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GLOBAL LEADER IN HEALTH SERVICES
About CignaRooted in health expertise dating back over 200
years through its predecessor companies, Cigna was
established in 1982 following the merger of the INA
Corporation and Connecticut General Corporations.
A respected leader in worldwide health services, we
continue to innovate, expand and grow globally. As
of 2013, our multi-national office network spans 30
countries and serves over 80 million customers.
Over the years our reliability and trustworthiness have
been recognized with consistently strong ratings by
internationally reputable bodies, as well as being ranked
103 on the Fortune 500.
International Rating Company Rating
A.M. Best A (Excellent)
Moody’s A2 (Good)
Standard & Poor’s A+ (Strong)
Fitch A (Strong)
Remark: Rating of Connecticut General Life Insurance Company as of 2013.
About Cigna Hong Kong Cigna has been committed to improving people’s health,
wellbeing and sense of security since its presence in
Hong Kong in 1933. Having delivered on this promise
for over 80 years, we continue to provide a broad range
of insurance solutions that are designed to satisfy our
customers and their loved ones’ every unique need.
Innovative to our products and services, we have
garnered a number of leading industry awards and
recognitions in Hong Kong:
•WinneroftheCapitalOutstandingEnterpriseAwards–
the Outstanding Life & Health Insurance Company for
two consecutive years (2013 & 2014)
•CapitalHonorGrandAwards– theMostCustomer-
Centric Company (2013)
•Annual Grand awards and a number of service
excellence awards from HK Call Centre Association
(2007-2013)
•Oneofthefirst local insurerstoachievethePayment
Card Industry Data Security Standard’s (PCI-DSS)
highest level of compliance (2012)
•Firstdedicatedlocaltelemarketinginsurancechannelto
receive certification by ISO 27001, the international best
practice standard for Information Security Management
Systems (2007)
Cigna HealthFirst Medical Plans annsla s Pl
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CIGNA HEALTHFIRST CHOICE
PLAN HIGHLIGHTS
A helping hand in the event of emergency, HealthFirst Choice saves your hassle at times when
you need to focus on your own health.
Cashless hospitalization - No admission deposit, no claim required after discharge1
You can be admitted in the private hospitals in Hong Kong for medical treatment without
deposit at hospital admission or claim procedures after discharge. Simply call our 24-hour Cigna
HealthFirst Hotline to arrange pre-approval to enjoy this hassle-free service that allows you to
concentrate on your health.
Extra protection when you are in deepest needWhenserious illnesscomes,oneneedsextramedicalanddailycare.Theplancoversnot
only your hospitalization expenses but also other common expenses such as pre-admission
and post-hospitalization treatment and private nursing expenses. It also includes additional
coverage for cancer treatment and dialysis. In addition, the Second Medical Opinion Service
offers you alternative medical opinions through a network of world-leading medical centers
and experts.
24-hour hotline 8203 2202 provides cashless hospitalization pre-approval services and
you can seek advice directly from medical professionals.
Cancer treatment and dialysis benefit up to HK$160,000, giving you an extra peace of
mind.
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APPLY NOW FOR EXCLUSIVE PRIVILEGES
Flexible plan that fits your unique needsThemedicaladvancesmakemanytreatmentsandcheck-upseasierwithout theneedof
hospitalization. Saving the hassle of being admitted to hospital, the plan even covers MRI,
CTScanandPETScancarriedout inaclinic formedicalconditionsrelatedtothehospital
confinement.What’smore?Theplanoffersanarrayofoptionalbenefits2 to customize your
coverage:
•SupplementaryMajorMedicalBenefit–additionalbenefitofuptoHK$575,000peryear
•HospitalCashBenefit–adailyHK$600hospitalcashperday
•OutpatientBenefit–ChineseHerbalist,ChineseBonesetter,Acupuncturist,Physiotherapist,
Home Consultation, etc.
•DentalBenefit–scalingandpolishing,oralexamination,extractions,fillings,X-ray,rootcanal
fillings, etc.
An array of optional benefits giving you an all-round protection. For a few more dollars a
day, you can also take up HealthFirst TopUp plan to extend your coverage to HK$1 million.
