Customer Rights
Your rights to medical care or treatment when you are feeling unwell
- You can locate a healthcare provider of your choice from the AXA Provider directory¹ if you need specialist treatment. You can be assured of high quality care provided by experienced doctors in an accredited healthcare facility.
- Please seek treatment promptly if you are not well. Our Customer Care Hotline can assist you to find the most appropriate health professional for your needs.
- You have the right to obtain information about what healthcare services are available, and what are the estimated charge.
- You can enjoy cashless transaction and direct billing experience within network provider¹ as long as the amount is within the overall annual benefit¹ and the pre-authorised limit of your plan¹, and provided the treatment is medically necessary and the disease or illness is not a pre-existing condition or under excluded items within the policy.
- You can expect AXA to cover the cost of your eligible medical expenses, subject to the overall annual benefit limit1 and exclusion list¹ as specified in your policy schedule.
- You have the right to provide feedback or complaint which is handled professionally and confidentially.
- You can find information on how to download Emma by AXA app at www.axa.com.hk/en/emma-by-axa today. Through Emma by AXA, you can have ready access to your policy documents, check your claims history, make e-claims and find doctors within AXA Provider Network¹.
Customer Responsibilities
Your responsibilities to minimised/avoid out-of-pocket expenses or uncovered items/services
- It is important to ensure medical care costs and expenses are kept within what is reasonable and customary² to keep premium affordable and sustainable for everyone.
- You will be billed directly by the healthcare facility for expenses unrelated to your medically necessary treatments including but not limit to room upgrades, meals for more than one person and other personal services including but not limited to parking and personal entertainment.
- Please remind your doctor not to admit you as an inpatient for minor treatment and surgery that can be performed in a day case setting or as an outpatient procedure unless medically indicated. You will be required to pay for the cost of tests or treatments that are of your own discretion and which are not medically necessary for you. Examples include and are not limited to routine checkups involving radiological or laboratory investigations, sight correction in addition to mono lens implant in cataract surgery, gastroscopy (OGD) in upper gastrointestinal diseases for screening purposes, colonoscopy in lower bowel diseases for screening purposes, general anaesthesia for minor surgery, inpatient stay for minor surgery, unless medically indicated.
- Please do not ask your doctor or healthcare provider to supply incorrect information about your illness or condition including but not limited to receipts and/or certificates.
- Please do not ask your doctor or healthcare provider to bill AXA for treatment of pre- existing conditions as they are not covered under your policy. For details please refer to the Policy’s Terms & Conditions¹. The policy will not reimburse providers for treatment of pre-existing conditions¹. Should you required treatment for any pre-existing condition, this will be at your own expense. Please contact AXA Customer Care Hotline if you are unsure if your disease or illness is a pre- existing condition.
- Please do not ask the hospital to bill AXA for meals not consumed by the patient or for more than one person. AXA will only cover foods consumed by the insured. Any additional meals will be charged to the customer and payable accordingly.
Remarks
1 Medical coverage, benefits and network access for direct billing varies from policies. Please refer to the product brochure and policy contract for detailed terms and conditions or you may contact AXA Customer Care Hotline for assistance.
2 Reasonable & Customary Charges: The charges for treatment, procedure, supplies or other medical services which do not exceed the general level of charges at the location for similar treatment, procedure, supplies or other medical services to individuals of the same sex and comparable age, for similar disease or injury.
a) the gazette issued by the Hong Kong government which sets out the fees for the private patient services in public hospitals in Hong Kong;
b) statistical information provided by local health authoritative body and information collected from medical specialists and surgeons practicing in the country or area where the treatment is received;
c) industry medical fee survey;
d) our internal claim statistics and/or our global experience and
e) the extent or level of benefits insured
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