Bao hi~m VietinBank (VB!)Tang 10, II toa nha 126 DOi can, Q. Ba Dinh, TP. HANOiTel 04 3942 5650 I Fax 04 3942 5646Website: vbi. . n

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",. CONGTY* co' PHA'N BAO HlfM *~ ',~ ~..'"' ..

CONG TY BAo IIIEM

Ha NQi,ngay 28 thang 09 nam 2019

RlNH BAo HIEM sue KHOETRIEN KHAI QUASMART BUDDY

Vi~tNam va Toan c.1u.p~ VI BAo lIlEM

DOl 111QNG DUQC BAoIIIEM (NDBH)

mOl GIAN CHO

T6ng cong ty CP Bao hi~mNgan bang TMCP Cong thirong Vi~tNam (G9itMla VBI)

NguOiduoc bao hiem la moi cong danVi~tNam hoac nguOimroc ngoai cutni tai hop phap tai Vi~tNam illsau mum (60) ngay tu6i d~n sau mum Him(65) tu6i tai thoi di~mMt ru1uhi~u IlJCcua Hop d6ng baohiem,

Tre em durn 6 tuc3ico th~ tham gia bao hib cungM/my hoac tham gia dQcl~p nhimg phi bao hi~m tang 30010. Chuang trlnh bao hi~m coo B6/my lachuang trlnh co quy~n loi nrong duong ho~ cao han chuang trlnh bao hi~mcoo con. Con duoc dinh nghia trong chuang trlnh bao hiSm nay la conde/mQt,con nuoi hQ'Pphap.

VB! khong chap nh(in bao hiim cho cdc db; tuvng sail

- Ngum dang bi tam thfuJ, thfuJ kinh, b~nh phong, ung thu

Ngum bi thuong t~t vinh vi~n qua 50%

Ngum dang trong thai gian di~u tri b~nh ho~c thuong t~t (chiapd\lIlgvrn nguCritham gia bao hi~m Ian<tAuho~ tai t\lC khong lient\lC)

B~nh thong thuang, di~u tri 6m dau (bao g6m nha khoa): 30ngay

Di~u tn ho~c tt'r vong do b~nh d~c bi~t, b~nh/thuong t~t cosfuI: 365 ngay

Thai san (sinh thuang, sinh m6, sinh kho, tai bi~n san khoa):270 ngay;

Di~u tn b§t thuang trong qua trinh mang thai va b~nh Iy phcitsinh trong thai ky: 90 ngay;

TiI vong do 6m dau, b~nh thong thuang: 90 ngay;

DONGCHITRA. DAng chi tra vOi tre em tir duOi 3 tu6i

D6i vo; cac S\I ki~n bao hi~m do nguyen nhan b~nh viemph6i cac IOl,li,viem ph~ quan, ti~u ph~ quan phat sinh trongthai giaIl til 30 ngay d~n 90 ngay k~ til ngay b~t ddu thai hl,lllbao hi~m: D6ng chi tea 50:50 chi phi y t~ thuQCphl,llll vi tl,li

tat ca cac co sa y teo

Dang chi tri voi quy~n lqi thai san:

- Neu khach hang sinh con! tai bi~n san khoa trong khoang thaigian tir 270 ngay - du 365 ngay k~ tir ngay bAt dAu thai hanbao hiem: Ap dung dang chi tra 50:50 chi phi y t~ thuocpham vi tai cit ca cac co sa y t~.

- N~u khach hang sinh con! tai bien san khoa sau 365 ngay k~tir ngay b~t dAu thai han bao hiem: Chi ap dung dang chi tra70:30 chi phi y t8 thuoc pham vi n8u khach hang dieu tri taico sa y t~ benh vien tu nhan, benh vi~n qu6c t~; chi tra 100%s6 ti~n bao hiSrn thuoc pham vi bao hiSrn n~u khach hangdi~u tri tai benh vien cong l~p (khong phan biet khoa tvnguyen hay thong thirong).

