CIGNA HEALTHFIRST
DIAMEDIC PLAN
PLAN BENEFITS
In Hong Kong, 1 in every 10 people has diabetes, and the number continues to rise1; Diabetes can incur significant long-term medical costs and potentially lead to a wide range of complications. Cigna HealthFirst DiaMedic Plan is the pioneering solution for diabetic patients or people at high risk of diabetes.
Guaranteed lifetime renewal regardless of future health changes.
HK$3,500 Health reward up to HK$3,500 per policy year.
Free membership of Angel of Diabetic to support your health goals.
PLAN TYPE, POLICY TERM AND PREMIUM STRUCTURE OF BASIC PLAN
- This product is a standalone individual policy. The basic plan provides hospitalization benefits which can be added with optional outpatient benefits. The policy provides indemnity benefits and contains no cash value.
- 1 year and Annually Renewable
- The plan provides a protection period of 1 year and renewable until age 100 of person insured, with payment period until the end of protection period. Premium Rate will increase with Age, and yearly adjustable.
HOSPITALIZATION AND SURGICAL BENEFITS
Hospital Room & Board Benefit of up to HK$3,600 per day, maximum of 270 days per policy year
Cover surgeon's, anaesthetist's, operating theatre expenses, etc. in Surgical Benefit
Provide Organ Transplantation Benefit, Cancer Treatment and Dialysis Benefit, Rehabilitation Benefit and Palliative Care Benefit
Offer 180-day coverage for post-hospitalization visits to a clinic each time when you are discharged from the hospital or after surgery performed in a physician’s clinic
Cashless hospitalization arrangement at network hospitals in Hong Kong
HEALTH REWARD
We motivate you to get healthier each year by offering an annual health reward of up to HK$3,500 at each policy anniversary date, based on the figures in your latest health report.
ISSUE AGE & RENEWAL
From 15 days to age 75. Renewal is guaranteed regardless of any future changes to your health.
COMPLIMENTARY BENEFITS
Free membership of diabetic association “Angel of Diabetic” - Through this membership, you can join other diabetic patients in various classes on healthy lifestyle, get consultation related to diabetes, and purchase healthy food suitable for diabetics. This can also help you get support and educational information on this disease.
Free annual diabetes medical check up.
Digital diabetes management tool - empowering you to engage in day-to-day disease management.
Our Second Medical Opinion Service offers you an alternative medical opinion from a global pool of experts based at world-class institutions via our worldwide medical network, allowing you to make better-informed decisions.
Source:
1. Hospital Authority, Hong Kong ; http://www21.ha.org.hk/smartpatient/SPW/en-us/Disease-Information/Chronic-Diseases-Zone/Details/?guid=c73a0386-fe66-42eb-a979-7619ac8359da
Covers visits to a general practitioner, specialist, Chinese medicine practitioner, and acupuncturist, as well as expenses for dietetic guidance, prescribed western medicine, and diagnostic imaging and laboratory tests.
Eliza’s mother suffered from diabetes. Because of her family history, Eliza worried about developing diabetes as well, particularly with the high medical expenses associated with the condition’s complications.
During a health check, she discovers that her HbA1c level is at 5.8% and fasting glucose at 6.3mmol/l, which puts her on the verge of being diabetic. Luckily, she purchased the Plan for a greater peace of mind, even facing medical expenses that may arise from diabetes.
Digital diabetes management tool
With the help of personalized tips from Health2Sync, she realizes that her lifestyle was doing more harm than good, and that she needs to properly manage her diabetic risks. With the help from the educational content on Health2Sync, she begins to eat healthily and do exercise more often. Around the time of her first policy anniversary, she notices a remarkable improvement in her HbA1c and fasting glucose levels.
Well-being monitoring
Annual free check-up is provided to help Eliza to get a better idea of her health condition.
Reward
She submits her latest medical report to Cigna. Following assessment, she gets a health reward of HK$2,000 as a bonus for her efforts to stay healthy.
Eliza is able to maintain her health condition. She earns her health reward and renews her policy, with no hassle.
For more details, please click here.
You may submit your application by calling Cigna on 8102 2338, or contact your insurance brokers for details.
If you are already covered under “Cigna HealthFirst Medical Plan Series”, including “Cigna HealthFirst Elite Medical Plan”, “Cigna HealthFirst Choice Medical Plan”, “Cigna HealthFirst DiaMedic Plan”, or “Cigna VHIS Series” products, Cigna will not accept the application in that case.
