BUPA CAREPRO

STAYING HEALTHY
JUST GOT EASIER

www.bupa.com.hk

INTRODUCTION TO
BUPA CAREPRO

Bupa CarePro offers you exceptional medical protection

at an affordable rate, so you have access to quality
healthcare when you need it. And because you wont be
compromising on your cover in order to support your
budget, Bupa CarePro is a sustainable option. Whats
more, we understand everyones health needs are
different, so we give you the flexibility to add on optional
extras to suit your individual needs.

There is no waiting period, meaning

that you are protected as soon as
your membership starts.

OVERVIEW OF YOUR COVER

Cover at a glance
Basic benefit

Hospital and Surgical Benefit

Optional benefits

Full Cover Benefit

Supplementary Major Medical Benefit

Hospital Cash Benefit

Clinical Benefit

Maternity Benefit

Free benefit

Free Bupa Worldwide Assistance Programme

Medical card

Yes (For members choosing Full Cover Benefit and/or Supplementary Major Medical Benefit)

(/)

Choice of benefit levels

Private (Plan 1 or 4)

( 1 4)
Semi-private (Plan 2 or 5)

( 2 5)
Ward (Plan 3 or 6)

( 3 6)
Eligibility
Issue age

18 years or above

18

Renewal of scheme

Renewal of your cover is guaranteed for life regardless of your claims or changes in
your health

Please refer to the Schedule of Benefits for more information.

1

STEP INTO A WORLD

OF BENEFITS

Our healthcare expertise means that we are able to offer

unparalleled benefits to our members, from higher cover to
expert healthcare and a lifetime of support.

Supporting you ALWAYS

Higher pay-out from a lump sum benefit

No claims renewal bonus

The optimal combinationof our Hospital and Surgical

Benefit and Full Cover Benefitcan cover your basic hospital
expenses.The Full Cover Benefitguarantees that100%
of your hospital expenses will be paid, regardless ofeach
individualitem limit, as long as thetotal bill falls withinthe
annual limit (from HK$200,000 to HK$700,000). To enjoy the
Full Cover Benefit,simplyselect anattending doctor from our
network providers. And in seven renowned private hospitals
appointed by Bupa, you can receive quality treatment without
any payment or claims thanks to our pioneering medical card.
If youwish to consult a doctor outside our network, you will
stillbe coveredunderthe Hospital and Surgical Benefit.

If you do not claim within a specific period, you can enjoy an

increasing renewal discount on your Hospital and Surgical
Benefit and Full Cover Benefit. You will receive 5% discount
if you do not claim for two or three consecutive years, 10%
discount for four or five consecutive years and 15% discount for
six or more consecutive years.

No extra subscription
Regardless of your claim history or changes in health after
joining Bupa CarePro, there will be no increase in subscription
on an individual basis when you renew your contract.

Top-up benefit to cover seriousillnesses

Someseriousor long-term illnesses can rack up unexpected
costs.The Supplementary Major Medical Benefitwill help
to reduce potential out-of-pocket expenses by boosting
your basic cover. Itpays 80% ofyour medical expensesin
excess ofthe amount covered by the Hospital and Surgical
Benefitor Full Cover Benefit. Similar toFull Cover Benefit,
you will receivea medical card. Before a hospital stay,
simply call us to complete a simple registration process and
present this card at any local private hospital. We will payall
your eligible medical expenses directly up to yourcredit
limit,so you dont have to submit any claims.

Please refer to the Question Time section for more details.

w Supplementary Major Medical Benefit is not applicable to

Pre-admission and Post-hospitalisation Out-patient Care and
Emergency Out-patient Benefit for Accidents. A small
deductible is required.

If you choose to add the Full Cover

Benefit to your cover, we will
pre-authorise your medical expenses
before your hospital admission, so all you
have to think about is getting better.

(2070)
100%
7

5%10%
15%

With medical
expertise

Higher cover thanks to per-surgery benefit

Most insurance schemes pay for surgical fees per disability. This
means that all operations related to the same condition will be paid
out of a single maximum benefit limit. Once the limit is exhausted,
you will need to pay the excess. With Bupa, you can claim up to the
maximum benefit limit for each operation, allowing you to enjoy
higher cover if you require more than one operation.

Extra Cancer Treatment and Kidney

Dialysis Benefit

60
10

Bupa Group has been dealing with the diagnosis and treatment of
serious illness like cancer and kidney failure for over 60 years. As
we understand that they often require prolonged treatment, we
offer additional coverage of up to HK$100,000 per year, making
it easier for you to afford more costly and advanced treatment
options. Whats more, if this cover is fully claimed in any one year, it
will be reinstated in the following year for the rest of your lifetime.

Clinical surgery and day-case procedure

We know a lot of treatments do not require overnight hospital

stay such as endoscopies or colonoscopies, so we have not
included a minimum length of stay in your cover. Our Hospital
and Surgical Benefit covers you for both day-case surgery and
clinical operations, increasing the value of your cover.

Cover for accidental injuries

Accidents such as bumps, bruises, burns and scalds can occur
anytime, so we now offer you Emergency Out-patient Benefit
for Accidents, which covers emergency treatment received
at the out-patient department or accident and emergency
department of a hospital, from the result of an accident.
4

Service pledge
No claims procedure is required if you use the
Bupa medical card. All other hospitalisation and
consultation claims will be settled within 5 7
working days after full documentation is received.

5 7

Throughout your life

Lifelong guaranteed renewal

We guarantee that your cover can be renewed for life,

regardless of any changes in your health after joining.

Maternity Benefit

To take care of mums-to-be, we will cover medical expenses

related to your pregnancy needs including the obstetricians
fees, hospitalisation charges, prenatal and postnatal checkup costs, and nursery care for newborn baby for normal
delivery, caesarean section and miscarriage. You will receive
reimbursement after your maternity cover takes effect for 9
months or more.

50%

()
25%
50%

Up to 50% discount for family enrolment

We want to support you as your family grows. If both you and
your children enrol together, each child can enjoy a discount
on Hospital and Surgical Benefit and Full Cover Benefit, if any,
on Bupa Care Kid Health Insurance Scheme for as long as your
membership continues. If one parent enrols, each child will
receive a 25% discount and if both parents enrol, then they will
receive a 50% discount.

Easy enrolment
No medical examinations are required.

THE WORLD OF BUPA

Bupa Group

Established in the UK in 1947, Bupa is now a leading international

healthcare group serving over 14 million customers in more than
190 countries. We are the largest health insurer in the UK.

1947
1901,400

Our diversified healthcare services include health insurance,

hospitals, primary care and dental centres, workplace health
services, home healthcare, health assessments, chronic disease
management services, nursing and residential care for elderly
people.

With no shareholders, we invest our profits to provide more and

better healthcare and fulfill our purpose.

62,000

Bupa employs more than 62,000 people, principally in the UK,

Australia, Spain, Poland, New Zealand and the USA, as well as
Saudi Arabia, Hong Kong, India, Thailand, China and across Latin
America.

Bupas purpose is longer, healthier, happier lives.

BUPAS PRESENCE IN HONG KONG

Bupa is a leading provider in healthcare funding and provision
with two independent units, Bupa Hong Kong and Quality
HealthCare.

Bupa Hong Kong

Bupa Hong Kong has been a health insurance specialist since
1976. Our expertise in healthcare has gained the trust of more
than 310,000 individuals, 2,500 companies and the Hong Kong
Government, who for 17 consecutive years has recommended
Bupa as the provider of quality health insurance for civil
servants.

We have applied our expertise to provide our members with

comprehensive and flexible insurance plans to suit every life
stage and lifestyle. Through our extensive provider network in
Hong Kong, we offer our members a wide choice of doctors.

1976
3031
2,50017

Quality HealthCare
Quality HealthCare Medical Services Limited (QHMS), a leading
private medical network in Hong Kong, became part of the Bupa
group in October 2013. QHMS operations span diagnostics,
primary healthcare and day care specialties.

201310
1868
100500

www.qhms.com

With roots tracing back to 1868, QHMS serves the community

through a network of 100 multi-specialty centres and
approximately 500 affiliated clinics offering Western Medicine,
Traditional Chinese Medicine, Diagnostics & Imaging, Dental,
Physiotherapy and other healthcare services. For more
information, please visit www.qhms.com.

KEEPING YOU
HEALTHY

At Bupa, we use our healthcare expertise to

help people live longer, healthier and happier
lives. We understand that keeping you and
your family well is as important as protecting
you when you become unwell. Using the
expertise of consultants in the UK and Hong
Kong we have created a wealth of free and
easy to use information and tools to help you
take control of your health. These include:
online health information
online health risk calculators and
assessments
fitness apps for your smartphone or iPad
health videos
online doctors advice
health tips and member privileges on
Bupas Facebook page and Weibo page



iPad


Facebook

Use our free services

www.bupa.com.hk
Join Bupas community Facebook
Bupa Hong Kong

QUESTION TIME

1 Is there any minimum length of hospital stay?

There is no minimum length of stay, meaning that procedures

such as endoscopy, a plaster cast, wound sutures,
radiotherapy and chemotherapy, which do not require
hospital confinement, are covered.

