CIGNA HEALTHFIRST ELITE
MEDICAL PLAN

PLAN BENEFITS

Cigna Care Manager Service

Comprehensive Medical Insurance Coverage

Global Medical Network

Flexible Options
5 STAR RATED IN THE HIGH END CATEGORY
Cigna HealthFirst Elite Medical Plan has been recognized by 10Life as a preferred choice for high-end medical insurance plan in the market. It garnered a 5-star Rating and Medical Coverage Score of 10/10 at both Private Room Level and Semi-Private Room Level3 (As of 31 March 2023).
Medical Insurance Coverage Details















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 benefits of outpatient or other medical protection. The policy provides both indemnity and non-indemnity benefits. It does not contain any cash value.
- 1 year and Annually Renewable.
- The plan provides a protection period of one year, and is guaranteed renewable for the lifetime of the Person Insured, with payment period until the end of protection period. Premiums will increase with age and are subject to annual adjustment at policy renewal.

HOSPITALIZATION AND SURGICAL BENEFITS
Comprehensive cover for hospital benefits, with full health insurance coverage in various medical expenses.
All your basic needs are fully covered, from hospital room and board to surgery, attending physician, specialist, intensive care, and private nursing fees, cancer treatment and kidney dialysis, rehabilitation, palliative care, and psychiatric inpatient treatment fees.
We offer you up to HK$2,000 in cash benefit for each day you’re in hospital or during compulsory quarantine4 for Notifiable Infectious Diseases5.
We cover all the medical appliances you may need, including pacemakers, stents, prosthetic ligaments, and metallic or artificial joints.
Extended benefits cover pre-admission and post-hospitalization outpatient expenses, post-hospitalization auxiliary treatment, traditional Chinese medicine, home nursing expenses, accident emergency outpatient treatment and accident emergency dental treatment, accidental death, and costs of local ambulance.

EXCLUSIVE PRIVILEGES
Additional Discounts
First year premium discount: 10% discount on your policy for the first year.
Spouse discount: An extra 10% discount on both you and your spouse’s policies for the first year.
Children’s discount: Enroll with your children (aged below 18) and enjoy a premium discount on their policies (not applicable to Optional Dental Benefits) - 50% discount until they reach the age 18.

ISSUE AGE
From 15 days to 75 years.

INSURANCE COVERAGE AMOUNT
Elite medical plan provides you with comprehensive medical coverage. Our superior annual limit is up to HK$50 Million2.
Unlimited lifetime claims apply to all basic benefits and most optional benefits, including:
- Hospital Room & Board
- Surgical Expenses
- Cancer Treatment (covers treatments of cancer including radiotherapy, chemotherapy, targeted therapy, immunotherapy, hormonal therapy, proton therapy, gamma knife and cyberknife therapies, as well as any ; andphysician consultation charges associated with these treatments (including planning, monitoring, follow-up etc.) whether in hospital, clinic or at home.
- Kidney Dialysis
- Advanced Diagnostic Imaging
For detailed coverage amounts for each of the Hospitalization and Surgical Benefits and Recommended Additional Benefits, please click here.

CASHLESS HOSPITALIZATION ARRANGEMENT
To enjoy our speedy “Cashless Hospitalization” service, we recommend that you submit an application via MyCigna or call the Cigna Customer Service Hotline as soon as possible once you know your treatment date, so we have time to make the proper arrangements. Once the Customer Service Department has looked into your case, we will assign a dedicated Care Manager to help you follow up on hospital surgery or treatment arrangements until your recovery. At the same time, we will provide emotional support to you and your family, allowing you to recover with comfort and peace of mind. Simply check this procedure to arrange pre-approval and obtain a Guarantee of Payment Letter.

