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Silver Plan
  • Benefits up to RMB10 million
  • Coverage area: Asia including Australia and New Zealand
  • Access to quality health care: easy access to top private hospitals, VIP and international departments in the best public hospitals
  • Advanced treatment and important drugs: covering expensive advanced treatment and imported drugs
  • Direct billing service which is popular in Europe and the United States: treatment fee is directly paid by Cigna & CMB to the network hospital
  • World-class service experience: worldwide 7*24 hour support; Chinese and English bilingual service; online health assessment, wellness information, crisis support, appointment, accompaniment and foreign/local expert second opinion services are offered.

Overview

Insurance Benefit: RMB 10,000,000 per insurance period
Maximum per main insured person / insured dependant per insurance period

Coinsurance:
The percentage of changes for covered expenses that the main insured person or insured dependant will be required to pay under the plan after satisfying the required deductible.
There will be 50% coinsurance applied to Silver Plan if seeking services at hospitals or clinics in the Provider Copayment List below.

Coverage Area: Asia including Australia and New Zealand

In-Patient/Day Case

Hospital Charges for: 100% Refund

  • Nursing and accommodation for in-patient treatment
  • Day case treatment
  • Operating theatre and recovery room
  • Prescribed medicines, drugs and dressings for in-patient or day case treatment

Parental Accommodation: 100% Refund; Up to 30 days per insurance period
This applies to insured dependant under the age of 18. Cigna & CMB will pay for reasonable costs for a parent staying in the same hospital with the insured dependant.

Surgeons and Anaesthetists Fees: 100% Refund

Specialist Physicians Fees: 100% Refund
This benefit is paid in full for regular visits by a specialist physician during stays in hospital including intensive care by a specialist physician for as long as is required by medical necessity

Surgical Procedures: 100% Refund

Radiotherapy, Chemotherapy, Oncology and Physiotherapy: 100% Refund

Radiology, Pathology: 100% Refund

Home Nursing charges: Not Covered

Surgical Appliance and/or Medical Appliance: 100% Refund
This benefit will be paid in respect of:

  • an artificial limb, prosthesis or device which is inserted during surgery;
  • an artificial prosthesis or device which is necessary part of the treatment immediately following surgery for as long as is required by medical necessity;
  • a prosthesis or appliance which is medically necessary and is part of the recuperation process on a short-term basis.

Psychiatric Care: 50% Refund, up to 30 days per insurance period
This benefit will be paid in respect of psychiatric conditions, other mental disorders or addictive conditions

Private Ambulance: 100% Refund
This benefit is payable for transport to or from a hospital when ordered for medical reasons

Out-Patient

Consultations with Medical Practitioners and Specialists: 100% Refund

Prescribed Medicines, Drugs and Dressings: 100% Refund

Physiotherapy, Acupuncture, Chiropody, Osteopathy, Homeopathy: 100% Refund
Up to RMB 800 per visit of 20 visits per year

Hormone Replacement Therapy: 100% Refund

Pathology, Radiography, Radiology, Chemotherapy: 100% Refund

Non-surgical and Minor Surgical Procedures and Treatment: 100% Refund

Annual Routine Test: 100% Refund                                                               
One eye test and hearing test for insured dependant under the age of 15

Travel Vaccinations: 100% Refund
This benefit will be payable for vaccinations related to travel

Emergency Dental Treatment: 100% Refund, up to RMB 10,000 per insurance period
This benefit will be payable for treatment received during the emergency visit immediately after accidental damage to natural teeth

Psychiatric Care: Not Covered

Chinese Herbal Medicine: 100% Refund
Up to RMB 240 per session of insurance, max of 20 sessions per year

Emergency Evacuation/Repatriation

Emergency Evacuation
100% Refund, evacuation within Mainland China only

Medical Repatriation
100% Refund

Repatriation of Remains
100% Refund

Transport Cost for Third Part
100% Refund

Note: These benefits require pre-approval

Cigna & CMB Care+

Health and Well-being assessment:

  • Personal health profile report
  • Online Health Library (Buy-up Benefit)
  • Targeted Risk Assessments (Buy-up Benefit)
  • Online Health Improvement Programs (Buy-up Benefit)

International Employee Assistance Program (IEAP):
You are supported worldwide 24 hours a day and 365 days a year no matter what difficulties you face.

  • Crisis intervention (Topics include, but are not limited to: relationships, stress, emotional support, anxiety, depression, bullying and harassment, life transitions, relocations and substance abuse, etc)
  • 5 session counselling
  • Community resource referrals
  • EAP work life referrals to professionals, including child care, legal services, elder care and financial services (Buy-up Benefit)

Expert Second Opinion:
The Cleveland Clinic has been one of America’s most respected medical referral institutions for more than 85 years. It will provide comprehensive expert online medical second opinions to you and covered family members, should someone receive a life-threatening or life-altering diagnosis. Each opinion is provided by a Cleveland Clinic doctor who specializes in the condition and provides a review of the diagnosis and prescribed medical treatment. Support from the Cleveland Clinic, in addition to the second opinion, includes a telephone consultation and secure email communication with a nurse.

