UNIVERSAL VIP

The most comprehensive
plan with annual coverage
of US$5 million

UNIVERSAL VIP

The most comprehensive plan with annual coverage of US$5 million

DEDUCTIBLE OPTIONS*

Option IOption IIOption IIIOption IVOption VOption VIOption VII
Outside USAUS$500US$2,000US$3,000US$5,000US$10,000US$20,000US$50,000**
Inside USAUS$1,000US$2,000US$3,000US$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$5,000,000
Age limit to apply 75
Waiting Period30 days
Geographical coverageWorldwide without restrictions of Doctors and Hospitals
DescriptionCoverage
Standard Private Hospital Room100%
Special benefit for SuiteUp to US$2,000 per day within the “USA Special Network”
Intensive care unit100%
Adult companion accommodation (related to a hospitalization of a child under age 18)US$350 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
Emergency room 100%
Physician and specialist visits 100%
Physician and specialist home visits 100%
Prescription Medication 100%
Complementary therapy: chiropractor, psychologist, psychiatrist, osteopathy and/or acupunctureUS$3,500
Nurse care at home 100%
Preventive Health Checkup, per Insured, no Deductible (options I, II, III, IV, V & VI)• US$300 per visit, up to 6 visits from 0 to 12 months of ages
• US$500 from 12 months of age and older including up to US$75 for preventive dental checkup in options I, II & III
Hearing aids (per Lifetime)US$2,000
Specialized treatments (occupational therapist, speech therapist, sleep apnea and other sleep disorders)US$3,000
Alzheimer’s100%
Allergy treatment100% UCR
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$25,000 (after a 12-month waiting period)
Dialysis100%
Prostheses and medical appliances implanted during surgery 100%
Organ transplant (per organ/tissue, per lifetime)US$1,100,000
Benefits for live donorsUS$60,000
Durable medical equipment 100%
Physical therapy and rehabilitation 100%
Congenital conditions diagnosed before age 18 (per lifetime) US$2,000,000
Congenital conditions diagnosed after age 18 100%
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)
Surgical treatment of symptomatic foot disorders100% (after a 24-month waiting period)
DescriptionCoverage
Maternity (options I, II & III)US$7,000
Extension of the maternity coverage (When the insured selects a hospital from the "Special Maternity Network")US$1,500
Extraction and storage of stem cells (options I, II & III)US$1,000 per covered pregnancy
Maternity and newborn complications (options I, II & III)US$1,000,000 (per lifetime)
Inclusion of the newborn (options I, II & III)Without underwriting if born from a covered maternity
DescriptionCoverage
Emergency transportation by ground ambulance100%, no deductible applies
Emergency transportation by air ambulance 100%, no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulanceUS$2,000 per person
Repatriation of mortal remains100%
DescriptionCoverage
Hazardous hobbies and professional sports 100%
Emergency dental coverage 100% for the first 180 days
Refractive eye surgery (per lifetime)US$500 per eye (after a 24-month waiting period)
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 2 years
Free coverage for dependents (options I & II) Up to 5 years old, max. of 2 children born in the policy from a covered maternity
Deductible elimination/reduction for no claims made• Elimination for 1 year, after the 3rd year without claims (options I, II, III & IV)
• Reduction of up to 50% for 1 year after the 3rd year without claims (options V & VI)
Second Medical Opinion VIPAccess to the medical opinion of internationally renowned experts from around the world regarding a condition, without deductible