2 How do I pay my subscription?

You can pay your subscription monthly or annually according

to your preference.

3 How do I use my Bupa medical card to get the most from my

Full Cover Benefit?

You will need to visit a specialist and clinic appointed by

Bupa and present your medical card upon registration. The
specialist will then get pre-authorisation of the medical
expenses for you if hospital confinement is required. You
can choose from one of the Bupa HealthCare Appointed
Hospitals where your specialist is registered. Once the preauthorisation is confirmed, we will issue you with a Preauthorisation Confirmation / Guarantee of Payment Letter
for your hospital confinement. You will need to show your
medical card and this letter to your selected hospital to enjoy
cashless treatment. Upon discharge, all you need to do is
sign on the claim form provided by the hospital. You are not
required to submit any claims as Bupa will directly settle your
expenses with the hospital.

4,000

You can also use the medical card to settle the expenses
for medical procedure taken at the appointed specialists
designated clinic. If the expenses are under HK$4,000, preauthorisation is not required.

For emergency hospital confinement outside our office

hours, the pre-authorisation can be arranged on the next
working day.

Step-by-step details will be provided in your Membership

Guide.

24

4 If I opt for the Supplementary Major Medical Benefit only,

how do I use my Bupa medical card?

Call us and submit a registration form before you

are admitted to hospital. We will then give you a
Pre-authorisation Confirmation / Guarantee of Payment
Letter. For emergency hospital confinement outside our
office hours, the registration can be submitted on the next
working day.

5 How can I check my membership details or claim status?

You can log in to Bupa Active on our website to access

a host of 24-hour online services or call our dedicated
Customer Care helpdesk. If you have submitted a claim,
once it has been processed you will also receive our SMS
confirmation if you provide us with an up-to-date mobile
phone number.
8

General EXCLUSIONS

We want to help you understand your coverage before enrolment. Below

are the general exclusions:
Pre-existing conditions (whether they are known or unknown to the
member or the subscriber, unless such conditions have been disclosed
in the application and accepted by Bupa).



Treatment, medical service, medication or investigation which is not

medically necessary.



Any illness or injury for which compensation is payable under any

laws or regulations or any other insurance policy or any other sources
except to the extent that such charges are not reimbursed by any
such compensation, insurance policy or sources.



Any charges for accommodation, nursing and services received in

health hydros, nature cure clinics, convalescent home, rest home,
home for the aged or similar establishments.



Any charges in respect of surgical or non-surgical cosmetic treatment,

or hearing tests, routine blood tests, general check-ups, vaccinations
or inoculations, Hair Mineral Analysis (HMA), health supplements
or body weight control, eye refraction including but not limited to
routine eye tests or any costs of fitting of spectacles or lens.



Congenital conditions, developmental conditions or hereditary

conditions.



Treatment that commenced during the first five years of the

members coverage commencement date of this contract and which
in any way arises from, is attributable to, or is consequential upon
Human Immunodeficiency Virus infection.



5


Sexually transmitted (venereal) diseases or their sequel.

Treatment relating to pregnancy, including diagnostic tests for
pregnancy or resulting childbirth, abortion or miscarriage (unless
benefit is available); birth control or sterilisation of either sex;
infertility including in-vitro fertilisation or any other artificial method
of inducing pregnancy; sexual dysfunction including but not limited to
impotence, erectile dysfunction, premature ejaculation, regardless of
cause.





Misuse or overdose of drugs or being under the influence of alcohol,

self-inflicted injuries or attempted suicide.



Treatment relating to any illness or injury resulting from participation

in criminal activities.
Alternative treatment including but not limited to Chinese medicines
treatment, acupuncture, acupressure, Tui Na, hypnotism, rolfing,
massage therapy, aromatherapy, unless benefit is available.



Senile Dementia (including Alzheimers disease), Parkinsons disease,

psychological or psychiatric condition(s) of any and all kinds,
including but not limited to psychoses, neuroses, depression, anxiety,
anorexia nervosa, schizophrenia, behavioural disorders, delirium,
insomnia, neurasthenia.



Any charges for the procurement or use of special braces and

appliances, including but not limited to spectacles, hearing aids and
other equipments such as wheel chairs and crutches.



Any treatment or investigation related to dental or gum conditions

except for emergency treatment arising from accidents or the
extraction of impacted wisdom teeth during hospital confinement.
Follow-up treatment from such hospital confinement shall not be
covered.





Treatment arising from war, invasion, acts of foreign enemies,

hostilities (whether war be declared or not), civil war, rebellion,
revolution, insurrection or military or usurped power or terrorist acts.
Non-medical services, including but not limited to guest meals, radio,
telephone, photocopy, taxes (except the Value-Added Tax or Goods
and Services Tax for medical services), medical report charges and
the like.

 /

Experimental and / or new medical technology or procedure not yet

approved by Bupa.
If you have any pre-existing medical conditions, special exclusions may
be added after underwriting.

Bupa CarePro Health Insurance Scheme

Schedule of Benefits
Effective from 1 January 2014 201411

Maximum Limit (HK$) ()

A Hospital and Surgical Benefit

1

Room and Board (Maximum 270 days each Contract Year)

(270)

Plan 1, 4
Private

Plan 2, 5
Semi-private

Plan 3, 6
Ward

3,100 each day

1,530 each day

750 each day

2 Miscellaneous Hospital Services (Each Contract Year)

()

36,100

21,500

13,600

3 Intensive Care (Supplement to Room and Board)(Each Contract Year)

()()

26,000

22,000

20,500

870 each day

520 each day

320 each day

95,000
49,000
21,100
7,350

59,500
33,300
14,050
6,000

46,500
25,500
10,300
5,000

29,900
13,850
6,450
3,370

17,500
9,450
4,200
2,190

13,500
7,450
3,200
1,970

31,100
15,100
7,190
4,010

18,000
10,400
4,700
2,400

13,700
8,270
3,600
2,180

4 Private Nursing (Maximum 120 days each Contract Year)

(120)

Nursing services during Hospital Confinement or at home after discharge from Hospital
rendered by a Qualified Nurse, subject to written referral from the attending Registered
Medical Practitioner


5 Surgeon and Attendance Fees (For surgical case only)(Each operation)

()()

Complex
Major
Intermediate
Minor

6 Anaesthetists Fees (Each operation)

()

Complex
Major
Intermediate
Minor

7 Operating Theatre Fees (Each operation)

()

Complex
Major
Intermediate
Minor

8 In-patient Physicians Fees (For non-surgical case only)

(Maximum 270 days each Contract Year)
()(270)

2,460 each day

1,080 each day

630 each day

9 In-patient Specialists Fees (Each Contract Year)

()

10,600

3,700

2,300

100,000

75,000

50,000

1,540 each day

765 each day

375 each day

Subject to written referral from the attending Registered Medical Practitioner (except for
services performed by pathologist, radiologist or Physiotherapist during Hospital Confinement)
()

10 Cancer Treatment and Kidney Dialysis (Each Contract Year)

()

Chemotherapy, radiotherapy, cyberknife or gamma knife for cancer treatment or kidney dialysis
during Hospital Confinement or in day-case unit of a Hospital or clinic upon recommendation
by the attending Registered Medical Practitioner


11 Companion Bed (Maximum 270 days each Contract Year)

(270)
12 Pre-admission and Post-hospitalisation Out-patient Care (Each Contract Year)
()

Including two pre-admission visits and all related post-hospitalisation follow-up visits on an
out-patient basis within six weeks after discharge from Hospital
26

4,700

2,650

1,750

10,000

8,000

6,000

13 Emergency Out-patient Benefit for Accidents (Each Contract Year)

()

Cover expenses for consultation, Western Medicaton, diagnostic imaging and laboratory
tests, as well as other related medical fees incurred on an out-patient basis in the out-patient
department or accident and emergency department of a Hospital as a result of an Accident


Overall Annual Limit - Below attained age of 65 on the Contract Effective Date
- 65

Overall Annual Limit - Attained age of 65 or above on the Contract Effective Date
- 65

Bupa (Asia) Limited ()

Address: 18/F, Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong
:25 18
Telephone : (852) 2517 5175 Facsimile : (852) 2548 1848
Website : www.bupa.com.hk

Bupa Hong Kong

Unlimited

720,000

360,000

171,000
MP054/10/0514

Bupa CarePro Health Insurance Scheme

Schedule of Benefits
Effective from 1 January 2014 201411

Maximum Limit (HK$) ()

