summary or any documents issued by doctor/hospital with diagnosis
- Identity card copy of the Policyholder
- If you have submitted a claim with another insurer then you will also need a copy of the Compensation Breakdown from the other Insurer(s)
How to use the Cashless hospitalization arrangement?
You need to apply for Guarantee of Payment (GOP) before hospitalization. Please have your admission note ready for the application. If you don’t organize GOP, you can still submit a claim (on reimbursement basis) after you are discharged from hospital. You may call Cigna HealthFirst 24 hours Hotline at 8203 2202 for further assistance.
Enquiry and Others
Any contact points for enquiry?
For general enquiries, you may contact
Cigna Customer Service Hotline: 2560 1990 during office hours
(Mon – Fri, 0900 - 1900, except Public Holidays).
For enquiries about your existing Choice policy or any claims:
Cigna HealthFirst 24 hours Hotline at 8203 2202 (applicable to Choice customers only)
TERMS & CONDITIONS
IMPORTANT INFORMATION
Premium
- Premium Level
The premium of the plan level selected by you is determined based on the age, sex and smoking habit of the person insured at policy commencement and at the time of renewal upon each anniversary date of the policy.
- Non-payment of Premium
If you fail to pay the initial premium, your policy will not take effect from the commencement date of your policy. Except for the initial premium payment, there will be a grace period of 1 month after any premium due date. Your policy will remain effective during this grace period. If any premium is not paid at the end of the grace period, your policy will lapse on the premium due date and you will lose the insurance cover.We will not make any claim payment or any other payment payable under the policy, until we receive payment of all outstanding premium up to the date of the claim payment or when the policy terminates.
- Mis-statement of Age or Smoking Habit
If age, sex or smoking habit has been mis-stated by you or any person insured but the relevant person insured would still be eligible for coverage, we have the right to adjust the premiums payable based on the correct information.
- Premium Adjustment
The Company reserves the right to revise the premium of the policy on the anniversary date or upon renewal. Factors leading to premium adjustment may include but are not limited to our experience in claims and expenses incurred by and/or in relation to this product.
Benefits
- Extent of Benefits
The coverage under this policy is worldwide, except under the Optional Insurance Benefits, which is subject to emergency conditions if expenses are incurred outside of Hong Kong. We reserve the right to request that the person insured obtain preapproval from us before incurring such relevant expenses.
- Supplementary Major Medical Benefit
If the person insured uses a higher level of hospital facilities and services than he is entitled under this policy, the benefit amount payable shall be lowered according to the adjustment factor. This benefit shall not be payable for class of suite/ VIP/ deluxe room of a hospital.
Plan Level Room type confined Adjustment factor Semi-Prtivate Room Private 50% Ward Semi-Private 50% Ward Private 25% Under the Supplementary Major Medical Benefit, the following terms and conditions shall apply regarding the Lifetime Limit starting from the anniversary date after the person insured reaches age 75:- Any benefit payable under this section will be deducted from the Lifetime Limit, the balance of the Lifetime Limit as at the end of the current policy year will be carried forward to the next policy year.
- If the person insured’s application for a change in the benefit level is approved by the Company, the Lifetime Limit applicable to the next policy year will be equivalent to the Lifetime Limit of the new benefit level, minus all benefits paid since the anniversary date following the person insured reaching age 75.
- This benefit will automatically terminate upon the first anniversary date after the Lifetime Limit is exhausted.
Duplicated Policy
Person insured can only be covered under one single "Cigna HealthFirst Medical Plan Series" policy. The series includes "Cigna HealthFirst Elite Medical Plan", "Cigna HealthFirst Choice Medical Plan", "Cigna HealthFirst DiaMedic Plan" and any other insurance policies that fall under the "Cigna HealthFirst Medical Plan Series", "Cigna VHIS Series" and "Cigna Cathay Premier Health Plan Series" as defined and issued by the Company from time to time.
Co-ordination of Benefits
If any Medically Necessary charges shall be reimbursed by another party or by us under another insurance plan, we shall only be liable for the difference between such reimbursement and the total amount of benefits which would otherwise be payable in respect of such medical expenses under the policy.
Renewal
The Hospital and Surgical Benefits will be effective for an initial period of 12 months and thereafter guaranteed and automatically renewable, for successive periods of 12 months each provided that we continue to issue new policy(ies) under the “Cigna HealthFirst Choice Medical Plan”, and upon payment of the premium at the time of renewal. The Company reserves the right to revise the terms of the policy and/or the premium and/or the benefit schedule upon each renewal.
Termination
- The policy will be automatically terminated when one of the following happens:
- The person insured passes away;
- Any premium is not paid at the end of the grace period; or
- The policy is terminated by the Company or the policyholder.