Cigna reserves the right to revise the premium of the policy on the anniversary date or upon renewal. Factors leading to premium adjustment may include but are not limited to our overall experience in claims and expenses incurred by and /or in relation to this product. However, we will not adjust your premium based on your own health status or personal claims record.
The basic benefits and optional insurance benefits will be effective for an initial period of 12 months and thereafter guaranteed and automatically renewable for successive periods of 12 months each provided that Cigna continue to issue new policy(ies) under the Basic Benefits and respective Optional Insurance benefits (if applicable) of DiaMedic, and upon payment of the premium at time of renewal. This means any change in your health won’t have any impact on your eligibility to renew your policy.
The basic benefits and optional insurance benefits will be effective for an initial period of 12 months and thereafter guaranteed and automatically renewable for successive periods of 12 months each provided that Cigna continue to issue new policy(ies) under the Basic Benefits and respective Optional Insurance benefits (if applicable) of DiaMedic, and upon payment of the premium at time of renewal. This means any change in your health won’t have any impact on your eligibility to renew your policy.
Please login to our customer portal or register at www.mycigna.com.hk or download our app from the app store or Google Play store.
When submitting a claim through My Cigna or the app please have the below documents ready.
- You will need to have your doctor completing an Accident or Medical Expenses Doctor Form(sample):
- Receipt from your treatment
- Statement of charges from the hospital/Hospital Invoice or Bill/Hospital charges breakdown list
- Hospital Discharge Summary or any documents issued by doctor/hospital with diagnosis
- Identity card copy of the Policyholder
- If you have submitted a claim with another insurer then you will also need a copy of the Compensation Breakdown from the other Insurer(s)
For details, you may visit https://www.cigna.com.hk/en/customer-service/insurance-claim-procedure. For further assistance, please call Cigna HealthFirst DiaMedic Hotline.
You may cancel your policy and get back your premium paid within the cooling off period (the earlier of 21 days after the delivery of the policy or the issue of a notice to you or your representative), you have to tell us by giving a written notice if you decide to terminate the policy.
After cooling off period, the policyholder may terminate the policy by giving not less than 30 days’ notice in writing to the Company. Such termination shall become effective on the Premium Due Date. There shall be no refund of Premium paid and Cigna reserves the right to charge the Premium until the end of such Policy year after the termination.
- Manned by experienced nurse to provide professional opinion
- Care Manager to provide hospital admission advice and assistance, in-hospital support, and post-discharge follow-up
- Referral for personalized services, including local limousine transportation to the hospital, medication delivery, and home modification.
Cigna HealthFirst Elite 24 hours Hotline at 8200 2211 (applicable to Elite customers only)
When submitting a claim through MyCigna HK, please have the below documents ready.
Hospitalization / Medical Expenses Claim
- Accident or Medical Expenses Doctor Form completed by your attending doctor
- Medical Receipt(s)
- Hospital statement of charges / invoice / bill with breakdown of charges
- Hospital Discharge Summary or any document(s) issued by doctor/hospital with diagnosis proof
- Identity card copy of the Policyholder
- If you have submitted a claim to other insurer(s), please provide a copy of the relevant Compensation Breakdown
1. Premium Level
The premium of the plan level selected by you is determined based on the age and smoking habit of the person insured on the policy commencement date and upon each anniversary date. An extra premium loading computed on a consistent basis shall be charged upon renewal (if applicable).
2. Non-payment of Premium
If you fail to pay the initial premium, your policy will not take effect from the commencement date of your policy. Except for the initial premium payment, there will be a grace period of 1 month after any premium due date. Your policy will remain effective during this grace period. If any premium is not paid at the end of the grace period, your policy will lapse on the premium due date and you will lose the insurance cover.
We will not make any claim payment or any other payment payable under the policy, until we receive payment of all outstanding premium up to the date of the claim payment or when the policy terminates.
3. Mis-statement of Age or Smoking Habit
If age or smoking habit has been mis-stated by you or any person insured but the relevant person insured would still be eligible for coverage, we have the right to adjust the premiums payable based on the correct information.
4. Premium Adjustment
The Company reserves the right to revise the premium of the policy on the anniversary date or upon renewal.