ADDITIONAL SERVICES
Cigna Virtual Consultation
Cigna has partnered with DoctorNow to bring you a convenient telemedicine service. Customers can simply download the app to obtain medical advice through video medical video consultations with locally-registered physicians. You can also enjoy same-day medicine delivery and receive a doctor’s certificate and receipt. If you need a specialist referral, the doctor will help prepare you may request a referral letter from the doctor and you can access this through the app. To enjoy, download the DoctorNow app (search for "DoctorNow" via App Store / Google Play).
For more details about DoctorNow, you may refer to this video .
Cigna Medical Card
Just show your Cigna e-medical card on your smartphone via MyCigna app to enjoy discounts of up to 40% off when getting access to our extensive medical network throughout Hong Kong6.
Free annual physical health check-up
To give you a clear and up-to-date understanding about the state of your health, we will send you a free body check-up coupon 30 days after each policy anniversary date.
Remark:
- The unlimited lifetime cover does not apply to Optional Pharmacy Benefits.
- The Basic Benefit and Optional Outpatient Benefits under standard private room and semi-private room types are subject to an overall maximum annual limit of HK$50 Million and HK$30 Million respectively.
- 10Life is a digital platform that provides professional and unbiased insurance information for consumers. Using factors that matter the most to the consumers, 10Life produces objective high-end medical insurance scores and rankings based on medical coverage and auxiliary benefits. Only medical insurance plans that have 10Life Overall Medical Score (includes Medical Coverage Score and Auxiliary Benefits Score) higher than 9, which also means both medical coverage and auxiliary benefits are higher than market average can be recognized with a 5-star rating. 10Life actuarie refers to the benefit limits on each expense category to calculate the estimated coverage amount (to be paid by the insurer) and out of pocket expenses (to be paid by the policyholder). The 10Life Medical Coverage Score (out of 10) is calculated according to the Estimated Average Coverage Ratio, so higher the score means higher the medical coverage for the insurance plan. For more, please refer to 10Life ratings.
- Compulsory Quarantine applies if as required by the government on a mandatory basis, the Person Insured is being confined in an isolated ward of a Hospital or kept in an isolated site appointed and provided by the government for at least twenty-four (24) consecutive hours due to Notifiable Infectious Disease(s) suffered by the Person Insured and the Person Insured continuously stays in there until discharged from quarantine. For the avoidance of doubt, this benefit does not include cases where the Person Insured stays at home or any premises not being a Hospital or an isolated site appointed and provided by the government.
- Notifiable Infectious Diseases refers to any kind of notifiable infectious diseases identified and defined and published by Hong Kong Government in accordance with the Prevention and Control of Disease Ordinance (Cap. 599) or any kind of infectious diseases for which an outbreak alert is issued by the World Health Organization.
- Discounts offered by different Cigna medical network doctors may vary. In case of any dispute, Cigna’s decision shall be final.
- Different deductible options may vary across different sales channels.
RECOMMENDED ADDITIONAL BENEFITS
OUTPATIENT BENEFITS
PHARMACY BENEFITS
DENTAL BENEFITS
DEDUCTIBLE DISCOUNT BENEFITS
PREMIUM WAIVER DUE TO CANCER
Cigna HealthFirst Elite Medical Plan offers comprehensive and superior benefit to ensure Kathy receives adequate protection throughout life’s journey. Kathy continues to pay her Elite premiums for 5 years. Over this time, Cigna HealthFirst Elite Medical Plan offers her ongoing support to help her maintaining her good health by providing free health check-up every year.
At age 45, Kathy was advised by her doctor to consult an oncologist following an annual health check-up. She was eventually diagnosed with a malignant tumor in her left breast, requiring 5 days of hospitalization for the surgical removal of the tumor. Kathy called Cigna’s Customer Service Hotline to inquire about her coverage. She was assigned a dedicated Care Manager, Jackie who arranged the appropriate follow-up services for her, from hospitalization to recovery.
Plan Level: Cigna HealthFirst Elite Medical Plan – Standard Private Room, Asia coverage, No Deductible
Premium Payment Frequency: Annual
Benefit Items | Benefit Paid(HK$) |