B Full Cover Benefit (Optional)

()

Plan 4
Private

Plan 5
Semi-private

Plan 6
Ward

This Benefit is payable for eligible expenses of the following items B1 to B11 incurred during your Hospital Confinement, Clinical Operation or Day Case
Surgery provided by the Hospitals, Specialists and day-case centres appointed by Bupa subject to the Maximum Limit per Contract Year. Your treatment
must be referred and attended by a Bupa HealthCare Appointed Specialist.
B1B11

Canossa Hospital

HK Adventist Hospital

HK Baptist Hospital

HK Sanatorium & Hospital

St Pauls Hospital

St Teresas Hospital

Union Hospital

Bupa HealthCare Appointed Hospitals

No. of Bupa HealthCare Appointed Specialists

1

Around 600

Room and Board

2 Miscellaneous Hospital Services

3 Intensive Care
4 Private Nursing

Nursing services during Hospital Confinement or at home after discharge from Hospital
rendered by a Qualified Nurse, subject to written referral from the attending Registered
Medical Practitioner


5 Surgeon and Attendance Fees

Full cover

6 Anaesthetists Fees

Full cover

Full cover

7 Operating Theatre Fees

8 In-patient Physicians Fees
9 In-patient Specialists Fees

Subject to written referral from the attending Registered Medical Practitioner (except for
services performed by pathologist, radiologist or Physiotherapist during Hospital Confinement)
 ()

10 Cancer Treatment and Kidney Dialysis

700,000

400,000

200,000

Maximum Limit (Each Contract Year)

- Attained age of 65 or above on the Contract Effective Date
() - 65

400,000

250,000

150,000

Full Cover Benefit is payable for eligible medical expenses incurred during Hospital Confinement, Day Case Surgery and Clinical Operation up to the

Maximum Limit per Contract Year. Pre-admission and Post-hospitalisation Out-patient Care, and Emergency Out-patient Benefit for Accidents will be
paid under items A12 and A13.
Your Bupa HealthCare (BHC) Card can be used to settle payment for Hospital Confinement or Clinical Operation(s) at the Bupa HealthCare Appointed
Hospitals and Specialists clinics, subject to a credit limit approved by Bupa.
After Full Cover Benefit is exhausted, you can claim the Hospital and Surgical Benefit for your next treatment.
A12A13




MP054/10/1113/50K

Maximum Limit (Each Contract Year)

- Below attained age of 65 on the Contract Effective Date
() - 65

Printed on recycled paper

11 Companion Bed

Bupa CarePro Health Insurance Scheme

Schedule of Benefits
Effective from 1 January 2014 201411

Maximum Limit (HK$) ()

C Supplementary Major Medical Benefit (Optional)

()

Plan 1, 4
Private

Plan 2, 5
Semi-private

Reimbursement percentage

Plan 3, 6
Ward

80%

Maximum Limit (Each Contract Year) ()

550,000

280,000

110,000

Lifetime Limit (Only applicable to Members who attain the age of 65 or above)
(65)

800,000

400,000

200,000

This Benefit is payable after any item of A1 - A11 under Hospital and Surgical Benefit or Full Cover Benefit (if applicable) is exhausted
and is subject to HK$500 deductible per claim.
Your Bupa HealthCare (BHC) Card can be used to settle payment for Hospital Confinement at any local private Hospitals, subject to
a credit limit approved by Bupa.
In case of overseas hospitalisation, only medical Emergency cases will be covered.

Adjustment factors will be applied if you are confined in a higher room level than your chosen level:
- From Semi-private Room to Private Room
: 50%


- From Ward to Semi-private Room
: 50%


- From Ward to Private Room
: 25%


A1 - A11()500



-
: 50%
-
: 50%
-
: 25%

D Hospital Cash Benefit (Optional)

()
Payable from the third day of Hospital Confinement
(Maximum 182 days each Contract Year)
3 (182)

Plan 1, 4

1,000 each day

E Clinical Benefit (Optional)

()
1

General Practitioner (Consultation fee only) ()

Specialist (Consultation fee only) ()

Subject to written referral from a Registered Medical Practitioner

3 Home Consultation (Consultation fee only) ()

Physiotherapist (Treatment fee only) ()

Subject to written referral from a Registered Medical Practitioner

Chiropractor (Treatment fee only) ()

Subject to written referral from a Registered Medical Practitioner

Plan 1, 4

300 each day

Plan 2, 5

Plan 3, 6

415 each visit

255 each visit

195 each visit

695 each visit

515 each visit

375 each visit

760 each visit

540 each visit

375 each visit

650 each visit

450 each visit

340 each visit

650 each visit

450 each visit

340 each visit

285 each visit

210 each visit

170 each visit

285 each visit

210 each visit

170 each visit

4,800

2,930

1,840

3,700

2,100

1,600

Chinese Herbalist
C
 onsultation fee (including basic Medically Necessary Chinese Medicines prescribed at the
Registered Chinese Medicine Practitioners clinic and obtained at a legitimate source on the
same day of consultation)
Payable for acupuncture performed by a Registered Chinese Medicine Practitioner
()

Chinese Bonesetter
C
 onsultation fee (including basic Medically Necessary Chinese Medicines prescribed at the
Registered Chinese Medicine Practitioners clinic and obtained at a legitimate source on the
same day of consultation)
Payable for acupuncture performed by a Registered Chinese Medicine Practitioner
()

Prescribed Western Medication (Each Contract Year) ()

M
 edically Necessary Western Medication prescribed by a Registered Medical Practitioner and
obtained at a legitimate source

Diagnostic Imaging and Laboratory Tests (Each Contract Year)

()
Subject to written referral from a Registered Medical Practitioner

Number of visits per Contract Year for items E1 E7 above is 30 in total and is subject to a maximum of one visit per item per day. Number of visits per
Contract Year for items E6 - E7 above is 10 in total.
E1E730E6E710

Printed on recycled paper

500 each day

Plan 3, 6

MP054/10/1113/50K

Plan 2, 5

Bupa CarePro Health Insurance Scheme

Schedule of Benefits
Effective from 1 January 2014 201411

Maximum Limit (HK$) ()

F Maternity Benefit (Optional)

()

Plan 1, 4

Plan 2, 5

Plan 3, 6

Normal Delivery (Per pregnancy) ()

35,000

23,000

16,000

Caesarean Section (Per pregnancy) ()

52,500

34,500

24,000

Miscarriage (Per pregnancy) ()

17,500

11,500

8,000

The Maternity Benefit shall cover medical expenses incurred for the following during pregnancy:


- Hospital Confinement


- Consultation of a Registered Medical Practitioner and Prescribed Western Medication


- Diagnostic tests, prenatal check-up and postnatal check-up

- Nursery care of newborn baby


This Benefit does not cover any medical expenses incurred by the newborn baby during Hospital Confinement.

This Benefit is payable provided that the pregnancy commences after this Benefit takes effect and you have been continuously covered under this Benefit
for 9 months or more.


-
-
-
-

9

G Free Bupa Worldwide Assistance Programme (Each Contract Year)

()
Provides admission deposit in the event of hospitalisation overseas and in Mainland China, unlimited cover for emergency medical evacuation and
repatriation, and an extra hospital benefit of HK$120,000 after repatriation to Hong Kong. A 24-hour hotline for travel, medical or legal information and
assistance is also available.

1224

6




(i)  ()

(ii) 
-
- 4,000
-

(iii)

(iv)

(v) /

(vi) 








()65


/ /

MP054/10/1113/50K

About Hospital and Surgical Benefit

Clinical Operation or Day Case Surgery, if eligible, will be paid under Hospital and Surgical Benefit. Clinical Operation and Day Case Surgery mean Medically Necessary
surgical procedures which may be carried out at a clinic or day-case unit of a Hospital by a Registered Medical Practitioner where a stay in Hospital is not required,
provided that the surgical procedure is classified as such by Bupa.
Referral letter

A referral letter is valid for the same or related medical condition for six months from the issue date. Another referral letter is required for treatment of a new or
unrelated medical condition.
About Full Cover Benefit

Please follow the requirements below to enjoy Full Cover Benefit:


(i) Always present your doctors referral letter (except for gynaecology, paediatrics and family medicine) and your BHC Card to the Bupa HealthCare Appointed
Specialist upon registration.


(ii) Pre-authorisation confirmation must be obtained from Bupa for the following situations:


- Hospital Confinement or Day Case Surgery


- Clinical Operation(s) exceeding HK$4,000


- Specialist treatment for which the relevant specialty is not practised by any Bupa HealthCare Appointed Specialist.


(iii) If you have received treatment outside our office hours, please obtain authorisation from Bupa on the next working day.