Dang chi tra vOi quy~n lqi nha khoa:

- N~u khach hang di~u tri nha khoa tai benh vien, co sa y t~ tunhful, qu6c t~: dang chi tra 70:30 chi phi y t~ thuQc ph~ vi.

- N~u khach hang di~u tri nha khoa tI;li b~nh vi~n cong l~p(khong phan bi~t khoa tv nguy~n hay thong thuOng): chi tra100% chi phi y t8 thuQc ph~ vi.

p~ VIBAo mEM Tir vonglthuang t~t toan bQvinh vi~n do tai nc.mva b~nh, Dieu tri nQitrU, di~u t:ri ngo~ trU, cham soc rang, thai san

SO TIEN BAo mEM Theo ph\ll\lc dinh kern

pHi BAo mEMlNAM Theo ph\ll\lc dinh kern

DrEU KHoAN CHAM DUr Cham dUtHDBHH<}PDONG BAo mEM - Ben rnua BH khong con quy~n lQ'ico th~ duQ'cbao hi~rn

- Ben rnua BH khong dong dll phi BH ho~c khong dong phi

bao hi~rn theo thai hc.mthoa thu~ trong HDBH, tm truang

hqp cac ben co thoa th~ khac;

- Ben rnua BH khong dong du phi BH trong thOi gian gia hc.m

dong phi bao hi~rn theo thoa thu~ trong HDBH

K~t thuc quy~n lqi DH

Tdt cit cac quy~n 19i BH theo quy cic BH m\y se chdm d(rt hi~u l\l'c

vao ngay cu6i coog cua thai hc.mBH duQ'c quy dinh tren Gidy chung

nh~ Hqp dang bao hi~rn ho~c vao ngay chdm d(rt hi~u l\Ic bao

hi~rn do Chu hqp dang bao hi~rn yeu cAu tily theo thai di~rn nao den

truce, bao gom ca nhtmg rui ro phat sinh trong thoi han bao hiemnhung thoi diarn khAephuc h~u qua xay ra ngoai thoi han boo hiarn.

BIEU Kq:NIf)IEU KHoAN Ban hanh thea Quy~t dinh s8 1368/QD-VBI6 ngay 17/07/2018 cua

T6ng Cong ty e6 phdn boo hiSrn Ngan hang TMCP Cong thuong

VN.

BAo HIEM VIETINBANK - VBI

;6lG

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PHV r.uc 01: QUYEN L<}IBAo HIEM

.Pham vi bao hi~m Vi~tNam Vi~t Nam Vi~tNam Vi~tNam Vi~tNam Toan cAu

A QUYEN L<}IBAo IDEM CHiNH DONG B~C TITAN VANG B~CHKIM KIMeUONG

BAo HIEM Tir VONG, TWONGI T~ T ToAN BO viNH VIEN DO TAl 50,000,000 100,000,000 200,000,000 500,000,000 1,000,000,000 2,000,000,000

N~NBAo IDEM Tir VONG, THUONG

II T~T ToAN BQ ViNH VIEN DO 25,000,000 50,000,000 100,000,000 250,000,000 500,000,000 1,000,000,000B~NH

III eID rnt Y TE DO TAl N~ 5,000,000 10,000,000 20,000,000 50,000,000 100,000,000 200,000,000

IV BAo DIEM DIEU TRJ NOI TRU, 12,500,000 25,000,000 50,000,000 125,000,000 250,000,000 400,000,000PIlAU THU~T DO BEND

1 Chi phi ndm viinlngay (Iai ila 60 625,000 1,250,000 2,500,000 6,250,000 12,500,000 20,000,000ngay/nam)Quyin lqi bao hiem:- Ti~n giirong, ti~n an theo tieu chuan taibenh vien- Chi phi hanh chinh, chi phi mau, huyetnrong- Thu6c va cac diroc pham sir dung trong Chi phi thirc Chi phi thuc Chi phi thirc Chi phi thuc Chi phi tlnrc Chi phi thuckhi nam vi~n t~, t6i da t~, t6i da t~, t6i da t~, t6i da t~, t6i da t~, t6i da- Bang, nep thong thirong va bQt 625,000dl 1,250,000dl 2,500,000dl 6,250,000dl 12,500,000dl 20,000,000dl- Chi phi xet n~~m hoac chfutdoan ngay Ngay Ngay Ngay Ngay Ngay- Cac chi phi y te khac trong thoi giannk vien(Bao gbm ca diSu tri trong ngay va diSutri c~pCUu c6 phat sinh chi phi giuongdiroc ap dung nhir diSu tri trong ngay)

