Frequently Asked Questions for customers of Heath Goal Insurance Plan

You are entitled to the Services if you are (1) the life insured covered under HSBC Health Goal Insurance Plan and (2) your policy is still in-force during the policy term.

Global Medical Care Services (the “Services”) are provided by a leading global patient care organisation, Preferred Global Health (“PGH”), to the life insured of HSBC Health Goal Insurance Plan policy. The Services consist of Personal Care Managers, Diagnosis Verification and Treatment Plan, Doctor-to-Doctor Dialogue, and US Care Management services.

U.S .Care Management service is only applicable to HSBC Health Goal Insurance Plan policy with Notional Amount of USD2 million or more. All the treatment and medical costs will need to be settled by the customer; and the relevant costs involved in travel, accommodation, after-care support, etc. in the U.S. will be borne by the customer via self-funding.

Global Medical Care Services are value-added services provided by PGH during the policy term of HSBC Health Goal Insurance Plan. For details, please refer to the service leaflet of Global Medical Care Services. HSBC Life (International) Limited (“the Company”, “we”, “us” or “our”) shall not bear any liability for the quality and scope of services provided by the organisation. We reserve the right to revise and change the details and the terms and conditions of these services to be provided by the organisation from time to time, as well as to cease and/or suspend the provision of such services at any time at our sole and absolute discretion without giving prior notice.

You can apply to activate the Services once you lodge a claim with HSBC Life upon diagnosis of a covered critical illness, PGH will review your request based on the terms of the Global Medical Care Services.

Yes, you can seek more information on their official website: www.pghworld.com/en/Services-Hongkong; and send your enquiries to their general public email address: info@pghworld.com if needed.

You are strongly advised to activate the Services as soon as a diagnosis is known to benefit from a timely specialist advice on the diagnosis or treatment plan. However, if you would like to activate the Services later, you can fill in and submit another claim form to HSBC Life again for raising the request.

Your service entitlement is based on the policy cover of HSBC Health Goal Insurance plan and the same set of coverage, exclusions and pre-existing conditions shall apply. Please refer to the Policy Provisions for the definitions of Cancer, Heart Disease and Stroke as well as exclusions.

As an eligible life insured, you are entitled for the Services as long as you are diagnosed with Cancer, Heart Disease, or Stroke by a Registered Medical Practitioner during the policy term.

A diagnosis for Cancer, Heart Disease and / or Stroke. The same set of coverage and exclusions of HSBC Health Goal Insurance Plan shall apply. Please refer to the Policy Provisions for the definitions of Cancer, Heart Disease and Stroke as well as exclusions.

A diagnosis by a Registered Medical Practitioner is acceptable.

Malignant Cancer is defined as any malignant tumor positively diagnosed with histological confirmation, such as a biopsy, and characterized by uncontrolled growth of malignant cells and invasion of tissue. The same set of coverage and exclusions of HSBC Health Goal Insurance Plan shall apply. Please refer to the Policy Provisions for the definitions of Cancer, Heart Disease and Stroke as well as exclusions.

Heart Disease is often used interchangeably with “cardiovascular disease”, and generally refers to conditions that involve narrowed or blocked blood vessels that can lead to heart attack, chest pain (angina) or Stroke. Heart Disease also includes conditions that affect the heart muscle, valves or rhythm (e.g. arrhythmic disease). The same set of coverage and exclusions of HSBC Health Goal Insurance Plan shall apply. Please refer to the Policy Provisions for the definitions of Cancer, Heart Disease and Stroke as well as exclusions.

Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS) by a vascular cause, including cerebral infarction, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH); and it is a major cause of disability and death worldwide. Please refer to the Policy Provisions for the definitions of Cancer, Heart Disease and Stroke as well as exclusions.

No. For your interest, immediate medical attention should be sought for emergency heart failure or disruption of blood supply to the brain by Stroke, via transient ichaemic heart attack (‘mini Stroke’) or hemorrhagic blood vessel or myocardial failure (‘heart attack’). PGH can only provide the medical care consultation services such as diagnosis verification, treatment plan development by Harvard-level specialists, Doctor-to-Doctor Dialogue and U.S. Care Management for treatment at a top ranked hospital in the U.S. after you have received immediate medical attention.