Factors leading to premium adjustment may include but are not limited to our experience in claims and expenses incurred by and/or in relation to this product.
The amount of the renewal premium will be stated in the policy schedule enclosed in the renewal pack which we will send to you 45 days in advance of the policy anniversary date.
1. Benefit in General
Benefits shall not be payable for hospital confinement in class of suite / VIP/ deluxe room of a hospital.
2. Extent of Benefits
The coverage under the Basic Benefits of this policy is worldwide, except General Practitioner Outpatient Consultation which is covered at medical network in Hong Kong. Meanwhile, all benefits under the Optional Outpatient Benefits are covered in Hong Kong.
A health reward corresponding to the plan level will be offered to the policyholder if the following conditions are fulfilled at the time of each renewal:
(a) premium of the policy year is fully paid;
(b) the person insured submits the latest evidence of insurability before the deadline as specified in the written notice sent by the Company; and
(c) if the person insured whose age is 18 or above and who meets 5 underwriting criteria set out in the relevant Health Reward Criteria table or if the person insured whose age is less than 18 and who meets 4 underwriting criteria set out in the relevant Health Reward Criteria table.
The person insured can only be covered under one single “Cigna HealthFirst Medical Plan Series” policy. The series includes “Cigna HealthFirst Elite Medical Plan”, “Cigna HealthFirst Choice Medical Plan”, “Cigna HealthFirst DiaMedic Plan” and any other insurance policies that fall under the “Cigna HealthFirst Medical Plan Series” as defined and issued by the Company from time to time.
The Hospital and Surgical Benefits and Extended Benefits, and Optional Outpatient Benefits will be effective for an initial period of 12 months and thereafter renewable, subject to the approval of the Company, for successive periods of 12 months each provided that we continue to issue new policy(ies) under the “Cigna HealthFirst DiaMedic Plan” and the following conditions are fulfilled at the time of the renewal:
• the person insured submits the latest evidence of insurability of the person insured before the deadline as specified in the written notice sent by the Company;
• the premium is paid at the time of renewal; and
• if the person insured whose age is 18 or above and who meets 5 underwriting criteria set out in the relevant Policy Renewable Criteria table or if the person insured whose age is less than 18 and who meets 4 underwriting criteria set out in the relevant Policy Renewable Criteria table.
The Company reserves the right to revise the terms of the policy and/or the premium and/or the benefit schedule upon each renewal.
If the Basic Benefits and or the respective Optional Outpatient Benefit are not renewed by the Company, we will send a written notice to the latest address we have of yours, at least 30 days before the next policy anniversary date, to notify you that the Basic Benefits and or the respective Optional Outpatient Benefit will not be renewed.
The policy will expire after the period of 12 calendar months if the policy is not renewed.
For person insured whose age is 18 or above and who has been diagnosed by a physician as having Type 1 diabetes:
| Examination Type | Examination Name | Reading | Acceptable or not |
| Blood Sugar Level | HbA1c | Less than 7% | Yes |
| 7% or above | No | ||
| Blood Pressure | Systolic Blood Pressure | Less than 90 | No |
| 90 – 140 | Yes | ||
| Above 140 | No | ||
| Diastolic Blood Pressure | Less than 60 | No | |
| 60 – 80 | Yes | ||
| Above 80 | No | ||
| Body Build | Body Mass Index (BMI) | Less than 17 | No |
| 17 – 25 | Yes | ||
| Above 25 | No | ||
| Cholesterol | Cholesterol Low-density Lipoprotein | <116 mg/dl or <3 mmol/l | Yes |
| ≥116 mg/dl or ≥3 mmol/l | No | ||
| Presence of Protein / Albumin in Random Urine Sample | Protein Concentration in Urine | <0.02g/l or <2mg/dl | Yes |
| ≥0.02g/l or ≥2mg/dl | No |