Prevention: | |
Free health check-up is offered every year (5 years x HK$1,200) | HK$6,000 |
---|---|
Diagnosis & Treatment: | |
Premium Waiver due to Cancer (6 months of premium) | +HK$5,921 |
Hospitalization Expenses (cashless) including mastectomy and breast reconstruction1 | +HK$250,000 |
Cancer Treatment (including chemotherapy and targeted therapy) | +HK$450,000 |
Hospital Cash for Confinement in a Lower Room Level of a Private Hospital (Semi-Private) (5 days x HK$2,000)2 | +HK$10,000 |
Recovery: | |
Post-Hospitalization Outpatient Expenses (20 follow-up consultations over the 6 months following her surgery) | +HK$27,920 |
Traditional Chinese Medicine Treatment (10 visits to a Traditional Chinese Medical Practitioner to help manage side-effects and restore immune system, valued at HK$600 per visit)Nutritional guidance and meal delivery service (3 meals per day x 10 days) HK$2,000 | +HK$6,000 |
Deductible | -HK$25,000 |
Total benefit paid: | =HK$726,841 |
Total premium paid from age 40 - 453: | -HK$64,656 |
Net benefit from Cigna HealthFirst Elite Medical Plan: | =HK$668,185 |
Apart from the financial coverage, what Kathy found most unexpected was the level of service provided by her dedicated Care Manager, Jackie. An experienced nurse, Jackie provided her with options of doctors4 prior to her admission, visited her following surgery, and made arrangements regarding her recovery after she was discharged. This support gave Kathy peace of mind during her sickness, while at the same time relieving the burden on her husband as her caretaker.
- Breast reconstruction is covered under the Surgical Expense benefits.
- Deductible does not apply to Hospital Cash for Confinement in a Lower Room Level of a Private Hospital.
- The premium quoted above are indicative only and subject to rounding. It may change from time to time at Cigna's discretion
- Applicable to network doctors only.
Stephen (age 38) and Mabel (age 35) insured Cigna HealthFirst Elite Medical Plan – Private Room, Worldwide (excluding the US) coverage with annual deductible of HK$75,000 with an optional benefit of Deductible Discount; Their son, Adrian (age 13) insured Cigna HealthFirst Elite Medical Plan – Private Room, Worldwide (excluding the US) with annual deductible of HK$15,000 and the optional benefits of Deductible Discount and Outpatient Benefit.
Three years later, Stephen and Mabel went to visit Adrian in Vancouver during Christmas and went skiing together. Unfortunately, Adrian broke his leg. Adrian stayed in hospital for 4 days. He also needed follow up physiotherapy after discharge.
Benefit Items | Benefit Paid(HK$) |
The following benefits are provided in full claims: | |
Hospitalization and surgical expenses | HK$220,000 |
---|---|
Companion Bed | HK$8,400 |
Local Ambulance Benefit | HK$1,440 |
Full cover for the 20 visits to a physiotherapy after discharge | HK$27,000 |
Hospital Cash for Confinement in a Lower Room Level of a Private Hospital1 (Semi-Private) for 4 days of hospitalization , HK$2,000/day | HK$8,000 |
Total Medical Expenses with Hospital Cash | HK$264,840 |
Deductible2 | -HK$12,000 |
Total Benefit paid | HK$252,840 |
Total Premium3 paid for the 3 years for Adrian $(17,840+814+23,851) x 40% = HK$17,002 $(18,338+839+24,501) x 50% = HK$21,839 $(18,984+873+25,334) x 50% = HK$22,595.5 | HK$61,437 |
Net benefit from Cigna HealthFirst Elite Medical Plan | HK$191,404 |
- Deductible does not apply to Hospital Cash for Confinement in a Lower Room Level of a Private Hospital.
- Deductible: $15,000 x (1-20% deductible discount ) = $12,000
- The premium quoted above are indicative only and subject to rounding. It may change from time to time at Cigna's discretion.
FAQS
- Your HKID no.
- The ID (HKID or otherwise) of any family members you wish to cover
- Your basic contact information
- The height, weight, and medical history details of you or any family members you wish to cover
- Your credit card information
If you choose semi-private as accommodation room type, the annual limit would be HK$30,000,000. If you choose standard private room as the accommodation room type, the annual limit would be HK$50,000,000.
There’s unlimited lifetime claims for Elite. The annual limit would start over every policy year.
Elite’s core coverage is focused on hospitalization and surgical coverage. However, there are various optional benefits for Elite customers to extend coverage to enhance your protection:
- Outpatient Benefits: Extensive treatments including Western and Chinese Medicine and much more
- Pharmacy Benefits: Prescription medication for Major Diseases up to HK$80,000 per year
- Dental Benefit: Scaling and polishing twice a year, with full coverage of X-rays and common dental procedures
