Your family responsibilities remain even as you progress with your career, arranging dependable medical protection is essential in your journey. This is why AIA’s CEO Essence Medical Plan 2 offers you and your family superb medical cover throughout Asia with guaranteed renewal. Enjoy full reimbursement with no benefit sub-limit for major medical expenses, hospital stays in a semi-private room and extended caring protection. Take on whatever challenges life has in store, and rest assured we’ve got your back.
CEO Essence Medical Plan 2 is a medical protection insurance plan that provides lifetime cover up to HK$/MOP25,000,000. With this plan, you will enjoy broad hospitalisation and surgical cover in Asia, giving you support when you need it most.
Lifetime guaranteed renewal
CEO Essence Medical Plan 2 guarantees that your premium for renewal will not be raised for any claim you have made, or any changes in your health condition. You can renew your cover every year for life. Renewal premium will be based on the prevailing premium rates at the time of renewal (Please refer to the Annual Premium Table for the first year premium provided by your financial planner).
EXTENDED CARING PROTECTION TO SAFEGUARD THE NEEDS OF STROKE AND CANCER PATIENTS
Stroke is a common disease with potentially harmful consequences, often requiring extensive periods of recovery and additional living support. This plan offers extended caring protection to address the daily needs and self-care capabilities of stroke patients, so that you may receive the proper care even in the comfort of your own home. These include:
Home facility enhancements approved by occupational therapists widening of corridors, adapting bathroom facilities and purchasing specialised furniture, etc.
Professional medical support consultations, treatments and prescriptions from chiropractors, physiotherapists, speech therapists, occupational therapists, neurologist, neurosurgeons and Chinese medical practitioners according to your personal needs
if you become unable to take care of yourself for at least 6 uninterrupted months, we will provide a disability subsidy of HK$/MOP5,000 per month to you for up to 24 months
This plan also includes enhanced support for cancer patients with cover for chemotherapy, radiotherapy, targeted therapy and the related consultations, medications and diagnostic tests. For patients with kidney diseases, we also cover the expenses required for regular dialysis treatments.
UNINTERRUPTED PROTECTION EVEN IN CRITICAL SITUATIONS
Accident may be one of your real concerns when planning your trip. Therefore, we have covered worldwide emergency conditions in CEO Essence Medical Plan 2. If you unfortunately have an accident during your trip outside your permanent residence country or place, including injuries resulting from acts of terrorism, we will cover worldwide emergency treatment expenses and provide worldwide emergency assistance services.
For more information, please refer to item 27 under the benefits schedule in product brochure for CEO Essence Medical Plan 2.
If no claim is made for two consecutive cover years, our CEO Essence Medical Plan 2 offers a 10% discount on your selected deductible choice in the following cover year. Such discount will accumulate every two consecutive cover years and can reach up to 100%, meaning that the deductible amount can be reduced to zero.
The discount applies to the original deductible amount of your plan, and will be reset to 0% in the next cover year upon claim payment.
Even if you received hospital cash benefit, outpatient surgery benefit, outpatient surgery cash benefit or worldwide emergency assistance services (see benefits schedule, items 8, 10, 12 and 27 for details), your eligibility for this discount will not be affected.
If you are diagnosed with a serious illness, an expert team is here to help. Through Personal Medical Case Management service, our designated service provider will get you the medical and emotional support you need with ongoing updates on your condition.
When you’re admitted to hospital, worrying about paying for medical care should be the last thing on your mind.
This plan alleviates your burden by settling your hospital bill on your behalf. Once the service is arranged successfully, we will settle directly with the private hospital the medical expenses incurred during hospital stay on your behalf.
You can then focus fully on your recovery without having to worry about paying hospital bills and making a subsequent claim. Any shortfall payment resulting from your hospital stay will be settled after treatment, leaving you stress-free at this critical time. After the final claim amount has been settled, any related benefit limits will be reduced accordingly.
For more information, please refer to our Credit Facility Service for Hospitalisation leaflet.
