HEALTH PLAN

OPTIMUM VIP

Optimum VIP provides protection for specific critical illnesses, giving you peace of mind that your unique needs are covered. This plan includes an annual coverage of US$1 million and covers eight conditions: neurological diseases, cardiac conditions, cancer, polytrauma, chronic kidney failure, severe burns, septicemia and transplant.

*Only one deductible per person, per policy year applies. For family policies, a maximum of two deductibles accumulated per policy, per policy year will be applied. For more information, please refer to the Conditions of Coverage of the policy.

(all benefits described only apply to the medical conditions specified)

DESCRIPTION COVERAGE
Maximum coverage per person per policy year
  • US$1,000,000
Age limit to apply
  • 75
Waiting period
  • 30 days
Coverage outside USA
  • 100% with free choice of hospitals and doctors
Coverage inside USA
  • 100% through the ‘USA Special Network’
  • Outside the ‘USA Special Network’ the coverage will be at 60%, with a maximum daily room rate of up to US$700 for a standard room and up to US$1,400 for intensive care
  • Emergency medical treatment will be covered 100% up to the benefits limits
COVERED CONDITIONS

Neurological diseases (including cerebrovascular accidents)

  • US$150,000
Cardiac surgery for revascularization and angioplasty
  • US$150,000
Cancer (chemotherapy, radiotherapy, surgery for tumor and reconstructive surgery)
  • US$200,000
Polytrauma (including rehabilitation)
  • US$200,000
Chronic kidney failure (dialysis or hemodialyisis)
  • US$150,000
Severe burns (including reconstructive surgery)
  • US$300,000
Septicemia
  • US$150,000
Organ and tissue transplant (per lifetime)
  • US$500,000
Benefits for live donors
  • US$50,000
INPATIENT BENEFITS
Intensive care unit
  • 100%
Adult companion accommodation (related to a hospitalization of a child under age 18)
  • US$100 per night, max. 30 nights
Prescribed medications while in a hospital
  • 100% for covered conditions
OUTPATIENT BENEFITS
Physicians and specialist visits
  • 100% for covered conditions
Prescription medication
  • US$5,000 for covered conditions
Nurse care at home
  • US$7,000 for covered conditions
GENERAL BENEFITS
Surgeon and anesthesiologist fees
  • 100% for covered conditions
Diagnostic study services (laboratory test, biopsy, X-rays, MRI/CT/PET scans)
  • 100% for covered conditions

Cancer tests, medication and treatment

  • 100% for covered conditions
Durable medical equipment
  • US$7,000 for covered conditions
Physical therapy and rehabilitation
  • US$7,000 for covered conditions
Congenital conditions diagnosed before age 18 (per lifetime)
  • 10% of the benefit for covered conditions
Congenital conditions diagnosed after age 18 (per lifetime)
  • 50% of the benefit for covered conditions
MEDICAL EVACUATION BENEFITS
Emergency transportation by ground ambulance 
  • 100% for covered conditions, without deductible
Emergency transportation by air ambulance
  • US$30,000 for covered conditions, without deductible
Repatriation of mortal remains
  • US$10,000
OTHER BENEFITS
Hazardous hobbies and sports (non-professional, per lifetime)
  • US$100,000 for polytraumas or severe burns
Palliative care for terminal cases
  • 100% for covered conditions
Temporary coverage for polytrauma while application is being underwritten
  • US$30,000
Second medical opinion VIP
  • Access to the medical opinion of internationally renowned experts from around the world regarding a condition, without deductible

Effective July 2016

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