SPECIAL VIP

Covers all your essential
health needs with an annual
coverage of US$3 million

SPECIAL VIP

Covers all your essential health needs with an annual coverage of US$3 million

DEDUCTIBLE OPTIONS*

Option IOption IIOption IIIOption IVOption VOption VI
Outside USAUS$500US$2,000US$5,000US$10,000US$20,000US$50,000
Inside USAUS$1,000US$2,000US$5,000US$10,000US$20,000US$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.

**Excludes Venezuela.

TABLE OF BENEFITS

DescriptionCoverage
Maximum coverage per person, per Policy YearUS$3,000,000
Age limit to apply 75
Waiting Period30 days
Coverage outside USA100% with free choice of hospitals and doctors
Coverage inside USA100% through the "USA Special Network"
DescriptionCoverage
Intensive care unit100%
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 Hospital100%
DescriptionCoverage
Physician and specialist visits 100%
Physician and specialist home visits 100%
Prescription Medication US$12.500
Nurse care at home US$10,000
Preventive Health Checkup, per Insured, no Deductible (options I, II, III, IV, V & VI)• US$100 up to 17 years old
• US$150 at 18 years and older
Hearing aids (per Lifetime)US$1,000
Specialized treatments (occupational therapist, speech therapist, sleep apnea and other sleep disorders)US$3,000
Alzheimer’s100%
DescriptionCoverage
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)
Dialysis100%
Prostheses and medical appliances implanted during surgery 100%
Organ transplant (per organ/tissue, per lifetime)US$500,000 (with rider)
Benefits for live donorsUS$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 US$2,000,000
HIV-AIDS (per lifetime)US$250,000 (after a 48-month waiting period)
Bariatric surgery (per lifetime)US$5,000 (after a 24-month waiting period)
Surgical treatment of symptomatic foot disorders100% (after a 24-month waiting period)
DescriptionCoverage
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
DescriptionCoverage
Emergency transportation by ground ambulance100%, 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 ambulanceUS$500 per person
Repatriation of mortal remainsUS$40,000
DescriptionCoverage
Hazardous hobbies and professional sports 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, III)
• Reduction of up to 50% for 1 year after the 3rd year without claims (options IV & V)
Second Medical Opinion VIPAccess to the medical opinion of internationally renowned experts from around the world regarding a condition, without deductible