We understand that everyone’s situation is different. That’s why we offer various benefit combination choices to suit your personal medical needs:
Annual Deductible Choices
HK$0 or US$0
HK$16,000 or US$2,000
HK$25,000 or US$3,125
Whether you are looking for full protection or top-up cover to supplement your current medical plan, annual deductible choices allow you to specify how much you are willing to pay before you claim. Higher deductible amount could lower your premium.
You can also choose to reduce your annual deductible amount to a specified amount without having to provide us with current details of your health upon the anniversary of your cover at the age of 50, 55, 60 or 65. The premium will be adjusted based on your selected deductible amount, and your out-of-pocket limit for a claim will be reduced. Before making your request for this reduction of deductible, you may have to reassess if this reduction can suit your personal needs.
In addition, you have the flexibility to take CEO Essence Medical Plan 2 as either a stand-alone insurance plan or as an add-on plan of specified basic plans.
All information here is for reference only. Please refer to the policy contract for the definitions of capitalised terms, and the exact and complete terms and conditions of coverage.
We would like to remind you to review the relevant product materials and proposal illustrations (if applicable) provided to you and seek independent professional advice if necessary.
Key Product Risks
You need to pay the premium for this plan for life as long as you renew for this plan or for this add-on plan until the basic plan it is attached to is terminated. If you do not pay the premium within 31 days of the premium due date, the policy will be terminated and you / the person protected under the policy will lose the cover.
We will terminate your policy and you / the person protected under the policy will lose the cover when one of the following happens:
the person protected under the policy passes away;
you do not pay the premium within 31 days of the premium due date;
the aggregate benefits under the relevant insurance policy reaches the overall lifetime limit; or
when you take this plan as an add-on plan of any basic plan which has been terminated.
If the person protected under the policy happens to be hospitalised on the date when this plan / add-on plan is terminated because you do not pay the premium within 31 days of the premium due date, we will extend the cover for an additional 30 days without the need for you to make any payments, subject to the same benefit limits which apply to your original plan.
We underwrite the plan and you are subject to our credit risk. If we are unable to satisfy the financial obligations of the policy, the person protected under the policy may lose his cover and you may lose the remaining premium for that policy year.
You are subject to exchange rate risks for plans denominated in currencies other than the local currency. Exchange rates fluctuate from time to time. You may suffer a loss of your benefit values and the subsequent premium payments (if any) may be higher than your initial premium payment as a result of exchange rate fluctuations. You should consider the exchange rate risks and decide whether to take such risks.
The future medical costs will be higher than they are today due to inflation. Hence, the benefit amounts and the future premium rate of this plan may be revised to reflect the inflation (Please refer to Annual Premium Table for the first year premium provided by your financial planner).
Under this plan, we will not cover any of the following events or conditions:
any treatment, investigation, service or supplies which is not medically necessary
any pre-existing condition or congenital defect that appears or is diagnosed before the person protected under the policy reaches the age of 17
self-destruction, intentional self-inflicted injury or drug abuse
war or warlike operations, and civil commotion, any violation or attempted violation of the law or resisting arrest, acts of terrorism for the insured is a terrorist, the use of atomic, biological or chemical weapons as well as radioactive, biological or chemical contamination due to any act of terrorism (except where the insured is injured during a Trip outside the insured’s permanent residence country or place); or when the insured travels to a country at war, or where there is warlike operation, mutiny, riot, civil commotion, martial law or state of siege, or a war zone as recognised by the United Nations
pregnancy, miscarriage, child birth, abortion, or related complications, AIDS or any complications associated with HIV infection, except for the “HIV / AIDS treatment benefit” (see benefits schedule, item 21 for details), mental or nervous disorder, except for the “mental or nervous disorder benefit” (see benefits schedule, item 22 for details)
cosmetic or plastic surgery, dental care or surgery, corrective aids and treatments of refractive errors unless necessitated by injury caused by an accident, body check- up, gradual recovery of health or rest care
consumption of any of the following traditional Chinese medicines, except for the “post-hospitalisation / outpatient surgery ancillary benefit” and "stroke ancillary benefit" (see benefits schedule, items 17b and 24biii for details):
The above list is for reference only. Please refer to the policy contract of this plan for the complete list and details of exclusions.