2 Chi phi phau thup_t 12,500,000 25,000,000 50,000,000 125,000,000 250,000,000 400,000,000

Don vi: VND

Quy~n 1C}'ibao hiim:- Ph~u thuat nQi tru, ph§u thuat trongngay, ph~u thuat ngoai tru do benh

Theo thirc t~, t&ida khong qua han mire tai muc IV- Ph~u thuat lien quan d~n dy ghep nQitang (khong bao g6m chi phi mua bQphan)

3 Cae quyJn [(Ii khae

3.1. Chi phi di~u tri tnroc khi nhap vien (t6i 625,000 1,250,000 2,500,000 6,250,000 12,500,000 20,000,000da 30 ngay truce khi nhap vien/nam)

3.2. Chi phi di~u tri sau khi xuAt vien (t&ida 625,000 1,250,000 2,500,000 6,250,000 12,500,000 20,000,00030 ngay k~ til ngay xu!t vi~nlnam)

3.3. Chi phi y ta cham soc tai nha ngay sau 625,000 1,250,000 2,500,000 6,250,000 12,500,000 20,000,000khi xuAt vien (t&ida 15 ngay/nam).

3.4. Tro dp nam vien/ngay (t6i da 60 12,500 25,000 50,000 125,000 250,000 400,000ngay/nam)Dich vu xe ciru thuong trong Ianh tho

Theo thuc t~, t6i da khong qua s&ti~n bao hiem3.5. Vi~t nam, loai tnr bfutg duong hangkhong

3.6. Tro cApmai tang phi trong tnrong hop ill 625,000 1,250,000 2,000,000 2,000,000 2,000,000 2,000,000vong tai benh vi~n

B QUYEN LQI BAo mEM BO SUNG DONG B~e TITAN VANG B~eHKIM KIMeUONG

THAI SAN (KHONG BAO GOM emI PHi KHAM THAI DJNH KI, Ap 5,000,000 10,000,000 20,000,000 40,000,000 64,000,000

DUNG DONG em TRA)] Sinh thuang2 Sinh rnB3 Tai bi~n san khoa Khong ap

Bat thuang trong qua trinh rnang thai va d\lflg4 cac b~nh ly phlit sinh nguyen nhan do Theo th\lc t~, t&ida khong qua s&ti~n bao hi~rn quy~n lqi thai san

thai leyChi phi khAm tru6c khi sinh (Ian khAm

5 cu6i cimg trong yang 30 ngay tru6c khide)

Chi phi di6u tri ngay sau khi xuAt vien va I

6 /ho(lc 1 IAntai kham (trong vong 14 ngaysau khi sinh)Chi phi Cham soc tre sau sinh/narn (trong

50,000 100,000 200,000 400,000 640,0007 vong 07 ngay sau sinh)

II BAo mEM DIEUTRJ NGO~ TRU 2,500,000 5,000,000 10,000,000 20,000,000 32,000,0001 Chi phi i1iJu tr] ngofJi tr" 2,500,000 5,000,000 10,000,000 20,000,000 32,000,000

Chi phi kham benh, ti6n thuoc thea ke Chi phi thirc Chi phi thuc Chi phi thuc Chi phi thuc Chi phi thucdan cua bac si, ti6n chup Xquang va lam t€, khong qua t€, khong qua t€, khong qua t€, khong qua t€, khong qua1.1 cac xet nghiem thea chi dinh cua bac si, Khongap 500,000d II 1,000,000d II 2,000,000d II 4,OOO,000dII 6,400,000d IITri lieu birc xa, li~u phap anh ~ang, v~t ly d\lllg IAnkham, tBi IAnkham, tBi IAnkham, tBi IAnkham, tBi lfut kham, tBitri lieu va cac phirong ph~p dieu tri nrong da 5lklnam da 10 Iklnam da 10 lklnam da 10 Iklnam da 10 lklnamnr (bao gAm ca di6u tri cap CUllngoai tni)

