Dear Students,

To align with the development of the University and provide better medical coverage, the University continues to provide a comprehensive medical insurance plan for all registered students that covers both in-patient and out-patient services. The insurance premium is MOP120 for the current academic year, while the related debit note will be issued on mid of September. Please review the following important details to ensure you are fully aware of the insurance coverage and claim procedures.

1. VALIDITY PERIOD:

• New Students: From the date of registration until July 31, 2025
• Current Students: From August 01, 2024, to July 31, 2025

2. DESIGNATED MEDICAL SERVICE PROVIDERS:

To further enhance service quality, the number of designated medical service providers has been increased from 07 to 14 and also extend to the below hospital in Zhuhai as well as Hengqin, offering more comprehensive medical coverage.

		Medical Service Providers	Telephone Number
Existing Providers	1.	Hospital Kiang Wu	(Macao) 2892 2822; (Taipa) 8295 4001
	2.	Hospital Conde de São Januário (CHCSJ)	(Macao) 2831 3731
	3.	Centro Medico – Diagnostico Popular	(Macao) 2857 7790; (Taipa) 2852 4468
	4.	Grupo Medico Hope	(Macao) 2858 9000; (Taipa) 2883 6992
	5.	Policlinica Chan’s de Macau	(Macao) 2853 0556
	6.	Centro de Radiologia de Macau Lda.	(Macao) 2837 2283, 28526190
	7.	Medical Center of University of Macau	(Macao) 8822 4123
New Providers	8.	The Fifth Affiliated Hospital of Sun Yat-sen University	(Zhuhai) 0756-252 8888
	9.	Guangdong Provincial Hospital of Chinese Medicine, Zhuhai	(Zhuhai) 0756-332 5114
	10.	Zhuhai People’s Hospital	(Zhuhai) 0756-222 2569
	11.	Zhuhai Center for Maternal and Child Health Care	(Zhuhai) 0756-231 0190
	12.	Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine	(Zhuhai) 0756-813 6023; (Zhuhai) 0756-813 6555
	13.	Hengqin Branch of Zhuhai People’s Hospital	(Hengqin) 0756-331 3273
	14.	First Affiliated Hospital of Guangzhou Medical University Hengqin Hospital	(Hengqin) 0756-331 3572

3. MEDICAL COVERAGE DETAILS:

Benefit	Maximum Limit of Reimbursement
	Remarks	(MOP)
A.  Hospitalization Benefit
1. Daily Room & Board	Limit per day (Max. day per disability: 30)	200
2. Hospital Special Services	Limit per disability	4,000
3. Anesthetists’ Fees	Limit per disability (up to 30% of the reimbursable surgical fees)	Complex – 3,000 Major – 1,500 Intermediate – 750 Minor – 375
4. Operation Theatre Fees
5. Surgical Fees	Limit per disability According to the Surgical Schedule of Asia Insurance Co., Ltd.,	Complex – 10,000 Major – 5,000 Intermediate – 2,500 Minor – 1,250
6. In-hospital Physician’s Visit	Limit per day (Max. day per disability: 30)	100
7. In-hospital Specialist Consultation (*)	Limit Per disability	1,000

 

B. Out-patient Expenses		(MOP)
1. Out-Patient Physician’s Visit	Per visit ( [1.] + [2.] + [3.] + [4.]: Max. 5 visits per academic year) ※Note: Max. 1 visit per day	200
2. Chinese Medicine / Bonesetter
3. Physiotherapist’s / Chiropractor’s Visit (*)
4. Specialist’s Consultation (*)
5. Prescription Medicine (Outside Clinic) (*)	Max. limit per academic year	500
6. X-ray and Laboratory Test (*)	Max. limit per academic year	1,000

 ※Note: (*)Written referral from the attending physician is required. The relative referral letter and prescription for medicines should be submitted with claim document. For Specialist’s consultation, referral letter for Gynaecology, Orthopaedics & Traumatology, Otorhinolaryngology(ENT), Ophthalmology, and Dermatology is waived.

