PRIME VIP

Offers a wide range of benefits with a lifetime coverage of US$5 million

PRIME VIP

Offers a wide range of benefits with a lifetime coverage of US$5 million

DEDUCTIBLE OPTIONS*

Option IOption IIOption IIIOption IVOption V
Inside USAUS$1,500US$3,000US$5,000US$10,000US$20,000
Outside USAUS$1,500US$3,000US$5,000US$10,000US$20,000

*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

DescriptionCoverage
Maximum coverage per person, per lifetimeUS$5,000,000
Maximum coverage per person, per policy yearUS$1,500,000
Maximum coverage per person, per policy year at 70 years and olderUS$500,000
Age limit to applyUp to 75 years old
Waiting period60 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 USA100% UCR with free choice of hospitals and doctors*
Coverage inside USA• 100% UCR within the Prime Network®
• Outside the Prime Network®, the coverage will be at 60%
• Emergencies will be covered at 100% UCR, up to the policy limits

*Excluding the Hospitales Star Médica hospitals in Mexico.

DescriptionCoverage
Standard private hospital room• 100% UCR within the Prime Network®
• Up to US$500 daily, max. of 180 days outside the Prime Network®
Use of intensive care unit• 100% UCR within the Prime Network®
• Up to US$1,400 daily, max. of 60 days outside the Prime Network®
Adult companion accommodation expenses of a hospitalized insured under 18 years oldUS$150 per night, max. of 100 nights per policy year
Prescribed medication while hospitalized100% UCR
Inpatient laboratory tests and X-rays100% UCR
DescriptionCoverage
Emergency room care100% UCR
Physician and specialist visits (including home visits where available)US$80 per visit, max. of 30 visits
Outpatient surgeryUS$12,000
Prescribed medication following a hospitalization100% UCR for up to 6 months
Outpatient or non-hospitalization prescription medicationUS$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 policy year
Nurse or therapist care at homeUS$5,000
Preventive health checkup per insured, no deductible applies (options I & II)US$100 (after a 12-month waiting period)

The following benefits offer the same coverage for both inpatient and outpatient procedures.

DescriptionCoverage
Surgeon and anesthesiologist fees100% UCR
Oncology: tests, treatment (chemotherapy and/or radiotherapy) and medication100% UCR, max. of US$125,000 per policy year
Dialysis services100% UCR
Prostheses and medical appliances implanted during surgery100% UCR
Durable medical equipmentUS$1,000
Physical therapy and rehabilitationUS$5,000
Congenital and/or hereditary conditions diagnosed before age 18US$125,000 per lifetime
Congenital and/or hereditary conditions diagnosed after age 18US$500,000 per lifetime
Reconstructive surgery after an accident or illnessUp to the benefit limit

10-month waiting period, no deductible applies.

DescriptionCoverage
Maternity (options I & II)US$3,000
Maternity and newborn complications (options I & II)US$25,000
Inclusion of the newborn within 90 days after the birth (options I & II)Without underwriting, if born from a covered maternity
DescriptionCoverage
Emergency transportation - Ground ambulance100% UCR, no deductible applies
Emergency transportation - Air ambulanceUS$35,000, no deductible applies
Repatriation or cremation of mortal remains100% UCR
DescriptionCoverage
Emergency dental coverage100% UCR for treatment within the first 30 days of the covered accident, max. of US$6,000 per policy year
Palliative careUS$7,500
Temporary coverage for accidents while application is being underwrittenUS$30,000
Second Medical Opinion VIP®Access to a second medical opinion of renowned experts from around the world, no deductible applies
DescriptionCoverage
Organ/tissue transplantUS$500,000 per lifetime
Maternity and newborn complications (options I & II)Additional US$25,000
Travel VIP LightUp 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.