Yes, PGH will assign a Personal Care Manager who will take care of your medical condition from diagnosis to recovery. They are committed to your medical condition until your case is closed.

You can opt to activate the Service immediately following a diagnosis of Cancer, Heart Disease or Stroke by a Registered Medical Practitioner. To do so, complete and submit the relevant claim form to HSBC Life in order to activate the Service. Your claim and service activation will be processed in parallel by HSBC Life while the service will be provided upon receipt of your request regardless of your claim result. All eligible life insured can enjoy the Diagnosis Verification and Treatment Plan, Doctor-to-Doctor Dialogue and Personal Care Managers (PCM). The U.S. Care Management service is only applicable to HSBC Health Goal Insurance Plan policy with Notional Amount of USD2 million or more. All the treatment and medical costs will need to be settled by the customer; and the relevant costs involved in travel, accommodation, after-care support, etc. in the U.S. will be borne by the customer via self-funding.

Please be rest assured that only the information requested in the service activation section of the relevant claim form (i.e. your full name, policy number, diagnosis category - Cancer, Heart Disease or Stroke, valid email, valid mobile contact number and preferred contact time) will be transferred by HSBC Life to PGH upon receiving the specific consent of the customers. The PGH service activation and HSBC Life's claim request will be handled independently by PGH and HSBC Life respectively. Apart from the information contained in the respective section in claim form, all your other personal information including medical information and claim assessment outcome etc. would not be shared between HSBC Life (International) Limited and PGH.

You will receive a notification SMS sent from HSBC Life upon receipt of your activation and claim requests. You will then be contacted by the Personal Care Manager (PCM) assigned by PGH via phone call and / or email within 24-48 hours. . If your PCM cannot reach you successfully within a month, you will receive an SMS sent by HSBC Life notifying the failure of such request. You need to re-submit a completed claim form to us for Service activation in this case.

The Personal Care Managers of PGH are registered nurses with fruitful medical project management experience and patient advocacy expertise. They are based in Boston, USA, from where they provide support and guidance to our eligible life insured and work closely with the Harvard-level specialists / hospitals for their medical condition.

Your Personal Care Manager (“PCM”) will provide you a dedicated care from end-to-end upon initiation of the Service. The PCM will speak to you to understand your case, situation, needs and concerns, etc and ask for complete medical files and all related documents to your case which will be sent to the specialists in the U.S. for further verification of your diagnosis and development of a treatment plan. Please be rest assured that your medical records as provided are totally owned by you and provided on your accord in terms of your rights as a patient. In case you require further assistance or do not feel comfortable speaking to your local doctor, the PCM will help engage your local doctor on your behalf with your consent sought beforehand.

The DVTP is a comprehensive evaluation of the medical records and imaging used in identifying the primary diagnosis. Harvard-level specialists will confirm or provide an alternative further diagnosis via a multidisciplinary review approach and develop treatment plan options. You will receive a Diagnosis Verification and Treatment Plan Report with the specialists’ opinions and advice.

PGH has access to a pool of thousands of Harvard-level specialists who will be engaged for your case based on your medical condition. For Cancer cases, it typically involves a multidisciplinary review from different oncology disciplines, such as medical oncology, radiation oncology, and surgical oncology.

For the DVTP, PGH will work with Harvard-level specialists and the leading medical center for practice, teaching and research & development in the world. Having said that, subject to availability of particular specialists in the U.S. as requested, PGH will make every effort to accommodate your request if possible.

Usually the report can be ready within 7 to 10 business days when a complete set of medical records are ready by you / your local doctor and well received by PGH.

The Personal Care Managers ("PCM") are experienced in supporting international patients and patients from Hong Kong. Translators are engaged as required for verbal and written communication with doctors in the U.S. and with your PCM. Professional medical translators are engaged to translate medical records as well as the reports by the specialists in the U.S. It usually takes 3 additional business days for translation. Translation service is free of charge.