(iv) Your treatment at any Bupa HealthCare Appointed Service Providers must be referred and attended by the Bupa HealthCare Appointed Specialist.


(v) Please present your BHC Card with Bupas Pre-authorisation Confirmation / Guarantee of Payment letter to the Bupa HealthCare Appointed Hospital upon
admission and use it to pay the medical expenses.


(vi) You must be confined at the restricted room level or lower.

If the above requirements are not followed, your claims, if eligible, will be paid under Hospital and Surgical Benefit.

If you receive treatment at the day-case centre of an appointed Hospital, there is no need to show your BHC Card. Please settle your expenses with the Hospital and
submit your claim to us.

Please settle your out-patient expenses at the Bupa HealthCare Appointed Specialists clinic, unless Hospital Confinement, Day Case Surgery or Clinical Operation is
Medically Necessary and pre-authorisation, if required, is obtained during the same clinic visit.
About Supplementary Major Medical (SMM) Benefit

This Benefit is subject to the Maximum Limit per Contract Year or the Lifetime Limit (if applicable), whichever is lower. The SMM Benefit, which is paid from age 65 will
be deducted from the Lifetime Limit and the balance will become the Lifetime Limit of the next Contract Year. After the Lifetime Limit is exhausted, this Benefit shall
automatically terminate.

This Benefit will not be payable for Hospital Confinement in the suite, VIP or deluxe room of a Hospital.

Printed on recycled paper

NOTES

BUPA CAREPRO HEALTH INSURANCE SCHEME

TABLE OF SUBSCRIPTIONS
Effective from 1 January 2014 201411
All figures in HK$ 

A Hospital and Surgical Benefit +

B Full Cover Benefit

A Hospital and Surgical Benefit

Plan 2
Semi-private

Plan 3
Ward

Plan 5
Semi-private

Plan 6
Ward

Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly 
5,370
5,437
5,513
5,618
5,667
5,717
5,767
5,849
5,963
6,078
6,200
6,355
6,774
7,460
7,564
7,651
7,779
7,913
8,076
8,274
8,533
8,787
9,128
9,462
9,775
10,121
10,415
10,762
11,047
11,334
11,663
12,008
12,450
13,899
15,095
15,312
15,630
15,919
16,240
16,722
17,331
18,091

515
521
529
539
543
548
553
561
572
583
595
609
650
715
725
734
746
759
774
793
818
843
875
907
937
971
999
1,032
1,059
1,087
1,118
1,152
1,194
1,333
1,448
1,468
1,499
1,527
1,557
1,604
1,662
1,735

2,981
3,020
3,060
3,121
3,149
3,176
3,204
3,248
3,313
3,375
3,442
3,527
3,780
4,154
4,203
4,242
4,310
4,385
4,477
4,587
4,729
4,869
5,058
5,244
5,417
5,609
5,772
5,964
6,121
6,281
6,466
6,657
6,934
7,625
8,368
8,470
8,646
8,808
9,001
9,269
9,662
10,076

286
290
293
299
302
305
307
311
318
324
330
338
363
398
403
407
413
421
429
440
454
467
485
503
519
538
554
572
587
602
620
638
665
731
802
812
829
845
863
889
927
966

1,617
1,637
1,661
1,693
1,708
1,723
1,738
1,761
1,791
1,830
1,867
1,915
2,049
2,252
2,300
2,325
2,353
2,392
2,439
2,496
2,568
2,653
2,743
2,844
2,937
3,042
3,131
3,228
3,326
3,413
3,507
3,610
3,719
4,136
4,558
4,631
4,728
4,817
4,908
5,025
5,210
5,413

The subscriptions below are for renewal only 

60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80 or above



Plan 4
Private

155
157
159
162
164
165
167
169
172
175
179
184
196
216
221
223
226
229
234
239
246
254
263
273
282
292
300
310
319
327
336
346
357
397
437
444
453
462
471
482
500
519

6,028
6,102
6,186
6,301
6,355
6,410
6,464
6,554
6,679
6,803
6,935
7,104
7,701
8,396
8,509
8,605
8,746
9,328
9,512
9,737
10,035
10,331
10,826
11,205
11,565
11,957
12,297
12,809
13,148
13,490
13,882
14,292
16,203
17,706
18,957
19,255
19,648
20,657
21,901
22,551
23,406
24,463

578
585
594
604
609
614
620
629
641
653
665
681
739
805
816
825
839
895
912
933
962
991
1,038
1,074
1,109
1,147
1,179
1,228
1,260
1,294
1,331
1,371
1,554
1,698
1,818
1,846
1,884
1,981
2,100
2,163
2,245
2,346

3,225
3,267
3,309
3,374
3,404
3,433
3,462
3,509
3,578
3,644
3,714
3,804
4,287
4,665
4,718
4,761
4,835
4,981
5,082
5,203
5,362
5,519
5,952
6,162
6,359
6,576
6,763
6,979
7,162
7,349
7,565
7,789
8,667
9,383
10,152
10,291
10,501
10,699
10,936
11,262
11,740
12,255

309
314
317
323
326
330
332
336
343
350
356
365
412
447
452
457
463
478
487
499
515
529
571
591
609
631
649
669
687
704
725
747
831
900
973
987
1,007
1,026
1,049
1,080
1,126
1,175

1,749
1,770
1,796
1,830
1,847
1,862
1,878
1,902
1,935
1,975
2,015
2,065
2,233
2,436
2,486
2,513
2,543
2,715
2,767
2,830
2,911
3,005
3,107
3,217
3,321
3,435
3,534
3,778
3,890
3,993
4,104
4,224
4,470
4,899
5,331
5,420
5,533
5,637
5,748
5,890
6,106
6,345

168
170
172
175
177
178
180
183
186
189
193
198
214
234
239
241
244
260
265
271
279
288
298
309
319
330
339
363
373
383
393
405
429
470
511
520
530
541
552
565
586
608

18,999
19,906
21,092
22,225
23,538
24,808
26,192
27,819
29,307
30,748
32,292
33,966
35,700
37,495
39,302
41,123
42,746
44,581
46,433
48,298

1,822
1,909
2,023
2,131
2,257
2,379
2,512
2,668
2,811
2,949
3,097
3,257
3,424
3,596
3,769
3,944
4,099
4,275
4,453
4,632

10,582
11,088
11,694
12,440
13,050
13,880
14,515
15,369
15,891
16,211
16,617
16,853
17,145
17,415
17,662
17,885
17,993
18,167
18,313
18,435

1,015
1,063
1,121
1,193
1,251
1,331
1,392
1,474
1,524
1,555
1,594
1,616
1,644
1,670
1,694
1,715
1,726
1,742
1,756
1,768

5,618
5,828
6,088
6,334
6,639
7,023
7,794
8,333
8,619
8,834
8,966
9,165
9,289
9,444
9,579
9,698
9,804
9,852
9,929
9,998

539
559
584
607
637
674
747
799
827
847
860
879
891
906
919
930
940
945
952
959

25,660
26,612
27,843
29,366
31,204
35,304
37,108
39,301
41,403
43,377
45,241
47,521
49,947
52,458
54,987
57,534
59,804
62,372
64,964
67,573

2,461
2,552
2,670
2,816
2,992
3,386
3,559
3,769
3,971
4,160
4,339
4,557
4,790
5,031
5,273
5,518
5,735
5,981
6,230
6,480

13,315
13,980
14,742
15,663
16,511
17,648
18,434
19,458
20,119
20,524
21,775
22,084
22,467
22,821
23,144
24,229
24,376
24,612
24,809
24,975

1,277
1,340
1,413
1,502
1,583
1,692
1,768
1,866
1,929
1,969
2,089
2,118
2,154
2,188
2,220
2,323
2,338
2,360
2,379
2,395

6,582
6,836
7,134
7,421
7,779
8,725
9,565
10,181
10,530
10,783
10,964
11,596
11,763
11,957
12,128
12,493
12,833
13,129
13,231
13,544


631
656
684
711
746
837
917
976
1,010
1,034
1,052
1,112
1,128
1,147
1,163
1,198
1,230
1,259
1,269
1,299

50,176

4,812

18,534

1,777

10,049

964

71,254

6,833

25,454

2,441

13,801

1,324

Printed on recycled paper

18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59

Plan 1
Private

MP055/11/1113/50K

Attained
Age

BUPA CAREPRO HEALTH INSURANCE SCHEME

TABLE OF SUBSCRIPTIONS
Effective from 1 January 2014 201411
All figures in HK$ 

A Hospital and Surgical Benefit +

C Supplementary Major Medical Benefit
Plan 2
Semi-private

Plan 3
Ward

Plan 5
Semi-private

Plan 6
Ward

Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly Annual  Monthly 
6,991
7,102
7,201
7,333
7,406
7,481
7,560
7,675
7,826
7,984
8,147
8,347
9,053
9,979
10,131
10,255
10,430
10,606
10,821
11,092
11,424
11,749
12,200
12,646
13,070
13,529
13,921
14,386
14,771
15,155
15,602
16,109
17,403
19,692
21,264
21,602
22,047
22,451
22,922
23,554
24,363
25,348

