UNIVERSAL VIP

The most comprehensive
plan with annual coverage
of US$7 million

UNIVERSAL VIP

The most comprehensive plan with annual coverage of US$7 million

DEDUCTIBLE OPTIONS*

Option IOption IIOption IIIOption IVOption VOption VIOption VII
Inside USAUS$500US$2,000US$3,000US$5,000US$10,000US$20,000US$50,000
Outside 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.

TABLE OF BENEFITS

DescriptionCoverage
Maximum coverage per person, per policy yearUS$7,000,000
Maximum age to apply for coverageUp to 75 years old
Waiting period30 days
Geographical coverageWorldwide, without restrictions of doctors and hospitals
DescriptionCoverage
Standard private/semi-private hospital room100% UCR
Special benefit for suite accommodation (subject to availability) Up to US$2,000 per day within the USA Special Network®
Use of intensive care unit100% UCR
Adult companion accommodation expenses of a hospitalized insured under 18 years oldUS$350 per night, max. of 30 nights
Adult companion accommodation expenses of a hospitalized insured over 18 years old100% UCR, max. of 21 nights
Prescribed medications while hospitalized 100% UCR
DescriptionCoverage
Emergency room care100% UCR
Physician and specialist visits100% UCR
Physician and specialist home visits (where available)100% UCR
Outpatient prescription medication100% UCR
Complementary therapy: chiropractor, psychologist, psychiatrist, osteopath and/or acupuncturistUS$3,500
Nurse or therapist care at home100% UCR
Preventive health checkup, no deductible applies (after a 10-month waiting period)Options I, II & III:
• US$200 up to 17 years old
• US$350 at 18 years and older

Options IV, V & VI:
• US$200, all ages

Preventive care benefits (options I, II, III & IV):
• Colon cancer screening (at 50 years and older): US$1,200 every 10 years
• Mammogram (at 40 years and older): US$400
• Pap smear (from 21 to 65 years of age): US$150 every 3 years
• Prostate cancer screening (at 50 years and older): US$300
Hearing aidsUS$2,000 per lifetime
Treatment for Alzheimer’s disease100% UCR
Allergy treatment100% UCR

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

DescriptionCoverage
Surgeon and anesthesiologist fees100% UCR
Diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/ PET scans)100% UCR
Oncology: tests, treatment (chemotherapy and/or radiotherapy) and medication100% UCR
Surgery to reduce the risk of cancer or prophylactic surgery US$30,000 per lifetime (after a 12-month waiting period)
Dialysis services100% UCR
Prostheses and medical appliances implanted during surgery100% UCR
Organ transplant (per organ/tissue)US$1,100,000 per lifetime
Includes US$60,000 benefit for expenses of the live donor
Durable medical equipment100% UCR
Physical therapy and rehabilitation100% UCR
Specialized treatments: autism, sleep apnea and other sleep disorders
Specialized therapies: occupational and speech
US$3,000
Congenital and/or hereditary conditions diagnosed before age 18US$2,000,000 per lifetime
Congenital and/or hereditary conditions diagnosed after age 18100% UCR
HIV-AIDS treatmentUS$1,000,000 per lifetime (after a 24-month waiting period)

Gastric bypass bariatric surgery and any type of surgical procedure
for weight loss, its complications or treatments, and/or weight loss
medication

US$10,000 per lifetime (after a 24-month waiting period)
Surgical treatment of symptomatic foot disorders100% UCR (after a 24-month waiting period)
Reconstructive surgery after an accident or illnessUp to the maximum benefit

10-month waiting period, no deductible applies.

DescriptionCoverage
Maternity (options I, II & III)

US$7,000
Includes deliveries for pregnancies that are a result of any type of fertility
treatments

Extension of the maternity coverage*US$1,500
Extraction and storage of newborn stem cells (options I, II & III)US$1,000 per covered delivery
Maternity and newborn complications (options I, II & III)US$1,000,000 per lifetime
Inclusion of the newborn within 90 days after the birth (options I, II & III)Without underwriting, if born from a covered maternity
Free coverage for dependents up to 5 years old (options I & II) **

• Max. of 2 children born from a covered maternity
(options I & II only), if both parents are insured in the policy
• Max. of 1 child born from a covered maternity (options I & II only),
if only the mother is insured in the policy

*When the insured selects a hospital from the Special Maternity Network®.
**Included in the policy within 90 days from birth. After 90 days, premium payment will be required.

DescriptionCoverage
Emergency transportation - Ground ambulance100% UCR, no deductible applies
Emergency transportation - Air ambulance100% UCR, no deductible applies
Cost of return ticket for the insured and one companion after an evacuation by air ambulanceUp to US$1,000 per ticket
Repatriation or cremation of mortal remains100% UCR
DescriptionCoverage
Treatment for injuries during the training or practice of hazardous hobbies and/or professional sports100% UCR
Emergency dental coverage100% UCR for treatment within the first 180 days of the covered accident
Refractive eye surgeryUS$500 per eye, per lifetime (after a 24-month waiting period)
Palliative care 100% UCR
Temporary coverage for accidents while application is being underwrittenUS$30,000

Free extended coverage for eligible dependents after the policyholder’s
death as a result of a covered accident or condition

2 years

Elimination/reduction of the policy deductible for no claims during the
last 3 years

Options I, II, III & IV:
• Elimination for 1 year after the 3rd year without claims
• Reduction of 50% of the deductible for 1 year after the
3rd year, if the deductible was not met in any of the years


Options V & VI:
• Reduction of 50% of the deductible for 1 year after the 3rd year
without claims

Elimination of deductible in case of a serious accident (all options)

Elimination of the annual deductible for the first hospital urgent
treatment that requires a hospitalization within the first 24 hours after
the serious accident

Second Medical Opinion VIP®

Access to a second medical opinion of renowned experts from around
the world, no deductible applies

DescriptionCoverage
Emergency coverage when traveling abroad*Up to US$5,000 for emergency medical treatment

*For policies issued to Argentina, Chile, Colombia, Paraguay, Peru and Uruguay residents, this benefit is included in their plan with no extra premium.
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.