It is understandable for patients to seek additional medical opinions from specialists on their diagnosis. It is also understandable that patients request the medical information pertinent to their diagnosis, as it is their right. PGH will review your medical records for completeness, have them professionally translated into English if necessary and share with the Harvard-level specialists in the U.S. PGH is experienced in dealing with local doctors and welcomes their collaboration with renowned and reputable Harvard-level specialists. Your Registered Medical Practitioner may also have a professional and confidential discussion about your case with the Harvard-level specialists in the U.S. if you choose, through the Doctor-to-Doctor Dialogue service.

However, if you don’t want to engage your Registered medical Practitioner directly, or in the event of any resistance from local doctors, PGH will engage a local National Medical Coordinator for assistance. Local National Medical Coordinators do not provide medical advice on the case.

Generally, alongside all the medical information and test results pertinent to your case, the Harvard-level specialists require imaging studies corresponding to the primary diagnosis, for example CT/PET scan, X-ray or MRI images, and, with Cancer diagnoses, pathology slides from the initial biopsy.

Medical records and the written DVTP report from the Harvard-level specialists in the U.S. are generally transmitted by encrypted email that is password protected. Medical documents can be scanned and sent electronically. Pathology slides and large sized files like imaging studies that are usually stored in CDs may be sent via tracked post or prepaid tracked courier. You may also choose to directly upload imaging studies to the reviewing team of specialists at the US hospital providing the medical opinion if you wish. The link will be provided to you by your Personal Care Manager who will assist you. You will need to create a temporary account and the uploaded medical imaging studies will be directed to the appropriate departments, for example radiology. You may also request the PGH to share the written opinion report from Harvard-level specialists with your local doctor if you wish.

The Diagnosis Verification and Treatment Plan report is a comprehensive written summary report in English produced after a multispecialty and/or multi-oncologist disciplinary review of the customer’s case. It covers the customer’s clinical history and gives detailed recommendations for the course of treatment. You may request a translation in your local language if needed. It usually takes an additional 3 business days for the translation upon generation of the report. Such translation service is totally free of charge.

Your Personal Care Manager will contact you within 1 business day after you have received the written report. Your PCM will help you understand the report, like medical terminology, and answer questions you may have. Your PCM may also help you bring one follow-up question on the report to the relevant specialist.

You can request the Doctor-to-Doctor Dialogue service. This enables the local doctor to confidentially discuss your case and treatment together with the Harvard-level specialist in the US directly via secured private video conference call.

For cases where the appointed Harvard-level specialist determines that additional tests are required for a precise diagnosis and treatment plan, the customer will be strongly advised to seek the tests as requested locally. The costs of diagnostic and medical tests are not a covered benefit.

The specialists may not be familiar with the availability of medical treatment in each country, but they will always recommend the best course of treatment to their best knowledge. Any specific details on the availability of this treatment in a particular country can be discussed via Doctor-to-Doctor Dialogue.

The DDD is a discussion between your local doctor and the Harvard-level specialist in the U.S. over your specific case and treatment. It is a further step you may request after your DVTP report is ready. The dialogue is designed to be a confidential discussion between two medical doctors without the participation of third parties, including the customer. Doctors will share their knowledge on a 30-45 minute secured video conference call. This dialogue brings expert medical minds together and gives high added value specially in cases of rare or complex diagnosis and reassurance over the course of treatment and implementation of the treatment protocols.

Not necessarily.

PGH will try to accommodate requests but will make the most appropriate selection from the Harvard-level specialist network. Specialists are selected based on their established expertise in the customer's condition and availability. Residents, interns and juniors are not eligible.

The DDD can be requested as soon as you receive the report if you wish. It is strongly advised the DDD be conducted within 365 days upon receipt of the report by you to ensure your medical circumstances are still valid.

Only one dialogue service is expected and generally 30 mins, up to 45 minutes per session. Additional sessions can be requested subject to the availability of the specialist and additional costs will be charged to you.

You can raise the request to your Personal Care Manager.