Remarks: 1 You are required to settle any expenses exceeding your maximum benefit limit.2 For details of coverage, please refer to Cigna HealthFirst Choice Benefit Schedule. You have to
enroll on the same benefit level for both Hospital and Surgical Benefits and optional benefits.
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EXCLUSIVE PRIVILEGES
Complimentary Cigna Lifelong Preventive ProgramTheplanoffersfree annual influenza vaccination, body check and skin consultation.Therearealso
various health and wellness services at a discounted price. Please visit www.cigna.com.hk/cignaclub for
details.
Health RewardTocelebrateyourgoodhealth,youcanenjoyapremiumdiscountatrenewal.
Number of consecutive policy years of no Hospital and Surgical claim record
Discount at Renewal (for whole policy)
2 5%
3 8%
5 or above 15%
Guaranteed Lifetime Renewal Thepolicyisguaranteerenewable1 every year regardless to your individual health/ claims record.
Children’s Discount30% premium discount2 on the first year for child (from 15 days to age 17) enrolling policy with his/her
parent.
Remarks: 1 You are guaranteed lifetime renewal of your policy subject to the continuing issuance of HealthFirst Choice medical plan
and the payment of the premium. Cigna reserves the right to revise policy premiums, terms and conditions, and /or the Benefit Schedule upon each renewal.
2 Discount applies to Hospital and Surgical Benefits and other optional benefits. Parent and child have to enroll on the same plan level and same option of riders in order to obtain the discount.
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For more details, please talk to your financial consultant or visitwww.cigna.com.hk.
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CASE ILLUSTRATION
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How HealthFirst Choice helped Mr. Wong? Cashless hospitalization can be easily arranged through the 24-hour hotline.
Chemotherapyiscoveredby“CancerTreatmentandDialysis”, leavingthe“OtherMedicalExpenses”benefittocover the miscellaneous hospital charges.
TheplancoversthePETscanconductedinaclinicthatsavedhimthehassleofadmissiontoahospital.
Totalamountcovered(HK$):
Cigna HealthFirst Choice Benefits Maximum Limit of Plan 2(Semi-private) Medical Expense Incurred Amount Covered
Room & Board 1,600x14days=22,400 1,600x14days=22,400 22,400
Surgical (complex) 65,000 60,000 60,000
Anaesthetist (complex) 16,000 16,000 16,000
OperationTheatre(complex) 16,600 15,000 15,000
Other Medical Expenses (includingoutpatientPETscan) 21,500 48,000 21,500
Chemotherapy 120,000 8,500x15times=127,500 120,000
Total 288,900 254,900
ExpensespaidbyMr.Wong 34,000
Remarks:
TheaboveSurgicalExpensesareforreferenceandillustrationpurposeonly.Actualamountmaydifferfromcasetocase.
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Theissueageisfrom15daysto75yearsold,policyrenewaltill100yearsold.
