HEALTH PLAN

PRIME VIP

Prime VIP offers an annual coverage of up to US$1.5 million and a full range of benefits, as well as free choice of hospitals and doctors anywhere outside the US and 100% coverage in the US within our “Prime Network.

*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.

DESCRIPTION COVERAGE
Maximum coverage per person, per lifetime
  • US$5,000,000
Maximum coverage per person, per policy year
  • US$1,500,000
Maximum coverage per person, per policy year at 70 years and older
  • US$500,000
Age limit to apply
  • 75
Waiting period
  • 60 days
Coinsurance (inside USA)
  • 20% of the first US$5,000 after the deductible; 1 per insured, per policy year; max. of 2 per policy, per policy year
Coverage outside USA
  • 100% with free choice of hospitals and doctors*
Coverage inside USA
  • 100% in providers of the ‘Prime Network’
  • Outside the ‘Prime Network’ the coverage will be at 60%
  • Emergencies will be covered at 100% up to the policy limits
INPATIENT BENEFITS
Standard private hospital room
  • 100% through the ‘Prime Network’
  • Up to US$500 daily, max. 180 days outside the ‘Prime Network’
Intensive care unit
  • 100% through the ‘Prime Network’
  • Up to US$1,400 daily, max. 60 days outside the ‘Prime Network’
Adult companion accommodation (related to a hospitalization of a child under age 18)
  • US$150 per night, max. of 100 nights per policy year
Prescribed medication while in a hospital
  • 100%
Inpatient laboratory tests and X-rays
  • 100%
OUTPATIENT BENEFITS
Physicians and specialists visits (including home visits)
  • US$80 per visit, max. of 30 visits
Outpatient surgery
  • US$12,000
Prescribed medication following a hospitalization
  • 100% up to 6 months
Outpatient or non-hospitalization prescription medication
  • US$3,000
Outpatient diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/PET scans)
  • US$600 per exam, per Insured; max. of US$1,800 per polficy year
Nurse care at home
  • US$5,000
Preventive health checkup per insured, no deductible (options I & II)
  • US$100 (after a 12-month waiting period)
GENERAL BENEFITS (The following benefits offer the same coverage for both inpatient and outpatient procedures)
Surgeon and anesthesiologist fees
  • 100%
Cancer tests, medication and treatment (chemotherapy and radiotherapy)
  • 100%, max. US$125,000 per policy year
Dialysis
  • 100%
Prostheses and medical appliances implanted during surgery
  • 100%
Organ transplant (per organ/tissue, per lifetime)
  • US$500,000 (with rider)
Benefits for live donor
  • US$30,000 (with rider)
Durable medical equipment
  • US$1,000
Physical therapy and rehabilitation
  • US$5,000
Congenital conditions diagnosed before age 18 (per lfifetfime)
  • US$125,000
Congenital conditions diagnosed after age 18 (per lifetime)
  • UU$500,000
MATERNITY BENEFITS (10-month waiting period)
Maternity (optfions I & II)
  • US$3,000, no deductible applies
Maternity and newborn complications (optfions I & II)
  • US$25,000
  • Additional US$25,000 with optional rider
Inclusion of the newborn (options I & II)
  • Without underwriting if born from a covered maternity
MEDICAL EVACUATION BENEFITS
Emergency transportation by ground ambulance
  • 100%, no deductible applies
Emergency transportation by air ambulance
  • US$35,000, no deductible applies
Repatriation of mortal remains
  • 100%
OTHER BENEFITS
Emergency dental coverage
  • 100% for the first 30 days, max. of US$6,000 per policy year
Palliative care for terminal cases
  • US$7,500
Temporary coverage for accidents 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

* Excluding the Hospitales Star Médica in Mexico.                                                                                                                                                                                                                     Effective July 2017

Download PDF Version Here

close
LinkedinLinkedinLinkedin
Visit Us On TwitterVisit Us On FacebookVisit Us On YoutubeVisit Us On Linkedin