Pre-approval -
Medical Expense &
Cashless Service

Medical costs are the last thing you want to worry about when you're sick, you can take control of your expenses before treatment

We offer pre-approval* & cashless** service for customer with your choice to choose a network doctor or your own preferred doctor.

  • Cashless service allows AIA to settle bills directly with designated hospitals or medical providers on your behalf, saving you the time and effort of paying hospital bills and making a claim
  • Please provide us details of your upcoming hospital admission or day treatment
  • We will review the surgery and test details***, confirm the expenses, and inform you of the pre-approved amount, ensuring you have a clear budget for your medical costs

Want a hassle-free experience?

Choose Network Doctor


Please rest assured that the network doctor will arrange and handle the pre-approval process for you and AIA would settle the pre-approved medical expenses directly to designated hospitals or medical providers, you could have a hassle-free treatment.

If you have your preferred doctor

If the completed form is not available, you may submit the following
  • Budget Estimate issued by attending physician/hospital
  • Referral letter or laboratory requisition form

Send it to us at least 2-4 working days before hospital admission, medical treatment or tests

Once pre-approval request is completed, you will be informed the result

Once cashless service has been successfully set-up, we will send a "Letter of Guarantee" (LOG) to the concerned hospital. Upon registration at hospital, please present insured's identification document for verification and notify hospital that "Letter of Guarantee" (LOG) has been arranged by AIA.

The hospital will send us the bills and we will settle the approved medical expense on behalf of you. Upon claim assessment is completed, if the medical expense exceeds the payable amount under eligible benefit, a shortfall notification will be sent to policyowner and the designated credit card will be automatically charged with the shortfall amount 14 days from the date of notification.

Reference case^

Without Pre-Approval

Jess
Jess experienced swelling around her neck for months. Her doctor advised her to undergo some tests and surgery

Unexpected experience

Jess paid the medical bills and filed claim with AIA
Since the bill amount exceeded the maximum limit of Jess' medical coverage, her medical bills couldn't be fully reimbursed
Out of her surprise, she had to bear HK$12,000 out of pocket

With Pre-Approval

Christine
Christine experienced abdominal pain for a month. She checked AIA's medical network and booked an appointment with a network doctor

Experience in AIA's medical network service

The network doctor directly contacted AIA, arranged an endoscopic surgery and submitted pre-approval application for Christine
AIA informed Christine that there would be an uncovered amount of HK$1,000 as her medical coverage couldn't fully cover the medical expenses
The consultation fee (before and after the surgery) was covered by Christine's medical coverage as well
The network doctor filed claim directly with AIA for Christine. She paid the uncovered amount HK$1,000 and then fully focused on her recovery

If you have any queries, please contact AIA Pre-Approval Hotline

Hong Kong
Mainland China
4008-428-009

 
Important Note :

 We only cover the charges and / or expenses of the insured person on medically necessary and reasonable and customary basis. 

"Medically necessary" means the need to have medical service for the purpose of investigating or treating the relevant disability in accordance with the generally accepted standards of medical practice and such medical service must:

  • Require the expertise of, or be referred by, a registered medical practitioner;
  • be consistent with the diagnosis and necessary for the investigation and treatment of the disability;
  • be rendered in accordance with standards of good and prudent medical practice, and not be rendered primarily for the convenience or the comfort of the insured person, his family, caretaker or the attending registered medical practitioner;
  • be rendered in the setting that is most appropriate in the circumstances and in accordance with the generally accepted standards of medical practice for the medical services; and
  • be furnished at the most appropriate level which, in the prudent professional judgment of the attending registered medical practitioner, can be safely and effectively provided to the insured person
"Reasonable and customary" means in relation to a charge for medical service, such level which does not exceed the general range of charges being charged by the relevant service providers in the locality where the charge is incurred for similar treatment, services or supplies to individuals with similar conditions, e.g. of the same sex and similar age, for a similar disability, as reasonably determined by us in utmost good faith. The reasonable and customary charges shall not in any event exceed the actual charges incurred.

The above "Medically necessary" and "Reasonable and customary" contents vary according to different insurance products, and policyholders should pay attention to the relevant terms and conditions in the policy.
 
 
 
 
 
Please note:

  1. Pre-approval service or cashless service is not a contractual service, but an administrative arrangement offered in our absolute discretion in respect of covered expenses incurred. It is subject to termination at any time without prior notice.
  2. If treatment or hospital is due to illness/disability/classified under exclusion or our whatsoever, no LOG will be issued.
  3. You will be required to provide treatment information and authorise AIA to collect any shortfall including any uncovered items, etc., if any, from your authorised credit card account.
  4. The actual date of claims notification depends on the submission of required documents by the hospital.
  5. All the claims settlement will be subject to the final bill and the policy terms and conditions.
*Applicable to all AIA individual medical plans.
**A "Letter of Guarantee" will be sent to designated medical providers prior to your treatment. Depending on your policy coverage, you may be required to pay part of the bill later.
***We use the "Reasonable & Customary" guideline to ensure all procedures are medically necessary, and costs are fair, based on market data.

^The example is hypothetical and for illustrative purposes only. If there are any changes in the values, no separate announcement will be made. It does not constitute any medical advice. You should seek independent professional advice before making any decision on this matter.