Health plan

Effective July 2018

UNIVERSAL VIP CHOICE

GENERAL PLAN INFORMATION
DESCRIPTION COVERAGE
Lifetime coverage
  • Unlimited
Maximum coverage per person, per policy year
  • US$5,000,000
Age limit to apply
  • 75
Waiting period
  • 30 days
Geographical coverage
  • Worldwide without restrictions of doctors and hospitals
INPATIENT BENEFITS
Standard private hospital room
  • 100% UCR
Special benefit for suite
  • Up to US$2,000 per day within the “USA Special Network”
Intensive care unit
  • 100% UCR
Companion during hospitalization
  • 100% UCR, max. of 21 nights
Prescribed medications while in a hospital
  • 100% UCR
OUTPATIENT BENEFITS
Emergency room
  • 100% UCR
Physicians and specialist visits
  • 100% UCR
Physicians and specialist home visits
  • 100% UCR
Prescribed medications following a hospitalization or outpatient surgery
  • 100% UCR up to 6 months
Outpatient or non-hospitalization prescription medication
  • 100% UCR, max. US$3,500 per policy year
Complementary therapy: chiropractor, psychiatrist, speech therapy, osteopathy, acupuncture, inpatient mental health treatment, psychology and/or mental health prescription medicaion
  • US$6,000, all therapies combined
Nurse care at home
  • 100% UCR
Preventive health checkup per insured, no deductible (after a 3-month waiting period)
  • Options I & II:
  • 100% UCR from 0 to 6 months of age, up to 5 visits
  • US$300 per policy year from 6 months to 17 years of age
  • US$600 per policy year from 18 years of age and older
  • Options III & IV:
  • US$300 per policy year for all ages
Hearing aids (per lifetime)
  • US$2,000
Specialized treatments (autism, sleep apnea and other sleep disorders)
  • US$3,000
Alzheimer’s
  • 100% UCR
Allergy treatment
  • 100% UCR
GENERAL BENEFITS (The following benefits offer the same coverage for both inpatient and outpatient procedures)
Emergency medical services
  • 100% UCR
Surgeon and anesthesiologist fees
  • 100% UCR
Diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/PET scans)
  • 100% UCR
Cancer tests, medication and treatment (chemotherapy and radiotherapy)
  • 100% UCR
Surgery to reduce the risk of cancer or prophylactic surgery (per lifetime)
  • US$25,000 (after a 12-month waiting period)
Dialysis
  • 100% UCR
Prostheses and medical appliances implanted during surgery
  • 100% UCR
Organ transplant (per organ/tissue, per lifetime)
  • US$1,100,000
Benefits for live donors
  • US$60,000
Durable medical equipment
  • 100% UCR
Physical therapy and rehabilitation
  • 100% UCR
Congenital conditions diagnosed before age 18 (per lifetime)
  • US$2,000,000
Congenital conditions diagnosed after age 18
  • 100% UCR
HIV-AIDS (per lifetime)
  • US$700,000 (after a 24-month waiting period)
Bariatric surgery (per lifetime)
  • US$10,000 (after a 24-month waiting period within special network)
Surgical treatment of symptomatic foot disorders
  • 100% UCR (after a 24-month waiting period)
MATERNITY BENEFITS (10-month waiting period, no deductible applies)
Maternity
  • Option I: US$8,500, no deductible applies
  • Option II: US$8,500, after deductible
Extraction and storage of stem cells (option I)
  • US$1,000 per covered pregnancy
Maternity and newborn complications (per lifetime)
  • Option I: US$1,000,000, no deductible applies
  • Option II: US$500,000, after deductible (with 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% UCR, no deductible applies
Emergency transportation by air ambulance
  • 100% UCR, no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulance
  • US$1,000 per person
Repatriation of mortal remains
  • 100% UCR
OTHER BENEFITS
Hazardous hobbies and professional sports
  • 100% UCR
Emergency dental coverage
  • 100% UCR for the first 180 days
Palliative care for terminal cases
  • 100% UCR
Temporary coverage for accidents while application is being underwritten
  • US$30,000
Free extended coverage for eligible dependents after policyholder’s death
  • 2 years
Free coverage for dependents (option I)
  • Up to 5 years old, max. 2 children born in the policy from a covered maternity
Deductible elimination/reduction for no claims made
  • Elimination for 1 policy year after the end of the 3rd year without claims (option I & II)
  • Reduction of up to 50% for 1 policy year after the 3rd year without claims (options III & IV)
Second Medical Opinion VIP
  • Access to the medical opinion of internationally renowned experts from around the world regarding a condition, without deductible

All benefits with 100% coverage are up to the policy limit.

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All content of this book are for afirmative purposes only. The benefits are governed by the terms described in the Conditions of Coverage of the policy.  Unless otherwise stated, the benefits are offered on a per-insured/per-policy year basis in which the chosen deductible applies.  All amounts are in US Dollars (USD).  The benefits are limited to the medical expenses covered under this policy and are subject to the usual, customary and reasonable expenses (UCR) for the geographic area where the expenses were incurred.


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