III NHA KHOA (APDVNG DONG cm 500,000 1,000,000 2,000,000 4,000,000 10,000,000TRA)1 Chi phi cham soc rang ngofJitr" 500,000 1,000,000 2,000,000 4,000,000 10,000,000

+ Kham va ch!n doan+ Viem lqi (nu6u)1 viem nha chu+ Ch\lp X-Quang va c~ lam sang Chi phi thl,lC Chi phi thl,lc Chi phi thl,lC Chi phi thgc.+ Tram rang bkg chAt li~u thong thuemg Chi phi thl,lc t€, khong qua t€, khong qua . t€, khong qua t€, khong qua(amalgam, composite, fuji ...) Khong ap d\lllg t€, tBi da 5 500000dll IAn 1000000dll 2000000&1 4000000&1+ Di6u tri my ,._ lklnam kham, tBi da 5 lfut kham, tBi IAnkham, tBi lfut kham, tBi+Nh3 rang b~nh Iy (bao gom tieu phau), lklnam da51klnam da 51klnam da 51klnamph~u thu~t c~t chop rang, lAyu voi rang+ LAycao fang (Cl;lOvoi rang), tBi da200,000dlnam

IV TRC}cAP NAM VI¥N DO TAl 1,500,000 3,000,000 6,000,000 12,000,000 18,000,000 60,000,000NAN(tai eta 60 ngay/nim)GiOih,n trv cip nim vi~n do tai n,n 25,000 50,000 100,000 200,000 300,000 1,000,000(ct/ngay)

N{)itnt, thai N{)itru, thaiKhongbao N{)itru N{)itni N{)itru san n{)itru, san nQitru,DICH VV BAo LANHVI¥N pHi va Thai san va Thai san va Thai san ngo,i tru va ngo,i tru vaV Hinh n{)itru n{)itrun{)itru nha khoa nha khoa

PHV LVC 02: pHi BAo HIEM

Don vi: VND.NHOMTUOI PHI BAO IDEM QUYEN L<JI BAO HIEM CHiNH

DONG BAC TITAN VANG BACH KIM KIMClfONG60 ngay tuoi - dum 1 tuoi (rnua kern) 756,600 1,513,200 3,026,400 6,184,750 12,187,500 38,480,000

1-3 tuoi (rnua kern) 582,000 1,164,000 2,328,000 4,757,500 9,375,000 29,600,0004-5 tuoi (rnua kern) 425,200 850,400 1,700,800 3,495,750 6,851,500 21,368,000

60 ngay tu6i - dum 1 tuoi (mua dQc l~p) 983,580 1,967,160 3,934,320 8,040,175 15,843,750 50,024,0001-3 tuoi (rnua dQc l~p) 756,600 1,513,200 3,026,400 6,184,750 12,187,500 38,480,0004-5 tuoi (rnua dQc l~p) 552,760 1,105,520 2,211,040 4,544,475 8,906,950 27,778,400

6 tu6i 425,200 850,400 1,700,800 3,495,750 6,851,500 21,368,0007-9 tuoi 390,000 780,000 1,560,000 3,212,500 6,285,000 19,520,00010-18 tuoi 374,000 748,000 1,496,000 3,083,750 6,027,500 18,680,00019-30 tuoi 358,000 716,000 1,432,000 2,955,000 5,770,000 17,840,00031-40 tuoi 390,000 780,000 1,560,000 3,212,500 6,285,000 19,520,00041-50 tuoi 406,000 812,000 1,624,000 3,341,250 6,542,500 20,360,00051-60 tuoi 422,000 844,000 1,688,000 3,470,000 6,800,000 21,200,00061-65 tuoi 454;000 908,000 1,816,000 3,727;500 7,315,000 22,880,000