Premium Adjustment and Product Features Revision
Premium Adjustment In order to provide you with continuous protection, we will annually review and adjust the premium of your plan accordingly at the end of policy year if necessary. During the review, we may consider factors including but not limited to the following:
claim costs incurred from all policies under this plan and the expected claim outgo in the coming year which reflects the impact of medical trend, medical cost inflation and product feature revisions
historical investment returns and the future outlook of the product's backing asset
policy surrenders and lapses
expenses directly related to the policy and indirect expenses allocated to this product
Product Features Revision We reserve the right to revise the benefit structure, terms and conditions and / or product features, so as to keep pace with the times for medical advancement and to provide you with continuous protection.
We will give you a written notice of any revision 31 days before the end of policy year or upon renewal.
Cover for specific items will be effective on the following dates (after the policy commences):
Accidental injury: Immediately
Illness: 30 days
Investigation / treatment / surgery for tonsils, adenoids, hernias or a disease particular to female generative organs: 120 days
Specialist network service: 180 days
HIV / AIDS treatment: 5 years
We only cover the charges and / or expenses of the person protected under the policy on medically necessary and reasonable and customary basis.
“Medically necessary” means that the medical services, diagnosis and / or treatments are::
delivered according to standards of good medical practice;
cannot be safely delivered in a lower level of medical care.
Experimental, screening, and preventive services or supplies are not considered medically necessary.
“Reasonable and customary” means:
the medical services, diagnosis and / or treatments are medically necessary and delivered according to standards of good medical practice;
the costs of your medical services and the duration of your hospital stay are not more expensive or longer than the usual level of charges or duration for similar treatment in the locality of such services delivered; and
does not include charges that would not have been made if no insurance existed.
We may adjust any and all benefits payable in relation to any hospital / medical charges which is not a reasonable and customary charge.
The person protected under the policy will be covered for any room type in which he stays at hospital, but there will be a reduction in his benefit pay-out amount in case the person protected under the policy stays in a room type higher than the plan covered. In such a case, the benefit pay-out amount will be adjusted by multiplying the following factor:
= Daily room charge of the covered room type in the hospital admitted by the person protected under the policy (depends on which country or place the person protected under the policy stays) / Daily room charge of the room the person protected under the policy stays
“Asia” means Afghanistan, Australia, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, New Zealand, North Korea, Pakistan, the Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, and Vietnam.
If the person protected under the policy continuously stays for 365 days in one of following regions, the medical services and / or treatments provided to the person protected under the policy in such region will be permanently reduced to 60% of his benefit pay-out amount. Such reduction applies to all items in the benefits schedule except items 27 and 28:
New Zealand: New Zealand
North America (For emergency treatment only): United States and Canada
Western Europe (For emergency treatment only): Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Monaco, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Vatican City
The Personal Medical Case Management, Specialist Network service and Credit Facility Service for Hospitalisation are not contractual services but the administrative arrangements offered in our absolute discretion. It is subject to termination at any time without prior notice.
If you wish to make a claim, you must notify us in writing within 20 days of the date the covered event happened, and send us the appropriate forms and relevant proof within 90 days of the same date. You can get the appropriate claim forms from your financial planner, by calling the AIA Customer Hotline (852) 2232 8888 in Hong Kong, or (853) 8988 1822 in Macau, or by visiting any AIA Customer Service Centre.
You have the right to cancel and obtain a refund of any premiums and any levy paid by giving written notice to us.
Such notice must be signed by you and submitted to the Customer Service Centre of AIA International Limited at 12/F, AIA Tower, 183 Electric Road, North Point, Hong Kong or the Customer Service Centre of AIA International Limited at Unit 1903, 19/F, AIA Tower, 251A- 301 Avenida Comercial de Macau, Macau within 21 days after the delivery of the policy or issue of the written notice to you or your representative informing you that the policy is available, whichever is earlier.
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