670
681
691
703
710
717
725
736
751
766
782
800
869
957
971
984
1,000
1,017
1,037
1,063
1,095
1,127
1,170
1,212
1,253
1,298
1,335
1,380
1,416
1,453
1,496
1,545
1,669
1,889
2,040
2,071
2,114
2,153
2,198
2,259
2,336
2,431

3,846
3,909
3,961
4,036
4,078
4,117
4,160
4,223
4,307
4,390
4,481
4,588
4,986
5,486
5,559
5,619
5,712
5,809
5,928
6,070
6,251
6,427
6,674
6,920
7,151
7,402
7,617
7,870
8,079
8,289
8,539
8,803
9,322
10,374
11,294
11,458
11,688
11,906
12,154
12,510
13,019
13,546

369
375
379
387
391
395
399
405
413
421
430
440
479
526
533
539
547
558
568
582
600
616
640
664
685
710
731
755
775
795
819
844
894
995
1,083
1,099
1,121
1,142
1,165
1,200
1,249
1,299

2,122
2,151
2,183
2,223
2,245
2,269
2,293
2,326
2,367
2,419
2,469
2,531
2,700
2,971
3,033
3,068
3,110
3,161
3,223
3,298
3,389
3,495
3,617
3,748
3,873
4,010
4,127
4,256
4,384
4,506
4,639
4,780
4,990
5,584
6,125
6,226
6,353
6,481
6,602
6,762
6,989
7,237

The subscriptions below are for renewal only 

60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80 or above



Plan 4
Private

203
206
209
213
215
217
220
223
227
231
237
243
258
285
291
294
299
303
309
316
325
335
347
360
372
385
396
409
420
432
445
458
479
536
587
597
609
622
633
649
671
694

7,649
7,767
7,874
8,016
8,094
8,174
8,257
8,380
8,542
8,709
8,882
9,096
9,980
10,915
11,076
11,209
11,397
12,021
12,257
12,555
12,926
13,293
13,898
14,389
14,860
15,365
15,803
16,433
16,872
17,311
17,821
18,393
21,156
23,499
25,126
25,545
26,065
27,189
28,583
29,383
30,438
31,720

733
745
756
768
776
783
792
804
820
836
852
872
958
1,047
1,062
1,075
1,093
1,153
1,175
1,203
1,239
1,275
1,333
1,379
1,425
1,474
1,515
1,576
1,617
1,660
1,709
1,764
2,029
2,254
2,410
2,449
2,499
2,607
2,741
2,818
2,919
3,042

4,090
4,156
4,210
4,289
4,333
4,374
4,418
4,484
4,572
4,659
4,753
4,865
5,493
5,997
6,074
6,138
6,237
6,405
6,533
6,686
6,884
7,077
7,568
7,838
8,093
8,369
8,608
8,885
9,120
9,357
9,638
9,935
11,055
12,132
13,078
13,279
13,543
13,797
14,089
14,503
15,097
15,725

392
399
403
411
415
420
424
430
438
447
456
467
528
575
582
589
597
615
626
641
661
678
726
752
775
803
826
852
875
897
924
953
1,060
1,164
1,254
1,274
1,299
1,323
1,351
1,391
1,448
1,508

2,254
2,284
2,318
2,360
2,384
2,408
2,433
2,467
2,511
2,564
2,617
2,681
2,884
3,155
3,219
3,256
3,300
3,484
3,551
3,632
3,732
3,847
3,981
4,121
4,257
4,403
4,530
4,806
4,948
5,086
5,236
5,394
5,741
6,347
6,898
7,015
7,158
7,301
7,442
7,627
7,885
8,169

216
219
222
226
228
230
233
237
241
245
251
257
276
303
309
312
317
334
340
348
358
369
382
396
409
423
435
462
474
488
502
517
551
609
661
673
686
701
714
732
757
783

26,577
27,828
29,348
30,859
32,514
36,593
39,813
42,725
45,467
48,099
51,107
54,202
57,542
61,032
64,599
68,244
71,613
75,395
79,259
83,205

2,549
2,669
2,815
2,959
3,118
3,509
3,818
4,097
4,361
4,613
4,901
5,198
5,519
5,853
6,195
6,545
6,867
7,230
7,601
7,980

14,194
14,835
15,615
16,549
17,342
19,515
21,029
22,440
23,416
24,105
24,930
25,517
26,195
26,848
27,473
28,062
28,478
29,001
29,484
29,932

1,361
1,422
1,497
1,587
1,663
1,871
2,017
2,152
2,246
2,312
2,391
2,447
2,512
2,575
2,635
2,691
2,732
2,781
2,827
2,871

7,491
7,773
8,113
8,467
8,885
10,150
11,413
12,264
12,810
13,233
13,601
14,001
14,344
14,717
15,066
15,396
15,677
15,923
16,194
16,449

719
746
778
812
852
974
1,094
1,176
1,229
1,269
1,304
1,343
1,376
1,412
1,445
1,476
1,503
1,527
1,553
1,578

33,238
34,534
36,099
38,000
40,180
47,089
50,729
54,207
57,563
60,728
64,056
67,757
71,789
75,995
80,284
84,655
88,671
93,186
97,790
102,480

3,188
3,312
3,462
3,644
3,853
4,516
4,865
5,198
5,521
5,824
6,143
6,498
6,885
7,288
7,699
8,119
8,503
8,936
9,378
9,828

16,927
17,727
18,663
19,772
20,803
23,283
24,948
26,529
27,644
28,418
30,088
30,748
31,517
32,254
32,955
34,406
34,861
35,446
35,980
36,472

1,623
1,699
1,789
1,896
1,995
2,232
2,393
2,544
2,651
2,726
2,886
2,949
3,022
3,093
3,161
3,299
3,344
3,399
3,450
3,498

8,455
8,781
9,159
9,554
10,025
11,852
13,184
14,112
14,721
15,182
15,599
16,432
16,818
17,230
17,615
18,191
18,706
19,200
19,496
19,995


811
843
878
916
961
1,137
1,264
1,353
1,412
1,456
1,496
1,576
1,613
1,653
1,689
1,744
1,793
1,841
1,870
1,918

87,230

8,365

30,343

2,909

16,677

1,600

108,308

10,386

37,263

3,573

20,429

1,960

Printed on recycled paper

18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59

Plan 1
Private

MP055/11/1113/50K

Attained
Age

A Hospital and Surgical Benefit +

B Full Cover Benefit +
C Supplementary Major Medical Benefit

BUPA CAREPRO HEALTH INSURANCE SCHEME

TABLE OF SUBSCRIPTIONS
Effective from 1 January 2014 201411

Additional Options

All figures in HK$ 

D Hospital Cash Benefit

Additional Subscription
Plan 1, 4

Attained
Age 

Annual


18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49

753
758
764
770
776
782
789
795
805
814
820
827
1,036
1,045
1,055
1,064
1,074
1,083
1,093
1,102
1,115
1,130
1,145
1,162
1,179
1,197
1,217
1,237
1,260
1,282
1,304
1,324

Monthly

72
73
73
74
74
75
76
76
77
78
79
79
99
100
101
102
103
104
105
106
107
108
110
111
113
115
117
119
121
123
125
127

Plan 2, 5
Annual

369
372
374
377
380
383
386
389
394
399
402
405
508
512
517
521
526
531
535
540
547
554
562
569
577
585
594
602
610
618
626
636

Monthly

35
36
36
36
36
37
37
37
38
38
39
39
49
49
50
50
50
51
51
52
52
53
54
55
55
56
57
58
58
59
60
61

Plan 3, 6
Annual

221
223
225
226
228
230
232
234
237
239
241
243
295
298
302
305
307
310
313
316
321
326
331
335
341
348
352
357
362
366
372
378

Monthly

21
21
22
22
22
22
22
22
23
23
23
23
28
29
29
29
29
30
30
30
31
31
32
32
33
33
34
34
35
35
36
36

Attained
Age 

50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80 or above


Plan 1, 4
Annual


Monthly


1,823
1,835
1,848
1,872
1,896
1,921
1,957
1,986
2,037
2,105
2,168
2,260
2,344
2,452
2,590
3,397
3,523
3,630
3,724
3,807
3,872
3,919
3,964
4,003
4,036
4,067
4,097
4,120
4,137
4,153