Hospital and Surgical BenefitsMaximumLimit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
Hospital Room and Board (maximum 270 days per Policy Year) 3,200 per day 1,600perday 750 per day
Surgical Expenses (Per Surgery)
Complex 95,000 65,000 48,000
Major 47,500 32,500 25,000
Intermediate 20,500 13,600 10,000
Minor 7,500 6,500 5,500
Anaesthetist’s Expenses (Per Surgery)
Complex 26,900 16,000 12,300
Major 13,200 9,100 7,100
Intermediate 6,000 4,000 3,000
Minor 3,200 2,200 2,000
OperationTheatreExpenses(PerSurgery)
Complex 27,400 16,600 12,500
Major 13,500 10,000 8,100
Intermediate 6,500 4,200 3,500
Minor 3,250 2,200 2,000
Inpatient Doctor's Call (for non-surgical case only, maximum 270 days per Policy Year) 3,200 per day 1,600perday 750 per day
CancerTreatmentandDialysis 160,000 120,000 80,000
Intensive Care Unit Expenses 25,500 22,000 20,100
Inpatient Specialist's Fee 10,000 3,800 2,500
Companion Bed (maximum 270 days per Policy Year) 1,500 per day 750 per day 350 per day
Pre-admission and Post-Hospitalization Outpatient Expenses (maximum 2 pre-admission and 2 post-hospitalization clinic visits)
4,500 2,500 1,800
Private Nursing Expenses (maximum 120 days per Policy Year) 850 per day 500 per day 325 per day
OtherMedicalExpenses– include in-hospital / clinicalexpensesofMRI,CTscan,PETscan,hospitalmiscellaneouscharges, etc. (per Policy Year)
35,000 21,500 13,600
Overall Annual Limit
Belowattainedageof65ontheCommencementDate Unlimited
Attainedageof65oraboveontheCommencementDate 700,000 375,000 175,000
No Claim Discount
No claim record for 2 consecutive years 5% 5% 5%
No claim record for 3 consecutive years 8% 8% 8%
No claim record for 5 consecutive years or more 15% 15% 15%
Life Benefit 5,000
Cigna HealthFirst Choice – Benefit Schedule
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Cigna HealthFirst Choice (Optional Benefits) – Benefit Schedule
Supplementary Major Medical Benefit
MaximumBenefit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
Maximum limit per Policy Year 575,000 290,000 120,000
Lifetime Limit (applicable from age 75 onwards) 850,000 450,000 220,000
Remarks: • Foreachclaim,HK$500willbedeductedfromtheclaimamountandthereimbursementamountis80%oftheremainingbalance.• Theclaimamountwillbeadjustediftheactualhospitalconfinementishigherthantheeligibleplanlevel.Pleaserefertothepolicy
provisions for details.
Hospital Cash BenefitMaximumBenefit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
Covers from the 3rd day of hospital confinement, maximum 182 days per Policy Year 600perday
Outpatient BenefitMaximumBenefit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
1. General Practitioner (include 3-day basic medication) 380 240 180
2. Specialist* (include 3-day basic medication) 660 480 350
3. Physiotherapist* (treatment fee only) 630 430 330
4. Chiropractor* (treatment fee only) 630 430 330
5. Chinese Herbalist (include 2 packs of Chinese medicines) 230 180 150
6.ChineseBonesetter 230 180 150
7. Acupuncturist (treatment fee only) 230 180 150
8. Home Consultation (consultation fee only, per visit) 720 520 350
9.PrescribedWesternMedicine(perPolicyYear) 2,500 1,500 1,000
10.DiagnosticImagingandLaboratoryTests*(perPolicyYear) 3,500 2,000 1,500
Remarks: * Referral from a Physician required.•Maximum30visitsforitems1to8,withinwhichamaximumof10visitsforitems4to8perPolicyYear.• Foritems1to7,fullcoverfornetworkclinicor80%reimbursementuptotherespectivemaximumbenefitlimitfornon-networkclinic.
Dental BenefitMaximumBenefit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
Scaling and Polishing (per Policy Year) 2 visits
Fillings; dentures, crowns and bridges; drainage of abscesses; extractions;X-rays;rootcanalfillings;routineoralexamination
Unlimited visits, with maximum limit of 5,000 for all items per Policy Year
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Recommended plan for extra protection
CIGNA HEALTHFIRST TOPUP
Thankstoadvancementinmedicaltechnology,manynewmedicaltreatmentshaveemerged.Youmay
thus choose a better treatment, but also implies higher medical fees. For as low as a few extra dollars a day,
HealthFirstTopUpoffersanannualcoverageofuptoHK$1milliontohelpeaseyourfinancialburdeninthe
event of unexpected medical expenses.
Case Illustration
How Cigna HealthFirst TopUp helped Mr. Lee?ThoughthewardlevelplanofHealthFirstChoiceisenoughtocoverbasicmedicalexpenses,TopUpmakesadifference
when it comes to very complex and high risk surgery which involves substantial medical expense like in Mr. Lee’s case.
SincethebenefitpayableunderCignaHealthFirstChoiceishigherthantheHK$50,000deductibleofCignaHealthFirst
TopUp,Mr.Leedidnotneedtopayanydeductible.
