Coverage and Benefits

Notes

• X is a sum assured multiple of AIA HB Extra.
• *For surgical operation using either general anesthesia or spinal anesthesia, the Company will pay the benefit only one time per confinement.
• **According to the definition of CI diseases in AIA HB Extra, the Company will pay benefit only one time per confinement regardless of the number of CI diseases. The Company will not pay this benefit when the Insured is hospitalized again from complications or sequelae caused by the same CI diseases.

13 Acute CI diseases covered under AIA HB Extra

1. Acute Heart Attack
2. Major Stroke
3. Coronary Artery By-Pass Surgery
4. Major Organs Transplantation or Bone Marrow Transplantation
5. Fulminant Viral Hepatitis
6. Bacterial Meningitis
7. Major Burns
8. Coma
9. Viral Encephalitis
10. Open Heart Surgery for the Heart Valve
11. Major Head Trauma
12. Surgery to Aorta
13. Kawasaki Disease with Heart Complications

Benefits for Inpatient Treatment without Staying Overnight in Hospital (Day Case Benefits)

1. Extracorporeal Shock Wave Lithotripsy (ESWL)
2. Coronary Angiogram / Cardiac Catheterization
3. Extra Capsular Cataract Extraction with Intra Ocular Lens
4. All Types of Laparoscopic Surgery
5. All Types of Endoscopy
6. Sinus Operations
7. Excision Breast Mass
8. Bone Biopsy
9. Finger or Toe Amputation
10. Liver Puncture / Liver Aspiration
11. Bone Marrow Aspiration
12. Lumbar Puncture
13. Thoracentesis / Pleuracentesis / Thoracic Aspiration / Thoracic Paracentesis
14. Abdominal Paracentesis / Abdominal Tapping
15. Curettage / Dilatation & Curettage / Fractional Curettage
16. Colposcope / Loop Diathermy
17. Marsupialization of Bartholin’s Cyst
18. Gamma Knife Radiosurgery

Waiting Period

• Any illnesses occurring within 30 days following the date on which this contract is issued or reinstated, whichever is later.
• The following illnesses occurring within 120 days following the date on which this contract is issued or reinstated, whichever is later:
  • Hernia
  • Pterygium or Cataract
  • Tonsillectomy or Adenoidectomy
  • Endometriosis

• Inpatient hospitalization due to any acute critical illness according to the definitions stipulated in this rider for acute critical illnesses or disorders, which have been confirmed by a medical practitioner and are clearly and evidently related to the acute critical illnesses covered under this rider occurring within 60 days following the date on which this contract is issued or reinstated or, whichever is later.

Some Exclusions of AIA HB Extra Rider

1. The Insured suffers from a chronic disease, illness, or any injury that is not treated before the contract’s effective date, or before the effective date of the latest reinstatement, whichever is later, or a congenital disease, a developmental problem or a genetic disorder.
2. The Insured is under surgical or other treatment for the purposes of cosmetic, skincare, acne, melasma, freckle, dandruff, hair loss or weight loss, or an optional surgery; however, the cosmetic surgery to address wounds suffered from an accident under the policy contract will be covered.
3. Pregnancy, miscarriage, abortion, child delivery, obstetric complications, solutions to infertility problems (including investigations and treatments), sterilization and contraception.
4. General health check-up, request for hospitalization or request for surgical procedure, convalescence or specific purpose for rehabilitation, any investigation not directly related to hospital admission, diagnosis, injury or illness, any treatments or investigation that are neither medically necessary nor in accordance with the standards of medical practice, and fees for special nursing services.
5. Treatments for eyesight problems, Lasik, expenses for corrective optical aids, or treatments for refractive errors.
6. Dental treatments or surgeries, prosthodontics, dental crown treatment, root canal treatment, dental filling, orthodontic treatment, dental scaling, tooth extraction, dental implant, except the treatment to address injury from an accident, which does not include the costs of denture, crown treatment, and root canal or implant treatments.
7. Other treatments besides conventional medicine including alternative medicine.

Requirements

• Insurable age: 15 days - 70 years
• Coverage period: Until the age of 80 or until the basic plan has expired
• Premium payment period: Until the age of 80 or until the basic plan has expired
• Maximum sum assured per an insured person for a health insurance rider: Depending on the consideration criteria of AIA Company Limited
• Payment mode: Annually / Semi-annually / Quarterly / Monthly

Premium Rates

Standard annual premium rates per sum assured of 100 Baht for the age of 15 days - 70 years (depending on gender, age and payment mode, excluding increased premiums due to health conditions).

Note: A rider is a one-year and renewable insurance contract. The Company reserves the right to adjust the premium rate during the policy year due to several factors such as age, occupation and claim payment experience, etc. Riders that cover medical expenses may include other factors such as medical inflation and medical expenses which must be approved by the Insurance Commissioner.