175
176
177
180
182
184
188
190
195
202
208
217
225
235
248
326
338
348
357
365
371
376
380
384
387
390
393
395
397
398

4,163

399

Plan 2, 5
Annual


Plan 3, 6

Monthly


Annual


Monthly


892
899
910
920
930
941
956
973
998
1,032
1,062
1,107
1,148
1,202
1,269
1,648
1,701
1,752
1,799
1,830
1,860
1,884
1,906
1,927
1,946
1,961
1,972
1,983
1,991
1,997

86
86
87
88
89
90
92
93
96
99
102
106
110
115
122
158
163
168
173
175
178
181
183
185
187
188
189
190
191
192

536
540
543
550
558
565
574
584
596
610
622
638
654
672
694
989
1,023
1,056
1,082
1,103
1,118
1,131
1,142
1,155
1,167
1,178
1,184
1,187
1,192
1,199

51
52
52
53
54
54
55
56
57
58
60
61
63
64
67
95
98
101
104
106
107
108
110
111
112
113
114
114
114
115

2,006

192

1,203

115

E Clinical Benefit
Additional Subscription
Plan 3, 6

Monthly


Annual


Monthly


Annual


Monthly


Attained
Age 

18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49

5,430
5,532
5,621
5,708
5,794
5,867
5,942
6,018
6,097
6,179
6,267
6,350
7,315
7,478
7,650
7,810
7,975
8,141
8,294
8,449
8,626
8,796
8,997
9,179
9,362
9,566
9,783
9,983
10,186
10,379
10,589
10,813

521
531
539
547
556
563
570
577
585
593
601
609
702
717
734
749
765
781
795
810
827
844
863
880
898
917
938
957
977
995
1,015
1,037

4,186
4,255
4,332
4,410
4,466
4,523
4,581
4,639
4,696
4,754
4,818
4,876
5,640
5,765
5,899
6,023
6,147
6,276
6,393
6,514
6,643
6,780
6,915
7,017
7,136
7,270
7,403
7,527
7,670
7,815
7,998
8,184

401
408
415
423
428
434
439
445
450
456
462
468
541
553
566
578
589
602
613
625
637
650
663
673
684
697
710
722
736
749
767
785

3,308
3,362
3,421
3,483
3,535
3,585
3,632
3,680
3,723
3,769
3,821
3,871
4,433
4,536
4,641
4,748
4,852
4,957
5,049
5,146
5,242
5,339
5,437
5,519
5,612
5,717
5,824
5,918
6,013
6,114
6,251
6,396

317
322
328
334
339
344
348
353
357
361
366
371
425
435
445
455
465
475
484
494
503
512
521
529
538
548
559
568
577
586
599
613

50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80 or above
 

Plan 1, 4
Annual

11,280
11,548
11,763
11,943
12,140
12,333
12,517
12,732
12,958
13,202
13,480
13,754
14,042
14,363
14,731
15,571
15,879
16,130
16,341
16,534
16,718
16,912
17,064
17,240
17,386
17,507
17,595
17,681
17,772
17,872
17,948

Monthly

1,082
1,107
1,128
1,145
1,164
1,183
1,200
1,221
1,243
1,266
1,293
1,319
1,347
1,377
1,413
1,493
1,523
1,547
1,567
1,586
1,603
1,622
1,636
1,653
1,667
1,679
1,687
1,696
1,704
1,714
1,721

Plan 2, 5

Plan 3, 6

Annual

8,380
8,583
8,759
8,931
9,105
9,288
9,472
9,642
9,798
9,948
10,095
10,235
10,366
10,504
10,636
11,206
11,412
11,615
11,797
11,953
12,125
12,284
12,416
12,562
12,692
12,803
12,892
12,981
13,046
13,097

Monthly

804
823
840
856
873
891
908
925
940
954
968
982
994
1,007
1,020
1,075
1,094
1,114
1,131
1,146
1,163
1,178
1,191
1,205
1,217
1,228
1,236
1,245
1,251
1,256

Annual

6,476
6,595
6,703
6,814
6,927
7,053
7,167
7,281
7,391
7,515
7,652
7,787
7,943
8,105
8,252
8,374
8,489
8,612
8,757
8,888
9,010
9,128
9,242
9,369
9,463
9,565
9,632
9,697
9,748
9,806

Monthly

621
632
643
653
664
676
687
698
709
721
734
747
762
777
791
803
814
826
840
852
864
875
886
898
908
917
924
930
935
940

13,177

1,264

9,869

946

Printed on recycled paper

Plan 2, 5

Annual


MP055/11/1113/50K

Plan 1, 4

Attained
Age 

BUPA CAREPRO HEALTH INSURANCE SCHEME

TABLE OF SUBSCRIPTIONS
Effective from 1 January 2014 201411

Additional Options

All gures in HK$

F Maternity Benet (For Female Members with Maternity Benet only) (

Additional Subscription
Plan 2, 5

Plan 1, 4

Attained Age

Plan 3, 6

Annual

Monthly

Annual

Monthly

Annual

Monthly

11,812
15,750

1,133
1,510

7,762
10,350

744
993

5,400
7,200

518
690

15,750

1,510

10,350

993

7,200

690

18 - 29 years
30 - 49 years
50 - 54 years (For renewal only)
50 - 54 ()

No Claim Renewal Discount

A no claim renewal discount will be applied to the next renewal subscription of Hospital and Surgical Benet and Full Cover Benet provided that no claims
payment has been made or is payable under Hospital and Surgical Benet and Full Cover Benet during any one of the following periods:

Period without claims payment

No claim renewal discount

2 or 3 consecutive Contract Years

23

5%

4 or 5 consecutive Contract Years

45

10%

6 consecutive Contract Years or above

6

15%

Notes
This Table of Subscriptions is only applicable to Members who are aged 18 to 59 years (inclusive) on the Coverage Commencement Date. For those who are aged 60
years or above on the Coverage Commencement Date, please refer to other applicable Table of Subscriptions.
Any new applicant who is aged between 60 and 69 years has to pay an extra 50% subscription of Hospital and Surgical Benet and Full Cover Benet as shown in the
table upon enrolment and renewal. If the applicant is aged 70 years or above, the subscription of Hospital and Surgical Benet and Full Cover Benet will be doubled.
However, they only have to pay standard subscriptions for Hospital Cash Benet and Clinical Benet upon enrolment and renewal.
185960
606950%70

Subscription rates are not guaranteed and Bupa may adjust them on an annual basis.

Bupa (Asia) Limited ()

Address: 18/F, Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong
: 2518
Telephone : (852) 2517 5175 Facsimile : (852) 2548 1848
Website : www.bupa.com.hk

Bupa Hong Kong

MP055/11/0514

In the event of any discrepancy in respect of meaning between the Chinese version and the English version, the English version shall prevail. All terms and conditions are
subject to the Contract.

BUPA CAREPRO HEALTH INSURANCE SCHEME APPLICATION FORM

To ensure your cover can take effect on the first day of the following month, please send us the completed
application form at least 5 working days prior to the end of the month. Applications are subject to
underwriting.
c5ee

Contract No. 
Effective Date 

For Bupa use

only

Please complete this form in ENGLISH and BLOCK LETTERS. Please tick as appropriate.
ce

Personal Details of Applicant (Applicant must be aged 18 or above 18)

Given Name (Same as HKID Card) Sex HKID Card No. / Passport No. Date of Birth Height
DD  MM
YY



Surname

Weight

FP

ft

Home
Address

Flat / Room


Floor

Correspondence
Address

Block

Bldg. / Mansion / House



(If different from

Home Address
)

Court / Estate / Street



kg

lb

Flat / Room


Marital Status (Optional)


Single
Married
With children

Floor

Smoker

Yes
No

Block

Bldg. / Mansion / House


Court / Estate / Street


District

Kln / HK / NT


District

Business Nature

Home / Office Phone No.



Email Address 

Job Position

Home / Office Fax No.



Mobile Phone No.

Kln / HK / NT


Country of Residence #
(If not in Hong Kong )

Please give details if your spouse is a Proposed / Existing Member of Bupa CarePro and / or your child(ren) is a Proposed / Existing Member of Bupa Care Kid:
cci
Spouses Name
Date of Birth
HKID Card No.
Membership No.

Childrens Name

Date of Birth

HKID Card No.

Membership No.

Childrens Name

Date of Birth

HKID Card No.

Membership No.