4. EXCLUSIONS:

1. Congenital abnormalities or defects existing at the time of birth or wherever to be diagnosed.
2. Directly or indirectly as a result of disease or natural causes or from war (whether declared or not), strikes, riots, civil war, revolution or any warlike operations or join the military.
3. Disabilities arising from the Insured Person’s offences or participation in any illegal acts (except traffic offences and pedestrian offences).
4. Investigation and treatment of psychosis, psychological, emotional, mental or behavioral conditions or disorders; treatment of chronic alcoholism or drug abuse or any other complications arising therefrom; rest cures or convalescence; Suicide, attempted suicide or intentionally self-inflicted injury whether sane or insane.
5. Eye refraction, fitting of glasses or surgical procedure for correction of eye refraction (except necessitated by accidental injuries or as a result of disease), examination for fitting of hearing aids, procurement or use of special braces, prosthetic appliances or equipment such as artificial limbs and cosmetic surgery or treatment for beautification purposes.
6. Dental care and treatment including amalgam or composite fillings, orthodontics, (except necessitated by accidental injuries to sound natural teeth).
7. Pregnancy, resulting childbirth, abortion, miscarriage or conditions resulting therefrom, genetic testing or counseling, artificial fertilization treatment or treatment related to birth control or infertility.
8. Cost or expense of whatsoever nature arising out of daily room and board, accompany fee, SRN nursing care, meal fee, extra bed fee which are not medically necessary.
9. Special nursing care, routine physical examinations, health checks or tests not incidental to treatment or diagnosis of a disability or any elective treatments or services which are not medically necessary for any preventive treatments, medicines or examinations (incl. CT, MRI, X-ray, Lab. Test etc.), vaccinations, immunizations, or vaccinations.
10. Conditions related to sexually transmitted diseases, Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC).
11. Disabilities arising from racing of any kind (except on foot racing), skydiving, mountain or rock climbing, professional sports, aviation or aeronautics (other than travelling as a fare-paying passenger in commercial airplanes).
12. Treatment not by a registered doctor or legal operation hospital.
13. Care or treatment for which payment is not required or is waived or is recoverable from a third party or under any other insurance including (without limitation) Employees’ Compensation Insurance.
14. Experimental medical treatment which, at the time it is provided, is not considered safe, effective and appropriate for the injury or sickness, and is not accepted as standard treatment for the injury or sickness.
15. Disabilities arising from nuclear weapons material, ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste or from the combustion of nuclear fuel. For the purpose of this Exclusion, combustion shall include any self-sustaining process of nuclear fission.
16. Other as per Policy.

5. CLAIM PROCEDURES:

1. The necessary medical claim forms required for filling the claims are readily available at the website of/and Student Resources Section (Student Activity Centre E31, Room 2007).
2. Claim payment will be subjected to the terms and conditions set out in the corresponding master Policy.
3. Incomplete form or omission of required information may cause delay in processing.
4. The reimbursement of the claim takes around 4-6 weeks and it will be settled by account payee cheque. Students should have a bank account in any of the banks in Macao with the currency of “MOP”.

6. Hospitalization & Surgical Claim:

1. A “Medical Insurance – Hospitalization & Surgical” claim form should be completed and signed by both claimant and attending doctor.
2. The form and original official hospital invoice/ statement (with hospital or registered medical practitioner’s signature and chop) must be submitted to Student Resources Section within 70 days from the date of discharge from hospital. Otherwise, the claim shall be declined for reimbursement.

7. Out-patient Claim:

1. Request for the original official receipt and medical report after each consultation. It must include the following information and complete the claim form,
2. For Laboratory & X-Ray Tests/ Physiotherapist’s visit/ Chiropractor’s visit/ Specialist Consultation/ Prescription Medicine, a referral letter from attending Physician is required. The referral letter is valid for 6 months for same diagnosis. Should there be more than one claim for the same diagnosis; copy of the same referral letter should be attached together with each claim.
3. Claim form, original official receipts, and medical report must be submitted to Student Resources Section within 70 days from the date of consultation. Otherwise, the claim shall be declined for reimbursement. No copy shall be entertained

Medical Report should include:

1. Date of consultation
2. Diagnosis
3. Treatment
4. Patient’s name
5. Hospital or registered medical practitioner’s signature and chop

For any enquiries, please contact Mr. HO or Ms. NGAI

Phone： 8822 9902 / 8822 9912
Email： sao.services@um.edu.mo

Student Resources Section
Student Affairs Office