Totalamountcovered(HK$):
CignaHealthFirstTopUpBenefits Medical Expenses Incurred Maximum Limit ofHealthFirstChoice(Wardlevel)
CoveredbyTopUp(90% of remaining balance)
Surgical (complex) 300,000 48,000 226,800
Anaesthetist (complex) 90,000 12,300 69,930
OperationTheatre(complex) 120,000 12,500 79,380
Other Medical Expenses 90,000 13,600 68,760
Total 600,000 86,400 444,870
Expenses paid by Mr. Lee 68,730
Remarks:
TheaboveSurgicalExpensesareforreferenceandillustrationpurposeonly.Actualamountmaydifferfromcasetocase.
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Cigna HealthFirst TopUp – Benefit Schedule
Remarks: 1ThemaximumbenefitlimitforthisitemisHK$10,000perPolicyyear.2 If the benefit payable under Hospital and Surgical Benefits of Cigna HealthFirst Choice is higher than your selected deductible,
then the reimbursement amount is 90% of the claim without any deductible.
Theissueageisfrom15daysto65yearsold,policyrenewalistill100yearsold.
Hospital and Surgical BenefitsMaximumLimit(HK$)
Plan 1 (Private) Plan 2 (Semi-Private) Plan3(Ward)
Hospital Room and Board (maximum 270 days per Policy Year)
$1,000,000 (Pays 90% of Hospital and Surgical
Benefits after an annual Deductible2)
Surgical Expenses
Anaesthetist's Expenses (Subject to 35% of Surgical Expenses payable)
OperationTheatreExpenses(Subject to 35% of Surgical Expenses payable)
Inpatient Doctor's Call (maximum 270 days per Policy Year)
CancerTreatmentandDialysis
Intensive Care Unit Expenses
Inpatient Specialist's Fees
Companion Bed (maximum 270 days per Policy Year)
Pre-admission and Post-Hospitalization Outpatient Expenses1 (maximum 2 pre-admission and 2 post-hospitalization clinic visits)
Private Nursing Expenses (maximum 120 days per Policy Year)
Other Medical Expenses
Life Benefit 5,000
Deductible options (per year) 150,000 / 200,000 100,000 / 150,000 50,000 / 100,000
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EXCLUSION PROVISIONSCigna shall not be liable for the expenses incurred in the following situations:
Applicable to Cigna HealthFirst Choice and Cigna HealthFirst TopUp: 1. Pre-existing Medical Conditions;2. War,invasion,actofforeignenemy,hostilities(whetherwarisdeclaredornot),civilcommotion,rebellion,revolution,insurrection,militaryorusurped
power or terrorism;3. ThePersonInsured’sengaginginortakingpartin: a ) Naval, military or air force service or operations, armed force or service with the police of any nation; b ) Professional sports or hazardous activities such as but not limited to scuba diving involving the aid of breathing apparatus, rock climbing or
mountaineering, parachuting, hang-gliding (whether powered or not), paragliding, bungee-jumping, winter sports or any kind of race other than by foot; c) Workingatheight(over20feet); d ) Operating heavy machinery; e ) Aviation or aerial activities except air travel as a fare-paying passenger in or as a member of the aircrew; or f ) Manufacture, storing, filling, breaking down, handling or transport of any explosive (including but not limited to fireworks or firecrackers) or chemical
material;4. ThePersonInsured’ssuicide,attemptedsuicideorintentionallyself-inflictedinjurieswhilesaneorinsane;5. ThePersonInsuredbeingundertheinfluenceofalcoholordrugsunless, inthecaseofdrugconsumption, it isproventhatsuchdrugwastakenin
accordance with proper medical prescription by a physician other than for the treatment of drug addiction; the Person Insured’s driving any kind of vehicle while the alcohol content of his/her blood exceeds the level permitted by the laws of the country or territory where the accident resulting in bodily injury or sickness occurs; or any act of the person insured being contrary to the law of the country or territory in which the bodily injury or sickness occurs as a result of such act;
6. Pregnancy,childbirthandmiscarriageoforabortionbythePersonInsured, includingcomplicationsresultingtherefromnotwithstandingthatsuchincident may have been accelerated or induced by bodily injury or sickness;
7. 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; infertility or sterilization or any type of fertility;