* Unless requested below, Bupa will send the claims statement and Shortfall invoice, if applicable, by email only. No printed copy will be provided.
cce
Please send me printed copies of the claims statement and Shortfall invoice, if applicable. e
#
Unless otherwise specified by Member in writing, Inter Partner Assistance Hong Kong Limited will consider Hong Kong as the Country of Residence of the
Member and repatriate the Member to Hong Kong when Medically Necessary.
 cce
Unless requested below, Bupa will provide the List of Bupa HealthCare Appointed Hospitals and Specialists via our online service, Bupa Active, and we will
not provide any printed copy (If you have chosen the Full Cover Benefit).
ce
Please send me a printed copy of the List of Bupa HealthCare Appointed Hospitals and Specialists. e

Choice of Cover
Optional Benefit

Core Benefit

Hospital and Surgical Benefit



Full Cover Benefit (applicable to Plan 4, 5 and 6 4, 5 6)

Benefit Level (Choose one )

Hospital Cash Benefit

Supplementary Major Medical Benefit (age must be below 60 60)

Plan

1 / 4 Private

Plan

2 / 5 Semi-private

Plan

3 / 6 Ward

Total Subscription
paid with
Application (HK$)

()

Clinical Benefit
Maternity Benefit (age must be below 50 50)

The Full Cover Benefit is payable up to the Maximum Limit per Contract Year. e

Payment Method
Payment Method

Remarks

Autopay 
(From renewal payment only )

Please attach a cheque made payable to Bupa (Asia) Limited for

the 1st years Subscription with a completed Direct Debit
Authorisation Form c
c

Cheque
Bank Name

Please attach a cheque made payable to Bupa (Asia) Limited

c

Cheque No.
Please attach a completed Credit Card Authorisation Form

Autopay

Please attach a cheque made payable to Bupa (Asia) Limited for

the first 2 months Subscription with a completed Direct Debit
Authorisation Form c
c

Credit Card

Please attach a completed Credit Card Authorisation Form

If the cheque issuer is not the applicant, please fill in the following information. ce
Relationship with
Reason for paying Subscription
the applicant
on behalf of the applicant

PAAPP

Monthly

Credit Card

Printed on recycled paper

Yearly

MP053/11/1113/18K

Payment Frequency

Bank Account for Reimbursement

Claims payment will be reimbursed by autopay only. e
I hereby agree and authorise Bupa (Asia) Limited to reimburse claims payment to the account below. e
Account Holders Name
HKID Card No.

Personal Hong Kong savings / current account number (HK$ only) 
Bank Name

Bank No.

Account No.

If the above account holder is not the applicant, please fill in the following information.
ce
Relationship with the applicant (Applicable to
Reason for receiving claims payment on behalf of the applicant
spouse, parents or children only d)

Health Declaration
Please note that non-disclosure of health information may result in your Contract being void and / or disqualify your claim(s) from assessment and / or reimbursement.
ce
At any time during the past seven years from the time of this Application, have you:
ci
1 had any chronic or recurrent diseases, had any injuries not completely recovered or been diagnosed as a Hepatitis B carrier?
 dj
2 exhibited any of the following symptoms in a repeated / persistent way? j
Fever, headache, dizziness, chest pain or discomfort, shortness of breath, blood spitting, hoarseness or cough, night sweating, loss of consciousness,
seizure, indigestion, vomiting, abdominal pain, diarrhea, jaundice, blood in the stool or urine, abnormal vaginal bleeding, dysuria, incontinence, allergy,
back and / or leg pain, joint pain / swelling, or unintentional body weight change in the past 12 months, etc?
 ddddddddddddddddd
 dddd12j
3 received any in-patient treatment / operation / physiotherapy? j
4 had any medical investigations / examinations or is there a foreseeable need for these in future? j
5 taken any regular medications? j
If you answered YES to any of the above questions, please give details of the medical condition(s) in the table below and also provide a copy of the relevant
medical report(s). If the space below is insufficient, please fill in the Supplementary Health Declaration Form.

Yes

No

with attachment

Symptom / Diagnosis

Investigation and its result / Treatment /
Operation / Medication

Date of onset
Date of recovery
Fully recovered? (Yes / No)
"
Name, Address and Tel. No. of Doctor
d

Declaration and Authorisation

I enrol as a Member of Bupa CarePro Health Insurance Scheme (Scheme) and acknowledge that Benefit is not payable under this Scheme for any costs of treatment arising from
any existing illnesses, injuries or other conditions presented before the Coverage Commencement Date unless complete current details are fully disclosed by me in this Application
and accepted by Bupa. I declare that, to the best of my knowledge and belief, the statements contained in this Application are true and complete. I acknowledge that Bupa reserves
the right to ask for submission of more details of health status or medical reports of me at my own cost. I have read and agreed to be bound by the terms and conditions of the
Contract of this Scheme and I agree that this Health Declaration and the answers given in this Application shall be the basis of the Contract between me and Bupa.
I hereby authorise Bupa to appoint Registered Medical Practitioners, Hospitals, cancer centres, day case centres, diabetic centres and other service providers to provide Full Cover
Benefit (if applicable) and to do all things and acts incidental to such appointment for me. I acknowledge and agree that such appointment shall be made on such terms and conditions
as Bupa shall think fit at its absolute discretion. Bupa shall not be liable for any claim whatsoever which may be made against Bupa HealthCare Appointed Service Providers by me.
cdcc
ecccece
ce
dddde
ece

Applicable to Application through authorised insurance broker

I understand, acknowledge and agree that, as a result of me purchasing and taking up the policy to be issued by Bupa, Bupa will pay the authorised insurance broker commission
during the continuance of the policy including renewals, for arranging the said policy.
I further understand that the above agreement is necessary for Bupa to proceed with the Application.
dcce
ce

Personal Information Collection Statement

Signed in Hong Kong on



Agent's / Broker's / Telesales' Name (If applicable and must be completed by the applicant)


Agent's / Broker's / Telesales' Code



(Name i

DD / MM / Y Y

Agent's / Broker's / Telesales' Contact Tel. No.



For Transfer Contract Only

Previous Bupa Membership No.:
i
Subject to Bupa's approval of membership transfer, eligible claims related to any sicknesses or injuries that were covered under the previous Contract and
commenced before the effective date of coverage under this Contract will be payable up to the Maximum Limit of the Contract with the lower Benefit level.
cccce
Applicant's Signature

Date( DD / MM / Y Y)

MP053/11/1113/18K

Applicant's Signature

Printed on recycled paper

I have read and understand the Personal Information Collection Statement on the last page of this application form. I understand that I have the right to request Bupa to cease
using my Personal Information for direct marketing purposes by writing to Bupa's Data Protection Officer or calling the Customer Care helpdesk at 2517 5333.
c2517 5333ce

BUPA CAREPRO HEALTH INSURANCE SCHEME DIRECT DEBIT AUTHORISATION FORM

Subscribers Name

Tel No.

If autopay is chosen as the payment method, please complete this form, sign where marked "X" and return the original copy to Bupa with a cheque for the Subscription.
c;ce
If you choose to return this form by mail, please photocopy the Personal Information Collection Statement on the back of this page for your reference. This information
can also be found on our website. cee
Name of party to be credited (The beneficiary)

Bank No.

Branch No.

Account No.

0 0 4 4 9 9 2 1 5 0 0 2 0 0 1

BUPA (ASIA) LIMITED

I / We hereby authorise my / our below named Bank to effect transfers from my / our
account to that of the above named beneficiary in accordance with such instructions as my
/ our Bank may receive from the beneficiary from time to time.
I / We agree that my / our Bank shall not be obliged to ascertain whether or not notice of any
such transfer has been given to me / us.
I / We jointly and severally accept full responsibility for any overdraft (or increase in existing
overdraft) on my / our account which may arise as a result of any such transfer(s).
I / We agree that should there be insufficient funds in my / our account to meet any transfer
hereby authorised, my / our Bank shall be entitled, in its discretion, not to effect such
transfer in which event the Bank may make the usual charge and that it may cancel this
authorisation at any time on one week's written notice.
This authorisation shall have effect until further notice.
I / We agree that any notice of cancellation or variation of this authorisation which I / we may
give to my / our Bank shall be given at least two working days prior to the date on which such
cancellation / variation is to take effect.

    c 
e

My / Our Bank and Branch Name

Bank No.

My / Our Account No.





 e
c
e
c 
cc
e
e
  c  c 
e

My / Our name as recorded on Statement / Passbook

My / Our Signature(s)

HKID Card No. / Passport No.







X
Date ( DD / MM / YY)

My / Our address as recorded on Statement / Passbook


Debtor's Name (If other than account holder)
()

Membership No. (Debtor's Reference)

()

If the account holder is not the applicant / Subscriber, please fill in the following information. / ce
Reason for paying Subscription on behalf of the applicant / Subscriber
 
 
Relationship with the applicant / Subscriber
For bank use only

Signature Verified

Notes: 1. The box marked Membership No. is to be completed by Bupa.

2. The signature on this authorisation form must be the same as the signature of your Bank Account.

i 1. e
2. e

BUPA CAREPRO HEALTH INSURANCE SCHEME CREDIT CARD AUTHORISATION FORM

Subscribers Name

Tel No.

