OPTIMUM VIP
Offers protection for specific chronic conditions up to
US$1 million annually.
OPTIMUM VIP
Offers protection for specific chronic conditions up to US$1 million annually.
DEDUCTIBLE OPTIONS*
| Option I | Option II | Option III | Option IV | Option V | Option VI | |
|---|---|---|---|---|---|---|
| Inside USA | US$1,000 | US$2,000 | US$5,000 | US$10,000 | US$20,000 | US$50,000 |
| Outside USA | US$1,000 | US$2,000 | US$5,000 | US$10,000 | US$20,000 | US$50,000 |
*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 policy’s Conditions of Coverage.
TABLE OF BENEFITS
| Description | Coverage |
|---|---|
| Maximum coverage per person, per policy year | US$1,000,000 |
| Age limit to apply | Up to 75 years old |
| Waiting period | 30 days |
| Coverage outside USA | 100% UCR with free choice of hospitals and doctors |
| Coverage inside USA | • 100% UCR within 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% UCR, up to the benefits limits |
| Description | Coverage |
|---|---|
| Neurological diseases (including cerebrovascular accidents) | US$150,000 |
| Cardiac surgery for revascularization and angioplasty | US$150,000 |
| Cancer (tests, medication, chemotherapy, radiotherapy, surgery for tumor and reconstructive surgery) | US$200,000 |
| Polytrauma (including rehabilitation) | US$200,000 |
| Chronic kidney failure (dialysis or hemodialysis) | US$150,000 |
| Severe burns (including reconstructive surgery) | US$300,000 |
| Septicemia | US$150,000 |
| Organ and tissue transplant | US$500,000 per lifetime Includes US$50,000 benefit for expenses of the live donor |
| Description | Coverage |
|---|---|
| Standard hospital room | 100% UCR |
| Use of intensive care unit | 100% UCR |
| Adult companion accommodation expenses of a hospitalized insured under 18 years old | US$100 per night, max. of 30 nights |
| Adult companion accommodation expenses of a hospitalized insured over 18 years old | 100% UCR, max. of 21 nights |
| Prescribed medications while hospitalized | 100% UCR for covered conditions |
| Physical therapy and rehabilitation | 100% UCR for covered conditions |
| Description | Coverage |
|---|---|
| Emergency room care | 100% UCR |
| Physician and specialist visits | 100% UCR for covered conditions |
| Physician and specialist home visits (where available) | 100% UCR for covered conditions |
| Outpatient prescription medication | US$5,000 for covered conditions |
| Nurse or therapist care at home | US$7,000 for covered conditions |
| Physical therapy and rehabilitation | US$7,000 for covered conditions |
The following benefits offer the same coverage for both inpatient and outpatient procedures.
| Description | Coverage |
|---|---|
| Surgeon and anesthesiologist fees | 100% UCR for covered conditions |
| Diagnostic study services (laboratory tests, biopsies, X-rays, MRI/CT/PET scans) | 100% UCR for covered conditions |
| Durable medical equipment | US$7,000 for covered conditions |
| Congenital and/or hereditary conditions diagnosed before age 18 | 10% of the benefit for covered conditions, per lifetime |
| Congenital and/or hereditary conditions diagnosed after age 18 | 50% of the benefit for covered conditions, per lifetime |
| Reconstructive surgery after an accident or illness | Up to the benefit limit |
| Description | Coverage |
|---|---|
| Emergency transportation - Ground ambulance | 100% UCR for covered conditions, without deductible |
| Emergency transportation - Air ambulance | US$30,000 for covered conditions, without deductible |
| Repatriation or cremation of mortal remains | US$10,000 |
| Description | Coverage |
|---|---|
| Treatment for injuries during the training or practice of hazardous hobbies and/or non-professional sports | US$100,000 per lifetime, for polytrauma or severe burns |
| Palliative care | 100% UCR for covered conditions |
| Temporary coverage for polytrauma while application is being underwritten | US$30,000 |
| Second Medical Opinion VIP® | Access to a second medical opinion of renowned experts from around the world, no deductible applies |
| Description | Coverage |
|---|---|
| Travel VIP Light | Up to US$5,000 for emergency medical treatment while traveling abroad |
All benefits with 100% coverage are up to the policy limit. Benefits with established coverage will be up to the limits stated in each of them.