The specialist will review all your medical documents as provided by you or your local doctor, the DVTP Report, and any new medical information and circumstances that may have happened in the period up to the dialogue. You will be required to share this with your Personal Care Manager for further transmission of such information to the specialist.

Generally, the video conference session can take place between your local doctor with the specialist from Mondays to Fridays, from 8 am to 4.30 pm EST. An earlier start time from 6 am-7 am can be requested subject to the availability of specialist.

Your Personal Care Manager will help arrange and confirm the time session with the specialist. Upon confirmation of time, you can inform your local doctor.

It usually requires at least four business days’ notice. PGH aims for the session to take place within 7-14 business days.

Please give your Personal Care Manager 48 hours’ notice for cancellation or re-scheduling of your session.

The DDD session will require all the documentations that were made available for the DVTP, as well as any additional examinations and/or medical results that may have been received since the DVTP Report was produced. The relevant forms signed for the DVTP will also be applicable.

Yes.

(Only applicable to HSBC Health Goal Insurance Plan policy with Notional Amount of USD2 million or more.)

Your Personal Care Manager and a team of experienced medical professionals will provide end-to-end coordination of Harvard-level treatment at the top 1% hospitals in the U.S. as well as financial management services. During the treatment at the hospital, your Personal Care Manager will accompany you in person and assist you as well as your family throughout the treatment and recovery journey until you return to your home country. The service includes:

  • Travel and accommodation arrangements
  • Medical visa application support
  • Language (translation and interpretation) services
  • Medical appointment scheduling
  • Medical project management and quality control of course of treatment to reduce likelihood of preventable medical errors
  • Quality control of medication and drug course
  • Facilitation of medical communication and informed patient decision-making
  • Hospital admission and discharge processes
  • Financial management services to assist with hospital billing, subject to method of payment and terms
  • Personal Care Manager giving in-person support, guidance, and patient advocacy

U.S. Care Management provides high value personal guidance and patient advocacy delivered on-the-ground by the Personal Care Manager physically present and supports customers and their family throughout the treatment journey until they return home. U.S. Care Management services are only applicable to HSBC Health Goal Insurance Plan policy with Notional Amount of USD2 million or more. All the treatment and medical costs will need to be settled by the customer; and the relevant costs involved in travel, accommodation, after-care support, etc. in the U.S. will be borne by the customer via self-funding.

As often as necessary. You will have free interpreter support for all doctor and hospital purposes as well.

With all likelihood you will have followed the standard customer journey and utilized the Diagnosis Verification and Treatment Plan to identify the type of treatment that is recommended. Nonetheless, customers whose benefits include US Care Management and who have not used the other services, will be assisted to the extent possible.

Not necessarily. The Diagnosis and Verification Treatment Plan gives the patient an option for treatment. Ultimately it is the patient’s choice which treatment plan they want to utilize.

Please contact your Personal Care Manager directly if you have already received the Diagnosis Verification and Treatment Plan or Doctor-to-Doctor Dialogue.

Please inform your Personal Care Manager at least four weeks in advance for them to make the necessary arrangements of medical scheduling and travel & accommodation logistics.

Your appointment(s) will be with a specialist doctor and the specialist team in your condition and according to the diagnosis and agreed course of treatment at the treating hospital.

Your Personal Care Manager will coordinate these arrangements and confirm the suitability with you before finalizing. Reservation codes and confirmation will be provided prior to your travel. You will be provided with a full itinerary and briefed in as much detail as possible before your departure on the length of your projected treatment. The length of treatment plan will be based on the US Medical Specialist’s best estimates for treatment and recovery times. Like any medical treatment, it very much depends on your condition and response to prescribed care, unforeseen medical complications, varying recovery times, and changes in treatment plan. You will also be given in advance full orientation on all the details of your accommodation and stay. Suitable arrangements for any special dietary, religious, or other special needs will be made.

You can select any type of airfare you desire at your cost. Your Personal Care Manager will assist with the logistical preparation.

Accommodation is generally arranged to be in proximity to the treating hospital and may include hotels or short-term apartments for you/your companion's consideration and is entirely paid by you at your own costs. Your personal and companion's preferences will be taken into consideration.

