PDF《Insured by》

36 independent, community-based and locally operated Blue Cross and Blue Shield companies. Blue Cross Blue Shield Global is a brand owned by Blue Cross and Blue Shield Association. For more information about Bupa Global, visit www. bupaglobalaccess.com and for more information about Blue Cross and Blue Shield Association, visit www.BCBS.com BENEFIT AND EXPLANATION All benefits below, even those paid in full, will contribute to the overall annual maximum limit. Overall annual maximum USD 10,000,000 or RMB 63,000,000 OUT-PATIENT DAY TO DAY CARE *paid in full up to the annual maximum of out-patient day to day care limit of USD 75,000 or RMB 472,500 USD 75,000 or RMB 472,500 Co-insurance^ options: ? ? No co-insurance as standard ? ? Optional 20% Please see your insurance certificate for details of any co-insurance that applies to your out-patient day to day care benefits. Please note that co-insurance does not apply to out-patient day to day care received in public hospitals in Mainland China. Out-patient surgical operations Paid in full* Pathology, radiology and diagnostic tests Paid in full* Specialist consultations and doctors'

fees Paid in full* up to

60 consultations each insurance period Qualified nurses Mental health Physiotherapists, osteopaths and chiropractors Occupational therapist and orthoptist Footcare Complementary therapies: Acupuncture and reflexology Complementary medicines: Homeopathy, naturopathy and Chinese medicine Up to USD 4,000 or RMB 25,200 each insurance period Prescribed medicines and dressings Up to USD 6,000 or RMB 37,800 each insurance period. Once this limit is reach then 50% of any further costs. Durable medical equipment Dietetic guidance Up to

4 visits each insurance period PREVENTIVE TREATMENT Health screening (waiting period

6 months) Up to USD 1,500 or RMB 9,450 each insurance period Vaccinations Up to USD 1,500 or RMB 9,450 each insurance period Eye test Paid in full

1 test each insurance period Preventive dental (waiting period

6 months) Paid in full

2 visits each insurance period SUMMARY OF BENEFITS BENEFIT AND EXPLANATION DENTAL TREATMENT/HEARING AIDS/OPTICAL Dental treatment Up to USD 2,000 or RMB 12,600 each insurance period Accident related dental treatment Routine dental (waiting period

6 months) Major restorative (waiting period

6 months) Orthodontics (waiting period

12 months) Hearing aids/Optical Up to USD 1,000 or RMB 6,300 each insurance period Hearing aids Spectacle frames and lenses and contact lenses IN-PATIENT CARE: FOR ALL IN-PATIENT AND DAY-PATIENT TREATMENT COSTS Hospital accommodation, room and board Paid in full. Standard private room. Parent accommodation in hospital Paid in full Operating room, medicines and surgical dressings Intensive care Surgery, including surgeons'

and anaesthetists'

fees Physicians'

fees Pathology, radiology and diagnostic tests Mental health Physiotherapists, occupational therapists, speech therapists and dieticians Obesity surgery (waiting period of

24 months) Prophylactic surgery Prosthetic devices Per device up to USD 6,000 or RMB 37,800 Prosthetic implants and appliances Paid in full Reconstructive surgery Accident-related dental treatment PRE- AND POST-HOSPITALISATION Home nursing Paid in full Up to

60 days each insurance period Hospice and palliative care Up to USD 40,000 or RMB 252,000 for the entire insurance period, including the renewal period Rehabilitation (multidisciplinary rehabilitation) Paid in full up to

60 days each insurance period ^ The percentage you have to pay towards those covered benefits to which co-insurance applies, as indicated in your '