- Deductible Discount Benefits: 10% discount on your deductible for each eligible year
- Premium Waiver due to Cancer: 6-month premium waiver upon a cancer diagnosis to help focus on recovery
Cigna will start paying for the covered medical expenses once the deductible amount has been reached. The deductibles will be covered either by you or your other insurance plan(s) (e.g. group medical insurance).
For the higher deductible levels for the same coverage level, the lower the premium could be. It’s a way to coordinate the protection with your other insurance plans (including employee coverage) to achieve a lower premium.
- First year premium discount: 10% discount on your policy for the first year
- Spouse discount: An extra 10% discount on both you and your spouse’s policies for the first year
- Children's Discount: For parents covered by Elite, their child would enjoy a 50% premium discount until the age of 18
- Discount is only eligible for customer who has not cancelled any individual medical insurance scheme Cigna HealthFirst Elite Medical Plan underwritten Cigna Worldwide General Insurance Company Limited within 12 months prior to the date of submitting the application for Cigna Healthfirst Elite Medical Plan. Subject to the arrangement upon enrollment
Written notification of a claim must be given to the Company within 30 days after the occurrence of the event giving rise to the claim. Such notification shall include information sufficient.
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
You may cancel your policy and get back your premium paid within the cooling off period (the earlier of 30 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
- Understands and analyzes the health condition of customers, and offers network doctor options
- Care Manager to provide hospital admission advice and assistance and post-discharge follow-up in person
- Referral for personalized services, including local limousine transportation to the hospital, medication delivery, and home modification.
Cigna HealthFirst Elite 24 hours Hotline at 8100 3269 (applicable to Elite customers only)
- Premium Level
The premium corresponding to the accommodation room type, area of cover and annual deductible option you select is determined based on the age and smoking habit of the person insured at policy commencement and at the time of renewal upon each anniversary date of the policy.
- 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.
- Mis-statement of Age or Smoking Habit
If age or smoking habit has been mis-stated by you or any person insured, the relevant person insured would still be eligible for coverage, we have the right to adjust the premiums payable based on the correct information.
- 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.
- Benefit in General
For hospitalization in mainland China, benefit is payable only if the diagnosis and hospital confinement are made in a hospital of Tier 3 Class A or above. Except for the benefit payment in case of death of the person insured, we shall pay the benefit amount to the policyholder.For the benefit payment in case of death of the person insured, we shall pay the benefit amount to the beneficiary.
- Hospitalization and Surgical Benefits
Under Hospitalization and Surgical Benefits and Extended Benefits, the Company will reimburse the actual medical expenses incurred of insured event according to the following calculation formula:{(Amount of eligible medical expenses incurred) LESS (-) (The medical expenses of same insured event is reimbursed by another party or by us under another insurance plan or the deductible (per policy year) under this policy, whichever is the larger)} TIMES (x) (Adjustment factor in room type confined (if applicable))If the person insured uses a higher level of hospital facilities and services than he is entitled to under the policy, the benefit amount payable will be lowered according to the adjustment factor. This benefit will not be payable for class of suite/ VIP/ deluxe room of a hospital
Accomodation Room Type Room type confined Adjustment factor Semi-Prtivate Room Standard Private Room 50% - Deductible Discount and Premium Waiver due to Cancer
For the avoidance of doubt, while the Deductible Discount and/or Premium Waiver due to Cancer are inforce, the Basic Benefits including the selected accommodation room type, area of cover, deductible and/or payment frequency are not allowed to change. Otherwise, the Company will not pay any benefit under the Deductible Discount and/or Premium Waiver due to Cancer.
- The policy will be automatically terminated when one of the following happens:
