Health Plan

Effective July 2018

SPECIAL VIP

GENERAL PLAN INFORMATION
DESCRIPTION COVERAGE
Maximum coverage per person, per policy year
  • US$3,000,000
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 policy limits
INPATIENT BENEFITS
Intensive care unit
  • 100%
Adult companion accommodation (related to a hospitalization of a child under age 18)
  • US$150 per night, max. of 30 nights
Adult companion accommodation (related to a hospitalization of an insured 18 years and older)
  • 100%, max. of 21 nights
Prescribed medications while in a hospital
  • 100%
OUTPATIENT BENEFITS
Physician and specialists visits
  • 100%
Physician and specialists home visits
  • 100%
Prescription medication
  • US$11,000
Nurse care at home
  • US$10,000
Preventive health checkup per insured, no deductible (options I&II)(after a 10-month waiting period)
  • US$100 up to 17 years old
  • US$150 at 18 years and older

 

Hearing aids (per lifetime)
  • US$1,000
Specialized treatments (occupational therapy, speech therapy, autism, sleep apnea and other sleep disorders)
  • US$2,000
Alzheimer’s
  • 100%
GENERAL BENEFITS (The following benefits offer the same coverage for both inpatient and outpatient procedures)
Surgeon and anesthesiologist fees
  • 100%
Diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/PET scans)
  • 100%
Cancer tests, medication and treatment (chemotherapy and/or radiotherapy)
  • 100%
Surgery to reduce the risk of cancer or prophylactic surgery (per lifetime)
  • US$20,000 (after a 12-month waiting period)
Dialysis
  • 100%
Prostheses and medical appliances implanted during surgery
  • 100%
Organ transplant (per lifetime)
  • US$500,000 (with rider)
Benefits for live donors
  • US$30,000 (with rider)
Durable medical equipment
  • US$10,000
Physical therapy and rehabilitation
  • US$10,000
Congenital conditions diagnosed before age 18 (per lifetime)
  • US$500,000
Congenital conditions diagnosed after age 18 (per lifetime)
  • US$2,000,000
HIV-AIDS (per lifetime)
  • US$250,000 (after a 48-month waiting period)
Bariatic surgery (per lifetime)
  • US$5,000 (after a 24-month waiting period within special network)
Surgical treatment of symptomatic foot disorders
  • 100% (after a 24-month waiting period)
MATERNITY BENEFITS (10-month waiting period)
Maternity (options I & II)
  • US$4,000, no deductible applies
  • Includes extraction and storage of umbilical cord blood stem cells
Maternity and newborn complications (options I & II)
  • US$500,000 (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%, no deductible applies
Emergency transportation by air ambulance
  • US$60,000, no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulance
  • US$500 per person
Repatriation of mortal remains
  • US$20,000
OTHER BENEFITS
Hazardous hobbies and sports (non-professional)
  • 100%
Emergency dental coverage
  • 100% for the first 180 days
Palliative care for terminal cases
  • 100%
Temporary coverage for accidents while application is being underwritten
  • US$30,000
Free extended coverage for eligible dependents after policyholder’s death
  • 1 year
Deductible elimination / reduction for no claims made
  • Elimination for 1 year, after the 3rd year without claims (options I, II & II)
  • Reduction of up to 50% for 1 year after the 3rd year without claims (options IV & V)
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 is for informative 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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