Cigna & CMB Assist

  • Appointment services are available for all public hospitals in our network. In addition, we will work with our customers to secure appointments at select out of network public facilities.
  • Accompaniment services are available for the following treatments in select public facilities across our network.
  • All inpatient stays (including maternity deliveries);
  • All day surgeries;
  • Lab testing and radiological examination (such as PET-CT, MRI, CT) with amount above RMB3, 000.
  • Local Expert Second Opinion – A complement to our Global Second Opinion Service

In addition to provide global 2nd Opinion service via E-Cleveland Clinic, the worldwide leading provider, we offer local 2nd Opinion services through top tier public medical facilities in China.

Optional Maternity Benefits

Inpatient and Outpatient Maternity Cover:
This benefit is payable to female main insured person or insured dependant covered under the plan. It includes childbirth, pre-natal and post-natal exams and pre-natal vitamins.

  • Option One: 100% Refund up to RMB 30,000; Limit applies to routine and complicated maternity
  • Option Two: 100% Refund up to RMB 60,000 for normal delivery, unlimited if complications

Optional Wellness Benefits

Routine Physical Exams
This benefit will be paid for, or in connection with, routine physical examinations for main insured person or insured dependant.
Option Two: Payable up to RMB 3,000 per insurance period

Immunization
This benefit will be payable for insured dependant up to age 18.
Option Two: Payable up to RMB 3,000 per insurance period

Pap Smear
Cigna & CMB will pay charges for an annual Papanicolaou screening
Option Two: 100% Refund

Prostate Cancer Screening
Cigna & CMB will pay charges for an annual prostate cancer screening for male main insured person or insured dependant over 50 years old.
Option Two: 100% Refund

Mammograms for Breast Cancer Screening or Diagnostic Purposes
This benefit will be paid in respect of:

  • one baseline mammogram for asymptomatic women aged 35-39;
  • a mammogram for asymptomatic women aged 40-49 every two years or more if medically necessary;
  • a mammogram every year for women aged 50 and over

Option Two: 100% Refund

Optional Dental Benefits

Maximum Benefit per insurance period for Class One, Two and Three

  • Option One: RMB 2,000 per insurance period
  • Option Two: RMB 5,000 per insurance period
  • Option Three and Option Four: RMB 10,000 per insurance period

Deductible

  • Option One, Option Two and Option Four: none
  • Option Three: Individual (RMB 300), Family (RMB 900)

Class One
Investigative and Preventative Treatment
Benefits include: X-rays, Scale and Polish

  • Option One and Option Two: 80% refund
  • Option Three: 100% refund after the deductible
  • Option Four: 100% refund

Class Two
Basic restorative treatment, Periodontal treatment and treatment of dental injury.
Benefits include: Root canal treatment, extractions, surgical procedures, occasional treatment, anaesthetics, periodontal treatment

  • Option One and Option Two: 50% refund
  • Option Three: 80% refund after the deductible
  • Option Four: 80% refund

Class Three
Major Restorative and Orthodontic treatment
Benefits include: Dentures – acrylic/synthetic, metal and metal/acrylic; Crowns, inlays, mouth-guard or occlusal splint

  • Option One, Option Two and Option Four: 50% refund
  • Option Three: 50% refund after the deductible

Orthodontic Treatment for insured dependant under the age of 18

  • Option One, Option Two and Option Three: none
  • Option Four: 50% refund up to RMB 6,000 per year of insurance

Notes:

  • Examination and Scale & Polish will both be limited to 2 visits per year.
  • Full Case Assessment will be limited to one visit per year.
  • X-rays will be limited to four Bitewings and six Intra Oral per year and OPG every 3 years.
  • Prolonged Periodontal Treatment limit of one course per year

Optional Vision Benefits

One eye examination per insurance period by an Optometrist or an Ophthalmologist: 100% Refund

Expenses for:  Payable up to RMB 1,000 per insurance period

  • Lenses to correct vision
  • Eyeglass frames
  • Prescription sunglasses

Provider Copayment List

Plan co-insurance will apply if main insured persons or insured dependants choose the following hospitals/clinics in China/Hong Kong and out of the Cigna PPO network hospitals in the US for all treatments:

  • United Family Hospitals and Clinics (Beijing, Shanghai, Guangzhou, Wuxi and other cities if any)
  • Parkway Health Medical Centers (Shanghai, Chengdu)
  • SinoUnited Health Medical Center (Shanghai)
  • St. Michael Hospital
  • Shanghai East International Medical Center
  • Worldpath Clinic International (Shanghai)
  • International S.O.S Clinics (Beijing, Tianjin, Nanjing, Shekou and other cities if any)
  • Beijing International Medical Centre (IMC)
  • OASIS International Hospital (Beijing)
  • Institute for Western Surgery (Guangzhou and other cities if any)
  • Hong Kong Adventist Hospital
  • Matilda International Hospital (Hong Kong)
  • Hong Kong Sanatorium & Hospital
  • Asia Medical Specialist & Sport Performance (Hong Kong)
  • Sports Medical Centre (Hong Kong)

*The above list is subject to change

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