If credit card payment is chosen as the payment method, please complete this form, sign where marked X and return this form to Bupa by mail or by fax. If you have faxed
this form to Bupa, please do not return it to us by mail again. c;cece
If you choose to return this form by mail, please photocopy the Personal Information Collection Statement on the back of this page for your reference. This information can
also be found on our website. cee

Visa
Cardholders Name

Annual Payment Only

MasterCard
HKID Card No.

Diners Club

American Express

Credit Card Account No.

Credit Card Expiry Date

(MM / YY)

I hereby authorise and direct Bupa (Asia) Limited to debit the Subscription due from my credit card account on an annual /
monthly basis until further notice. ce

Total Annual / Monthly Subscription

 (HK$ )

If the Cardholder is not the applicant / Subscriber, please fill in the following information. ce
Reason for paying Subscription on behalf of the applicant / Subscriber
Relationship with the applicant / Subscriber



I hereby confirm to pay the Subscription due of Bupa CarePro Health Insurance Scheme for the applicant / Subscriber below

(Mr / Mrs / Ms)
with HKID Card No.


Cardholder's Signature

Contact Phone No.

Date(DD / MM / YY)

Printed on recycled paper

Annual / Monthly Payment

For Bupa use only

Bupa CarePro Membership No.i

Authorised Code :

Subscription (HK$) :

Date(DD / MM / YY) : 

MP053/11/1113/18K

Personal Information Collection Statement

Bupa (Asia) Limited (the Company)
Personal Information Collection Statement (the Statement) relating to the Personal Data (Privacy) Ordinance (the Ordinance)
In compliance with the Ordinance, the Company would like to inform you of the following:
1. From time to time, it is necessary for you, or the member, to supply the Company with certain personal information including without limitation your name,
identity card number (and copy of identity card), passport number, contact information, health and medical information(including family history)and
nancial information ("Personal Information") when you apply for insurance or nancial products and services from the Company, or when you apply to make
changes to your policy, or when you renew a policy ;
2. Failure to supply Personal Information requested by the Company may result in the Company being unable to process your Application and/or provide
products, services and other related services to you, or the member;
3. During the course of your relationship with the Company, further Personal Information relating to you, or the member, may also be collected in the ordinary
course of our business, for example, when you lodge insurance claims with the Company.
4. Personal Information relating to you, or the member, may be used for the following purposes:
a. processing, assessing and determining any Applications for insurance products and services;
b. offering and providing products and services to you, or the member, and processing requests made by you, or the member, from time to time, including
but not limited to requests for addition, alteration, deletion, maintenance, management and operation of insurance benets or insured members;
c. any purposes in connection with any claims made by or against or otherwise involving you, or the member, in respect of any products and/or services
provided by the Company including, without limitation, making, defending, analysing, investigating, processing, assessing, determining or responding to
such claims;
d. performing any functions and activities related to the products and/or services provided by the Company including, without limitation, audit, reporting,
market research, general servicing, maintenance of online and other services, identity verication, data matching, research and statistical analysis, and
reinsurance arrangements;
e. provision and design of products and services of the Company;
f. exercising the Companys rights in connection with provision of insurance products and services to you, or the member, from time to time, for example,
to determine any amount of indebtedness from you, and collecting and recovering owing from you or any person who has provided any security or
undertaking for your liabilities;
g. communication with you or the member in relation to any of the purposes set out in this Statement;
h. enabling an actual or proposed assignee, transferee, participant or sub-participant of all or a substantial part of the Companys rights or business to
evaluate the transaction intended to be the subject of the assignment, transfer, participation or sub-participation; and
i. making disclosure to satisfy the requirements of any laws, rules and regulations, codes of practice, guidance notes or guidelines binding on the Company.
5. Personal Information collected or held by the Company relating to you, or the member, will be kept confidential but the Company may provide such
Personal Information inside or outside the Hong Kong Special Administrative Region, for the purposes specified in paragraph (4) and (6) to the following
classes of transferees:
a. British United Provident Association Limited and Bupa International Limited (Group Company);
b. any insurance intermediaries authorised by you and the Company
c. any re-insurance companies authorised by the Company;
d. any agent, contractor or third party service providers who provide administrative, telecommunications, computer, payment, data processing or storage,
printing, research or other services to the Company in connection with the operation of business (including without limitation insurers, banks, lawyers,
accountants, claims investigators, debt collection agencies, data processing companies, research agencies and professional advisors);
e. any actual or proposed assignee, transferee, participant or sub-participant of all or a substantial part of the Companys rights or business;
f. any person to whom the Company is under an obligation to make disclosure under the requirements of any law, rules, regulations, codes of practice or
guidelines binding on the Company including, without limitation, any applicable regulators, governmental bodies, industry recognised bodies, credit
reference agencies, the Courts, and where otherwise required by law.
6. The Company may use your, or the members, Personal Information to provide you, or the member with Marketing Communications relating to the following
products and services of the Company or Group Company, including but not limited to:
a. insurance and related services and products; and
b. rewards, member activities, loyalty or privileges programmes and related services and products.
The Company will not disclose Personal Information relating to you, or the member to third parties for marketing purposes without your consent.
7. Under and in accordance with the terms of the Ordinance, you have the following rights:
a. to check whether the Company holds Personal Information relating to you or the member and to access such Personal Information;
b. to require the Company to correct any Personal Information relating to you or the member which is inaccurate;
c. to ascertain our policies and practices in relation to personal data and to be informed of the kind of personal data held by the Company, and
d. to request the Company to cease using your Personal Information for direct marketing purposes.
Requests can be made in writing to the Companys Data Protection Ofcer at the following address:
Data Protection Ofcer,
18/F, Berkshire House,
25 Westlands Road, Quarry Bay, Hong Kong
8. In accordance with the terms of the Ordinance, the Company has the right to charge a reasonable fee for the processing of any Personal Information access
or correction request.
9. For any enquiries about this Statement, please do not hesitate to contact our Customer Care helpdesk at 2517 5333.
10. Nothing in this Statement shall limit the rights of customers under the Ordinance.
11. In case of discrepancies between the English and Chinese versions of this Statement, the English version shall prevail.
()
()

1.
() ()
2. /
3.
4.
a.
b.
c.
d. /

e.
f.

g.
h.
i.

5. (4)(6)
a. British United Provident Association Limited Bupa International Limited()
b.
c.
d.

e.
f.

6. :
a.
b.

7. ,
To h
a.
elp u
b.
s pro
quic

kly,
cess
c.

enclo lease en your Ap

d.
plica
sure
sed

p
tion
Subs
that
you
cript ayment
2518
ha
o
ion a
HKI

mou f the cor ve:

in D Card
nt an
re
or P

itiall
d a c ct
a
e
opy
appli d any a ssport
8.
of yo
m
c
a
en

tion
ur
9. 2517 5333

form dments

on t
10.

his

11.

Rem

Bupa (Asia) Limited

Address: 18/F, Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong
: 2518
Telephone : (852) 2517 5175 Facsimile : (852) 2548 1848 Website : www.bupa.com.hk
Bupa Hong Kong

inde

Bupa Membership Important Notes

To help you understand the key aspects of this scheme clearly, we would like to call
your attention to the following:

Please take some time to study the general exclusions in your contract, as well
as the additional exclusion(s) listed on your Membership Certificate, if any.

This contract will last for 1 year and Bupa guarantees that your cover can be
renewed for your whole life, regardless of any changes in your health after
joining. We also understand that your health needs may change throughout
your life and thus you have the flexibility to change your benefits every year
upon renewal. If you wish to upgrade your plan or add any benefit in future, you
are required to complete a health declaration form for medical underwriting
purposes.

The Bupa Healthcare (BHC) Card is provided to members who are entitled to
Supplementary Major Medical Benefit or Full Cover Benefit. You do not need to
make payment when discharged or submit claims if you have the BHC Card.
However, we will place a temporary hold on your credit card for HK$500 until
the claim assessment is completed.

If you have enrolled for our Full Cover Benefit, please read through the relevant
section in your Membership Guide to make the most of your benefit. You will
need to choose a Bupa CarePro / Bupa Care Kid appointed specialist and clinic
for consultation. Please present your referral letter and BHC card upon your
visit.

Your renewal subscription will be automatically collected at the next renewal if

you choose to pay by autopay or credit card, unless we have received any
instructions from you to the contrary.

There is no waiting period for your cover and you are protected as soon as your
membership starts. However, you have the right to cancel this contract. If you
choose to do so, please send us a written notice within 21 days from the
Coverage Commencement Date that is shown on your Membership Certificate
and we will refund you the full subscription paid.

Bupa Membership Important Notes

500

21