- The Person Insured passes away; or
- The Policy is terminated or not renewed by the Policyholder; or
- Any premium is not paid at the end of the grace period.
- The Optional Maternity Benefits will be terminated upon the policy anniversary after the person insured reaches age 50.
- The Optional Pharmacy Benefits will be terminated if 100% of the lifetime limit has been paid.
- 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.
- The person insured is required to settle any shortfall of expenses incurred with the use of the Cigna HealthFirst Elite Medical Card which is not covered by the policy or exceeding the maximum limit. If such shortfall amount is not settled within 14 days after receipt of a payment advice from us or our designated medical service providers, the Company reserves the right to terminate this policy.
- The person insured aged below 6 applying for Elite Medical Plan must be enrolled in the same Basic Benefits and Optional Insurance Benefits with those of the policyholder’s. If the policyholder terminates or changes his/ her policy, the policy of the child must be terminated or changed accordingly as per the policyholder’s with effect from the next anniversary date. The policyholder is required to notify us in writing the request of changes.
- Naval, military or air force service or operations, armed force or service with the police of any nation;
- Professional sports or hazardous activities such as but not limited to rock climbing or mountaineering, parachuting, hang-gliding (whether powered or not), para-gliding, bungee-jumping or any kind of race other than by foot;
- Cave, wreck or free diving, professional diving, diving without holding the correct diving certification such as a Professional Association of Diving Instructors (PADI) and diving at depths below 40 meters;
- professional, semiprofessional or competitive winter sports, cross country skiing or snowboarding, ski or snowboard jumping, heli-skiing, off-piste skiing or snowboarding, Speed Skiing;
- Working at height (over 20 feet);
- Operating heavy machinery;
- Aviation or aerial activities except air travel as a fare-paying passenger in or as a member of the aircrew of a properly licensed, fixed-wing multi-engined aircraft constructed to carry passengers and operated by a licensed commercial air carrier or in a helicopter owned and operated by a commercial concern which is licensed for the regular transportation of fare-paying passengers provided such helicopter is operating only between commercial airports and/or licensed commercial heliports and provided further that in either event such travel is not for the purpose of any trade or technical operation in or on the aircraft; or
- Manufacture, storage, filling, breakdown, handling and transport of any explosive (including but not limited to firework or firecracker) or chemical material;
- facelifts (rhytidectomy);
- nose reshaping (rhinoplasty);
- liposuction and other procedures which remove fat tissue;
- hair transplants; and
- surgery to change the shape of, enhance or reduce breast (other than breast reconstruction following treatment for breast cancer);
- learning difficulties such as dyslexia;
- behavioral problems such as autism or attention deficit disorder (ADHD); or
- physical development problems such as short height.
- has a body mass index (BMI) of 40 or over and had been diagnosed as being morbidly obese; and
- can provide documented evidence of other methods of weight loss which have been tried over the past twenty-four (24) Calendar Months;
- One sleep study/year; and
- Surgery, only if Medically Necessary;
- is used to improve speech skills that have not fully developed;
- can be considered custodial or educational; or
- is intended to maintain speech communication.
- in the time of War;
- under orders for warlike operations; or
- restoration of public order. For the avoidance of doubt, armed force shall include any police force of a country or territory;
- underwater swimming or diving and use any type of equipment to aid breathing;
- any kind of climbing, or mountaineering using rope or guides;
- pot-holing;
- parachuting, any kind of gliding, ballooning, bungee-jumping or micro-lighting;
- Cave, wreck or free diving, professional diving, diving without holding the correct diving certification such as a Professional Association of Diving Instructors(PADI) and diving at depths below 40 meters;
- professional, semiprofessional or competitive winter sports, cross country skiing or snowboarding, ski or snowboard jumping, heli-skiing, off-piste skiing or snowboarding, Speed Skiing;
- hunting;
- driving or riding in any kind of race; or
- professional sports.