For person insured whose age is 18 or above and who has never been diagnosed by a physician as having Type 1 diabetes:
| Examination Type | Examination Name | Reading | Acceptable or not |
| Blood Sugar Level | HbA1c | Less than 8% | Yes |
| 8% or above | No | ||
| Blood Pressure | Systolic Blood Pressure | Less than 90 | No |
| 90 – 140 | Yes | ||
| Above 140 | No | ||
| Diastolic Blood Pressure | Less than 60 | No | |
| 60 – 90 | Yes | ||
| Above 90 | No | ||
| Body Build | Body Mass Index (BMI) | Less than 17 | No |
| 17 – 30 | Yes | ||
| Above 30 | No | ||
| Cholesterol | Cholesterol Low-density Lipoprotein | <129 mg/dl or <3.3 mmol/l | Yes |
| ≥129 mg/dl or ≥3.3 mmol/l | No | ||
| Presence of Protein / Albumin in Random Urine Sample | Protein Concentration in Urine | <0.66g/l or <66mg/dl | Yes |
| ≥0.66g/l or ≥66mg/dl | No |
For person insured whose age is less than 18 and who has been diagnosed by a physician as having Type 1 diabetes:
| Examination Type | Examination Name | Reading | Acceptable or not |
| Blood Sugar Level | HbA1c | Less than 7.5% | Yes |
| 7.5% or above | No | ||
| Blood Pressure | Systolic Blood Pressure | Refer to the following Table#1 | |
| Diastolic Blood Pressure | |||
| Body Build | Height and Weight | Refer to the following Table#2 | |
| Cholesterol | Cholesterol Low-density Lipoprotein | <110 mg/dl or <2.8 mmol/l | Yes |
| ≥110 mg/dl or ≥2.8 mmol/l | No | ||
For person insured whose age is less than 18 and who has never been diagnosed by a physician as having Type 1 diabetes:
| Examination Type | Examination Name | Reading | Acceptable or not |
| Blood Sugar Level | HbA1c | Less than 8% | Yes |
| 8% or above | No | ||
| Blood Pressure | Systolic Blood Pressure | Refer to the following Table#1 | |
| Diastolic Blood Pressure | |||
| Body Build | Height and Weight | Refer to the following Table#2 | |
| Cholesterol | Cholesterol Low-density Lipoprotein | <110 mg/dl or <2.8 mmol/l | Yes |
| ≥110 mg/dl or ≥2.8 mmol/l | No | ||
Table #1 – Acceptable range of blood pressure level for person insured aged under 18:
| Attained Age | Male | Female | ||
| Systolic Blood Pressure | Diastolic Blood Pressure | Systolic Blood Pressure | Diastolic Blood Pressure | |
| 1 | 83 – 100 | 36 – 53 | 85 – 101 | 39 – 55 |
| 2 | 87 – 104 | 41 – 58 | 87 – 103 | 44 – 60 |
| 3 | 89 – 107 | 45 – 62 | 88 – 104 | 48 – 64 |
| 4 | 91 – 109 | 49 – 66 | 90 – 106 | 51 – 67 |
| 5 | 93 – 110 | 52 – 69 | 91 – 107 | 53 – 69 |
| 6 | 94 – 111 | 54 – 71 | 93 – 109 | 55 – 70 |
| 7 | 95 – 113 | 56 – 73 | 95 – 111 | 56 – 72 |
| 8 | 97 – 114 | 58 – 74 | 96 – 113 | 57 – 73 |
| 9 | 98 – 115 | 59 – 76 | 98 – 114 | 58 – 74 |
| 10 | 100 – 117 | 60 – 76 | 100 – 116 | 59 – 75 |
| 11 | 102 – 119 | 60 – 77 | 102 – 119 | 60 – 77 |
| 12 | 104 – 121 | 61 – 77 | 104 – 121 | 61 – 77 |
| 13 | 106 – 124 | 61 – 78 | 106 – 124 | 61 – 78 |
| 14 | 109 – 126 | 61 – 79 | 109 – 126 | 63 – 79 |
| 15 | 112 – 129 | 63 – 80 | 112 – 129 | 63 – 80 |
| 16 | 114 – 131 | 64 – 81 | 114 – 131 | 64 – 81 |
| 17 | 116 – 134 | 66 – 83 | 116 – 134 | 66 – 83 |
Table #2 – Acceptable range of body build for person insured aged under 18:
| Attained Age | Height (in cm) | Weight (in kg) |
| 1 | 63 – 93 | 6.3 – 15.1 |
| 2 | 75.4 – 101.4 | 8.9 – 17.3 |
| 3 | 83 – 109 | 10 – 20.4 |
| 4 | 89 – 116.3 | 11.3 – 24 |
| 5 | 95 – 98.1 | 12.6 – 28 |
| 6 | 101.2 – 130.9 | 14.1 – 32.8 |
| 7 | 107.1 – 138 | 15.5 – 38.4 |
| 8 | 112.2 – 144.6 | 17.1 – 44.9 |
| 9 | 116.6 – 150.6 | 18.8 – 52 |
| 10 | 120.5 – 156.4 | 20.7 – 59.1 |
| 11 | 124.6 – 162.8 | 23.1 – 66.2 |
| 12 | 130.8 – 170.2 | 25.8 – 72.7 |
| 13 | 137.8 – 177.5 | 28.9 – 79.1 |
| 14 | 142.1 – 182.9 | 31.9 – 85.1 |
| 15 | 143.9 – 186.0 | 34.7 – 91.2 |
| Attained Age | BMI for Boys | BMI for Girls |
| 16 | 20.4 – 23.7 | 20.4 – 23.1 |
| 17 | 20.8 – 23.9 | 20.4 – 23.2 |
1. The policy will be automatically terminated when one of the following happens:
• The person insured passes away;
• Any premium is not paid at the end of the grace period; or
• The policy is terminated by the Company or the policyholder.