8. Birth defects, congenital conditions, development conditions, hereditary conditions or any disabilities arising therefrom; cosmetic and elective surgery; 9. Eye refraction error except due to bodily Injury, routine eye/ear examinations, cost of spectacles, contact lenses, hearing aids and artificial lens; vaccination
and immunization injections;10. All dental treatment prescribed by dentist except emergency treatments by a physician during hospital confinement due to bodily injury. Follow up
treatment from such hospital confinement shall not be covered (unless the Dental Benefit is covered under this Policy);11. Mental, psychiatric or nervous illness; congenital conditions; developmental conditions; or hereditary conditions;12. Artificial life maintenance including mechanical ventilation, where such treatment will not or is not expected to result in the person insured’s recovery, or
restore the person insured to his/her previous state of health; or fetal surgery or treatment;13. Treatmentforarelatedconditionresultingfromaddictiveconditionsanddisorders;sleepdisordersincludinginsomnia,snoring,sleep-relatedbreathing
problems or sleep studies;14. Not medically necessary;15. Nuclearenergyrelated(Nuclearreaction,radiationorcontamination;andthisclauseonlyappliestoCignaHealthFirstTopUp);16. ThePersonInsured’svoluntarilyexposureofthepersoninsuredtoanyhazardordanger;and17. Fees / expenses incurred from the following reasons: a ) Convalescence accommodation or treatment or services rendered in any sanatorium or similar establishment; b ) Prosthesis, corrective devices and medical appliances, which are not intra-operatively required; c ) All organ transplantation, transplant procedures and acquisition of the organ itself to be used for organ transplantation; d ) Medical treatment received after termination of this Policy or the expiry of the period of insurance notwithstanding that such expense may arise from
bodily injury or sickness occurring during the Period of Insurance; e ) Routine medical examinations or health screening checks; f ) Subject to the Clause on Co-Ordination of Benefits in Policy Provision, any bodily injury or sickness for which compensation is payable under any laws
or regulations or any other insurance plan except to the extent that such charges are not reimbursed by such laws or regulations or other insurance plan;
g) Alternativetreatmentincludingbutnot limitedtoChinesemedicinetreatment,acupuncture,acupressure,TuiNai,hypnotism,rolfing,massagetherapy, aromatherapy (unless it is an acupuncturist benefit, Chinese herbalist benefit and Chinese bonesetter benefit payable under the Benefit Schedule);
h ) Experimental and/or new medical technology/procedure not yet approved by Cigna; and i ) Non-medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes, medical report charges and the like.
Applicable only to Optional Dental Benefit: 1. Appliances or restoration necessary to increase vertical dimension or restore an occlusion; 2. Dental implants; 3. Cosmetic dentistry procedures such as bleaching and veneers; 4. Orthodontic services; 5. Repair or replacement of orthodontic appliances;6. Placementofbonegraftsorextra-oralsubstancesinthetreatmentofperiodontaldisorders; 7. Procedures or appliances to correct congenital malformations;8. Treatmentofmalignancies,cysts,orneoplasms; 9. Replacement of lost or stolen dentures;10. Servicesortreatmentfor,orassociatedwith,temporomandibularjoint(TMJ)dysfunctionordisorderorfororthognathicsurgery;11. Services or supplies intended to diagnose or treat any condition that is occupational injury or disease; or12. Replacement or additions to existing dentures or bridgework.
Notes:1. TheaboveinsuranceplansareunderwrittenbyCignaWorldwideLifeInsuranceCompanyLimited.2. Thisbrochureispreparedtoprovideyouwithabriefsummaryoftheinsuranceplans,theirterms,conditionsandexclusionsandisnotacontractof
insurance. For details of coverage and exclusions, please refer to the policy provisions.3. Any case example extracted in this brochure is for illustrative purpose only. It shall not be construed as an admission of our liability under any claim. Claim
payment depends on facts of different cases. Cigna reserves its right to make final decision on all claims payment.4. If there is any discrepancy between the English and Chinese version of this brochure, the English version shall prevail.