Claimable Amount Estimate and Cashless Arrangement Service | Insurance | Sun Life HK

Designated client should be insured under any of the following plans:

Step 1:  Claimable Amount Estimate

• If you already have a preferred doctor, you may consult them directly. Alternatively, you can contact your Advisor to access the “HealthCost Navigator”⁶ via eSunPro to obtain a list of suitable network doctors and reference information on treatment costs.
• Once you have obtained the information for surgery, hospitalization arrangement, and the estimated total cost for surgery or other related medical treatments, please contact your Advisor to submit a Claimable Amount Estimate application to HMG.
• Based on the scope of coverage under your medical insurance policy, HMG will provide a Claimable Amount Estimate.
• HMG will also provide appropriate network doctor as reference based on the information provided.

Step 2: : Get pre-authorization (for Cashless Arrangement Service only)

• After the doctor’s diagnosis, conduct an assessment of pre-surgery costs and medical needs.
• If you choose to use the cashless arrangement service, please complete the Pre-Authorization Application Form and submit it to your Advisor. Your Advisor will then process the pre-authorization on your behalf via “eSunPro”.
• When the pre-authorization process is completed, HMG will inform you the status of your Letter of Guarantee.
• For admission to hospitals in Mainland China, Hong Kong and Macau, cashless arrangement service application form must be sent to HMG at least 4 working days prior to the hospitalization or date of surgery.
• For admission to hospitals in other countries, cashless arrangement service application form must be sent to HMG at least 9 working days prior to the hospitalization or date of surgery.
• The approval result will be sent to the client and advisor by email, WhatsApp or WeChat within 2 working days after completion of the approval process.

Step 3: Undergoing designated day case procedure or admission to the hospital (approval for cashless surgical procedure)

• Designated day care procedures conducted within the HMG network in Hong Kong are eligible for the Cashless Arrangement Service.
• Present your personal identification document upon admission to the hospital or registration at clinic.

Step 4: Discharge

• No extra payment is required upon discharge if the cost is within your approved credit limit. Also, no claim filing is needed after discharge or day case procedure.
• However, if your bill includes unapproved items or services which are not covered in your Letter of Guarantee, you may need to pay the difference and file a claim later.