2. If there is any fraud, mis-statement or concealment in the application or declaration, or if you or your beneficiary makes a dishonest claim, we have the right to cancel the policy immediately. In such case, all the premium paid will not be returned and you shall immediately return all payment including claims paid by us under the policy.
3. If the policy is terminated by the policyholder during the policy year, we reserve the right to charge the premium until the end of such policy year after the termination.
While your current planned benefits will not be adjusted during the policy term, future medical costs may be higher than they are today due to inflation.
“Pre-existing Medical Conditions” means bodily injury or sickness sustained or suffered by the person insured which has been diagnosed or has exhibited symptoms or has occurred or required medical advice and/or treatment and/or the prescriptions of drugs before:
(a) the issue date or the commencement date (whichever is the later);
(b) the approval date of reinstatement (if the policy has been reinstated);
(c) the Optional Outpatient Benefit issue date (if the Optional Outpatient Benefit is added after the issue date); and
(d) the issue date or the effective date of increase in benefit, whichever is the later (if any benefit under this policy has been increased).
Notwithstanding the foregoing, “Pre-existing Medical Conditions” shall not include bodily Injury or sickness including but not limited to Diabetes which:
(a) has been fully disclosed in the application form; and (b) the Company agrees not to classify as an exclusion under the policy.
The following list is for reference only. Please refer to the policy provisions for the complete list and details of exclusions.
Cigna shall not be liable to pay any claim or expenses incurred directly or indirectly resulting from or consequent upon or contributed by the following items.
The following items are applicable to all benefits:
(a) Pre-existing medical conditions except any specified special exclusion(s);
(b) War, invasion, act of foreign enemy, hostilities (whether war is declared or not), civil commotion, rebellion, revolution, insurrection, military or usurped power or terrorism;
(c) The person insured’s suicide, attempted suicide or intentionally self-inflicted injuries, whether sane or insane;
(d) The person insured being under the influence of alcohol or drugs unless the drugs are properly prescribed by a physician and were not taken for the treatment of drug addiction;
(e) Pregnancy, childbirth, miscarriage, abortion or complications arising from any of them even though such loss may have been accelerated or induced by bodily injury or sickness;
(f) Infection with Human Immunodeficiency Virus (HIV) or variants including Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related complex (ARC);
(g) Sexually-transmitted diseases or treatment thereof;
(h) Infertility or sterilization or any type of fertility;
(i) Birth defects, congenital conditions, hereditary conditions or any disabilities arising therefrom;
(j) Cosmetic and elective surgery;
(k) Routine eye/ear examinations, cost of spectacles, contact lenses, hearing aids and artificial lens;
(l) All dental treatment prescribed by dentist except emergency treatments by a physician during hospital confinement due to bodily injury. No claims shall be payable for any follow up treatment from such hospital confinement; or
(m) Organ transplantation except such occurrence is covered under the item of Organ Transplantation section of the provision;
The above insurance plan is underwritten by Cigna Worldwide General Insurance Company Limited.
The above information is for reference only and does not constitute any contract or any part thereof between Cigna and any other parties. Please read the product brochure for details. For details of full terms, conditions and exclusions, please refer to the policy provisions. Cigna will be happy to provide a specimen of policy upon your request.