- If there is any fraud, mis-statement or concealment in the application or declaration, or if you or your beneficiary makes a dishonest claim, we have the right to cancel the policy immediately. In such case, all the premium paid will not be returned and you shall immediately return all payment includingclaims paid by us under the policy.
- The Company may terminate any Optional Insurance Benefit, by giving not less than 30 days’ advance notice in writing to you.
- If the policy is terminated by the policyholder during the policy year, we reserve the right to charge the premium until the end of such policy year after the termination.
Inflation risk
Your current planned benefit may not be sufficient to meet your future needs since the future cost of living may become higher than they are today due to inflation. Where the actual rate of inflation is higher than expected, you may receive less in real terms even if we meet all of our contractual obligations.
KEY EXCLUSIONS
The following list is for reference only. Please refer to the policy provisions for the complete list and details of exclusions.
We shall not be liable for any claims or the expenses incurred through, directly or indirectly caused by, or resulting from any one or more of the following:
Applicable to all benefits (including Optional Insurance Benefit) :
- Pre-existing medical conditions;
- War, invasion, act of a foreign enemy, hostilities (whether war is declared or not), civil commotion, rebellion, revolution, insurrection, military or usurped power or terrorism;
- The person insured’s suicide, attempted suicide or intentionally self-inflicted injuries while sane or insane;
- The person insured being under the influence of alcohol or drugs unless, in the case of drug consumption, it is proven that such drug was taken in accordance with a proper medical prescription by a physician other than for the treatment of drug addiction;
- Pregnancy, childbirth and miscarriage of or abortion by the person insured, including complications resulting therefrom notwithstanding that such incident may have been accelerated or induced by bodily injury or sickness; infertility or sterilization or any type of fertility;
- Infection with Human Immunodeficiency Virus (HIV) or variants including Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related complex (ARC); sexually-transmitted diseases or treatment thereof;
- Birth defects, congenital conditions, development conditions, hereditary conditions or any disabilities arising therefrom; congenital conditions; developmental conditions; or hereditary conditions;
- Cosmetic and elective surgery;
- Vaccination and immunization injections;
- All dental treatment prescribed by a dentist except emergency treatments by a physician during hospital confinement due to bodily injury; follow-up treatment from such hospital confinement (unless the Dental Benefit applies under this policy);
- Mental, psychiatric or nervous illness;
- Treatment for a related condition resulting from addictive conditions and disorders; sleep disorders including insomnia, snoring, sleep-related breathing problems or sleep studies;
- Treatment that is not medically necessary;
- The person insured’s voluntarily exposing himself/herself to any hazard or danger;
- Fees/expenses incurred due to the following reasons:
- Convalescence accommodation, treatment or services rendered at any sanatorium or similar establishment;
- Prosthesis, corrective devices and medical appliances, that are not intra-operatively required;
- All organ transplantation, transplant procedures and acquisition of the organ itself to be used for organ transplantation;
- Routine medical examinations or health screening checks;
- Alternative treatment including but not limited to Chinese medicine treatment, acupuncture, acupressure, Tui Nai, hypnotism, rolfing, massage therapy, aromatherapy (unless provided under the Acupuncturist benefit, Chinese Herbalist benefit and Chinese Bonesetter benefit payable under the Benefit Schedule).
- Experimental and/or new medical technology/procedure not yet approved by the Company; or
- Non medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes (apart from VAT and GST charged on eligible expenses), medical report charges and similar charges.
Applicable only to the Optional Dental Benefit :
- Appliances or restoration necessary to increase vertical dimension or restore an occlusion;
- Dental implants;
- Cosmetic dentistry procedures such as bleaching and veneers;
- Orthodontic services;
- Repair or replacement of orthodontic appliances;
- Placement of bone grafts or extra-oral substances in the treatment of periodontal disorders;
- Procedures or appliances to correct congenital malformations;
- Treatment of malignancies, cysts, or neoplasms;
- Replacement of lost or stolen dentures;
- Services or treatment for, or associated with, temporomandibular joint (TMJ) dysfunction or disorder or for orthognathic surgery;
- Services or supplies intended to diagnose or treat any condition that is an occupational injury or disease; or
- Replacement of or additions to existing dentures or bridgework.
The above insurance plan is underwritten by Cigna Worldwide General Insurance Company Limited.
The above information is for reference only and does not constitute any contract or any part thereof between Cigna and any other parties. Please read the product brochure for details. For details of full terms, conditions and exclusions, please refer to the policy provisions. Cigna will be happy to provide a specimen of policy upon your request.
