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
(All benefits described only apply to the medical conditions specified under Covered Conditions)
| Description | Coverage |
|---|---|
| Maximum coverage per person, per policy year | US$1,000,000 |
| Maximum age to apply for coverage | 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 maximum benefit |
| 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 |
|---|---|
| Emergency coverage when traveling abroad | Up to US$5,000 for emergency medical treatment |
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.