You can only travel if you are healthy enough to do so as determined by your doctors. If you are too fragile to travel, the Doctor-to-Doctor Dialogue service is designed to support and enhance local treatment at home as discussed between the U.S specialist and your local doctor. If you are not well enough to return home after treatment in the U.S, you will remain there, with continuing support by your Personal Care Manager, until it is medically safe to return home as determined by your treating doctor in the U.S.

You may need to make your own travel and accommodation arrangements, but you must notify your Personal Care Manager at least 4 weeks in advance if you wish to receive the US Care Management Service after your arrival.

You may take whomever you like. Your Personal Care Manager can assist you with the travel arrangements for your companions upon request.

You need to apply for the U.S. visa for yourself as well as your companion. Your Personal Care Manager can assist you in providing evidence of medically needed and financially guaranteed treatment in the form of a letter from the treating hospital.

You and your companion will be greeted at the airport in the U.S. by your Personal Care Manager and / or by a member of the Care Management Team and / or a professional translator upon request. You will be accompanied to your accommodation and given full orientation on all the details of your stay including the specific treatment plan and key milestones. Any required arrangements for any special dietary, religious, or other special needs you may have will be taken care of.

Key milestones are any major appointments throughout the course of treatment i.e. admission to the hospital, appointments with specialists, surgery, chemotherapy or radiation therapy, recovery.

Before departure your Personal Care Manager will exchange contact details with you for continuous communication. And the Care Management team will be monitoring the status of your arrival and will be available and prepared to assist you in meeting any eventualities that may delay your arrival.

The length of treatment in the U.S. depends on the diagnosis and treatment plan, including comorbidities. Most treatment and recovery take place over a period of three to six weeks with the majority of that time in recovery and follow up. However, there have been treatment cases of up to one year.

All the treatment and medical costs will need to be settled by the customer; and the relevant costs involved in travel, accommodation, after-care support, etc in the U.S. will be borne by the customer via self-funding.

PGH can assist with outlining steps for financial guarantee requirement, estimated costs of treatment, hospital billing and billing steps. In certain cases, the service provider may also support with re-pricing discussions with the hospital if applicable.

All the treatment and medical costs will need to be settled by the customer; and the relevant costs involved in travel, accommodation, after-care support, etc in the U.S. will be borne by the customer via self-funding.

If you are in doubt, you are highly recommended to refer to the respective Policy Provisions of your plans for detailed terms, conditions and exclusions; and consult with professionals for their advices as and when appropriate.

If a doctor recommends a period of recovery in the U.S. outside of the hospital and follow-up appointment(s) with the U.S. medical team after hospital discharge before traveling home, you will still receive support from the Care Management team until the treating specialist confirms that you are well enough to return home.

Your Personal Care Manager will provide you with care from the beginning to the end. You will be accompanied by them throughout your recovery time in the U.S. after the hospital discharge, including but not limited to the continuation of post-hospital medical care (ie appointments and scheduling of tests, etc), and regular checks, guidance and reinforcement of discharge self-care support.

You will receive a full medical record formally issued by the U.S. hospital around two weeks after your hospital discharge. Your Personal Care Manager will help monitor the progress to ensure that you will receive such records as soon as possible or prior to your departure.

Your Personal Care Manager and / or the Care Management team will try their best effort to ensure that you return home safely. Additional support includes arranging flights, pick up and drop off transfer to the airport.

Patients are generally required to receive some form of follow-up care such as periodic scans as suggested by their treating U.S. specialist and or hospital. This kind of follow-up care is likely to be carried out in your home country.

Your Personal Care Manager is committed to your medical condition until the case is closed. They will contact you regularly every 2 months, 4 months, 6 months, 1 year and 3 years for your post-recovery care after your departure from the U.S. depending on your circumstances to ensure the best possible outcomes.

Yes, you will be given all the relevant contact information of your U.S. treating specialist team for enquiries, particularly if you experience significant changes in your medical condition after returning home just in case.