NHOMTUOI PID BAO HIEM QUYEN L<JI BAO HIEM BO SUNGDONG BAC TITAN VANG BACH KIM KIMCl10NG

Thai san (19-50 tufii) - 1,000,000 1,700,000 3,400,000 6,800,000 10,880,000Di~u tri ngoai tri

60 ngay tuoi - dum 1 tuoi (rnua kern) - 1,243,125 2,486,250 4,420,000 8,840,000 14,144,0001-3 tuoi (rnua kern) - 956,250 1,912,500 3,400,000 6,800,000 10,880,0004-5 tuoi (rnua kern) - 680,625 1,361,250 2,420,000 4,840,000 7,744,000

60 ngay tuoi - dum 1 tuoi (rnua dQc l~p) - 1,616,063 3,232,125 5,746,000 11,492,000 18,387,2001-3 tuoi (rnua dQc l~p) - 1,243,125 2,486,250 4,420,000 8,840,000 14,144,0004-5 tuoi (rnua dQc l~p) - 884,813 1,769,625 3,146,000 6,292,000 10,067,200

6 tuoi - 680,625 1,361,250 2,420,000 4,840,000 7,744,0007-9 tuoi - 618,750 1,237,500 2,200,000 4,400,000 7,040,00010-18 tuoi - 590,625 1,181,250 2,100,000 4,200,000 6,720,00019-30 tuoi - 562,500 1,125,000 2,000,000 4,000,000 6,400,00031-40 tuoi - 618,750 1,237,500 2,200,000 4,400,000 7,040,00041-50 tuoi - 646,875 1,293,750 2,300,000 4,600,000 7,360,000

51-60 tuoi - 675,000 1,350,000 2,400,000 4,800,000 7,680,00061-65 tuoi - 731,250 1,462,500 2,600,000 5,200,000 8,320,000NhaKhoa

60 ngay tuoi - dum 1 tuoi (rnua kern) - 298,350 596,700 1,193,400 2,386,800 5,967,0001-3 tuoi (rnua kern) - 229,500 459,000 918,000 1,836,000 4,590,0004-5 tuoi (rnua kern) - 163,350 326,700 653,400 1,306,800 3,267,000

60 ngay tuoi - dum I tuoi (rnua dQc l~p) - 387,855 775,710 1,551,420 3,102,840 7,757,1001-3 tuoi (rnua dQc l~p) - 298,350 596,700 1,193,400 2,386,800 5,967,0004-5 tuoi (rnua dQc l~p) - 212,355 424,710 849,420 1,698,840 4,247,100

6 tuoi - 163,350 326,700 653,400 1,306,800 3,267,0007-9 tu6i - 148,500 297,000 594,000 1,188,000 2,970,00010-18 tu6i - 141,750 283,500 567,000 1,134,000 2,835,00019-30 tu6i - 135,000 270,000 540,000 1,080,000 2,700,00031-40 tuoi - 148,500 297,000 594,000 1,188,000 2,970,00041-50 tuoi - 155,250 310,500 621,000 1,242,000 3,105,00051-60 tuoi - 162,000 324,000 648,000 1,296,000 3,240,00061-65 tuoi - 175,500 351,000 702,000 1,404,000 3,510,000

TrO'cip nam vien do tai nan60 ngay tuoi - dum 1 tuoi (rnua kern) 19,500 39,000 78,000 156,000 234,000 1,300,000

1 - 5 tuoi (rnua kern) 15,000 30,000 60,000 120,000 180,000 1,000,00060 ngay tuoi - dum 1 tuoi (rnua dQc l~p) 25,350 50,700 101,400 202,800 304,200 1,690,000

1 - 5 tuoi (rnua dQc l~p) 19,500 39,000 78,000 156,000 234,000 1,300,000Til 6 tuoi den 65 tuoi 15,000 30,000 60,000 120,000 180,000 1,000,000