Lifetime
Maximum Benefit
|
$5,000,000 per Insured Person.
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Inpatient
Hospital Expenses/ Intensive Care
|
Average Semi-Private/ Intensive Care room
and board, Usual, Reasonable, and Customary (URC) Physician Charges,
Prescription Medications, Durable Medical Equipment, Nursing Services and
X-Rays up to the Policy Maximum.
|
Pre-existing
Conditions
|
All Pre-existing
Conditions will be considered, provided the Insured Person has not:
a) suffered
symptoms, consulted any Physician for Treatment, advice or check-ups for
these Pre-existing Conditions; and
b) taken
Medication (including drugs, Medicines, special diets or injections);
for
a continuous period of twenty-four (24) months prior to the date of the treatment
being consider for coverage.
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Surgery
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Usual, Reasonable, and Customary (URC)
Charges for Surgery, Physician and Anesthetics up to the Policy Maximum.
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Hospital
Daily Indemnity Benefit
|
$50 per day ($1,000 maximum per Policy Period), for every Medically Necessary
night spent in a Hospital (Hospital
Admission) outside of the United States and Canada.
|
Outpatient
Treatment
|
Usual, Reasonable, and Customary (URC)
Charges for Emergency Treatment, Surgery, Physician(s) office visits,
Prescription Medication up to the Policy Maximum.
|
Physiotherapy,
Chiropractic
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Up to $75 per visit ($10,000 Lifetime Maximum), when referred in advance by a
Physician.
|
Medical
Supplies
|
Usual, Reasonable, and Customary (URC)
Charges up to Policy Maximum.
|
Ambulance
|
Usual, Reasonable, and Customary (URC)
Charges up to Policy Maximum.
|
Well
Child Care
|
Up to $200 per Policy Period Maximum for
checkups and routine visits after twelve (12) month waiting period. Up to age eighteen (18). Not subject to Deductible and Coinsurance.
|
Mental
& Nervous
|
Usual, Reasonable, and Customary (URC)
Charges up to a Maximum of $10,000 per Policy Period after twelve (12) month waiting period. Inpatient limited to a maximum of forty-five
(45) days per Policy Period.
Outpatient limited to a maximum of forty (40) visits per Policy Period
at 70% of Eligible Expenses. Lifetime
Maximum of $30,000.
|
Dental
|
Usual, Reasonable, and Customary (URC)
Charges for repair and replacement of sound, natural teeth damaged as a
result of an accident, limited to $500 per Policy Period. A Dental Benefit Rider may be purchased to
expand Dental Coverage.
|
Emergency
Medical Evacuation
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$250,000 Limit per person per Policy Period
- when adequate medical facilities and/or treatment is not available when
traveling outside your current Country of Residence. (Pre-approval required).
|
Repatriation
of Remains
|
$25,000 Limit per person - when traveling
outside your current Country of Residence. (Pre-approval required).
|
Emergency
Medical Reunion
|
$10,000 Limit per person per Policy Period
- when traveling outside your current Country of Residence. (Pre-approval required).
|
Preventive
Benefits
|
Females and Males Age nineteen (19) and
over up to $175 per Policy Period Maximum for checkups, routine physical
exams, female preventative exams and mammograms after twelve (12) month
waiting period. Not subject to Deductible or Coinsurance.
|
Accidental
Death & Dismemberment (AD&D)
|
Principal Sum: $10,000 for Insured and
Spouse, $2,000 for Dependent Children.
Common Carrier, Principal Sum: $40,000 for Insured and Spouse, $8,000
for Dep. Children.
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