CARE +
The first level of our healthcare plans provides you with a comprehensive cover, especially when you’re admitted to hospital as a Day Patient or In Patient, but also if you’re in need of a cancer treatment, an organ transplant or evacuation and repatriation.
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COMFORT +
Comfort + plan provides you with an even better cover, especially when it comes to out-patient treatment and maternity benefits (complications of pregnancy).
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EXECUTIVE +
With Executive +, your cover extends to a wider scope of health issues, such as dental ones, with routine dental treatments and extraction of wisdom teeth (as an in-patient, out-patient or day care), as well as in-patient psychiatric treatment.
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ELITE +
With Elite +, you’ll benefit from the highest level of cover for any health issues you might face.
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Plans Compared
Download PLANS (pdf)
Under the Terms and conditions of the Policy, we will pay necessary, customary and reasonable expenses up to an overall maximum, per Insured Person per Period of Insurance
| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Lump sum in case of death | $5,000 | $8,000 | $12,000 | $15,000 |
| OVERALL MAXIMUM LIMIT | $1,000,000 | $1,000,000 | $1,500,000 | $2,500,000 |
in-patient and day-patient benefit
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| IN-PATIENT AND DAY-PATIENT BENEFIT | Care + | Comfort + | Executive + | Elite + |
|---|---|---|---|---|
| Hospital Accommodation (single room) including Nursing, Theatre charges and HDU | 100% | 100% | 100% | 100% |
| Surgeons, Consultants, Anaesthesiologists, and Medical Practitioners | 100% | 100% | 100% | 100% |
| Surgical Appliances where used as an integral part of Surgical Procedure | 100% | 100% | 100% | 100% |
| Prescription Drugs and Medicines | 100% | 100% | 100% | 100% |
| Diagnostic Test including MRI/CT/PET Scans, Pathology and X-rays | 100% | 100% | 100% | 100% |
| Hospital Accommodation for One Insured Person to stay with an Insured Child under age 19 | 100% | 100% | 100% | 100% |
| Medical Treatment during the first 2 months following birth | not included | Within limit of $50,000 for 1st 90 days | Within limit of $50,000 for 1st 90 days | Within limit of $50,000 for 1st 90 days |
| Home Nursing | $200 per day for 10 days | $200 per day for 10 days | $200 per day for 10 days | $200 per day for 10 days |
| Hospital Cash Benefits, daily allowance only when room, board and treatment are not paid by the insurer | $50 per day up to 50 nights | $60 per day up to 50 nights | $100 per day up to 50 nights | $200 per day up to 50 nights |
| Emergency Dental Treatment (Received within first 48 hours following an accident) | 100% | 100% | 100% | 100% |
| Rehabilitation received on an In-patient basis | 30 days in/out patient | 30 days in/out patient | 30 days in/out patient | 30 days in/out patient |
| Physiotherapy | 100% | 100% | 100% | 100% |
| In-Patient Psychiatric Treatment | 100%, Maximum 100 days per lifetime membership | 100%, Maximum 100 days per lifetime membership | 100%, Maximum 100 days per lifetime membership | 100%, Maximum 100 days per lifetime membership |
| Palliative Care | not included | not included | Up to 30 days | Up to 30 days |
ORGAN TRANSPLANT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Medically necessary implantations We do not pay for the costs associated with the donor or the donor organ | 100% | 100% | 100% | 100% |
EVACUATION & REPATRIATION (Excess does not apply)
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Evacuation to the nearest suitable Medical Facility and Return to Country of Residence after Treatment | 100% | 100% | 100% | 100% |
| Local Ambulance | 100% | 100% | 100% | 100% |
| Cost of a Medical Escort | 100% | 100% | 100% | 100% |
| Travelling Costs for a Relative to stay with or near Insured Person | 100% | 100% | 100% | 100% |
| Overnight Accommodation Costs incurred by the Insured Person or the Relative travelling with him/her (Maximum 10 Nights per Event) | 100%, Maximum $100 per night | 100% Maximum $150 per night | 100% Maximum $200 per night | 100% Maximum $250 per night |
| Medical Referral/Assistance Services including Medical advice and help on replacing essential Prescription Medication | 100% | 100% | 100% | 100% |
| Following Emergency Medical Transfer, arrangement to transport any children under age 19 to a destination of the Insured Person’s choice or an Economy Class Air Ticket for someone to travel to the Children | 100% | 100% | 100% | 100% |
| Transportation of Deceased to their Home Country; OR | 100% | 100% | 100% | 100% |
| Contribution Towards a Coffin; OR | 100%, Maximum $250 | 100%, Maximum $300 | 100%, Maximum $350 | 100%, Maximum $400 |
| Cremation Costs in Country where death occurred and transportation of the Urn to either the Home Country or Country of Residence; OR | 100%, Maximum $250 | 100%, Maximum $300 | 100%, Maximum $350 | 100%, Maximum $400 |
| Local Burial in the Country where death occurred (other than Home Country) | 100%, Maximum $750 | 100%, Maximum $1,000 | 100%, Maximum $1,500 | 100%, Maximum $2,000 |
CANCER TREATMENT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| In-Patient, Out-Patient, and Day-Patient | 100% | 100% | 100% | 100% |
OUT-PATIENT BENEFIT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Surgical procedures | 100% | 100% | 100% | 100% |
| Doctors‘ fees (general practitioners', family doctors’, paediatricians', specialists'), medical personnel care | not included | 100%, Maximum $2,000 | 100%, Maximum $5,000 | 100% |
| Diagnostic tests: Diagnostic laboratory and instrumental tests including pathology tests, electrocardiograms, Medical Imaging (including X-Ray, CT, MRI, PET...) | 100%, Maximum $500 | 100% | 100% | 100% |
| Out-Patient treatment in direct connection with a hospitalisation related to Inpatient treatments within 15 days prior to admission and up to 30 days following hospital release | 100%, Maximum $1,000 | 100% | 100% | 100% |
| Out-Patient drugs and dressings prescribed by a doctor and that are not available without prescription | not included | 100%, Maximum $350 | 100%, Maximum $800 | 100%, Maximum $1,500 |
| Chiropractic, Homeopathy, Osteopathy, Acupuncture, Ayurveda and Herbal and Chinese Medicines, including Prescribed Drugs and Medicines | not included | 100%, Maximum 5 visits with $100 max per session but included within the annual limit for Doctors’ fees | 100%, Maximum 10 visits with $100 max per session but included within the annual limit for Doctors‘ fees | 100%, 15 Visits with $100 max per session |
| Physiotherapy | not included | 10 visits but included within the annual limit for Doctors‘ fees | 15 visits but included within the annual limit for Doctors' fees | 30 visits |
| Out-Patient Psychiatric (12-month waiting period and subject to primary physician referral) | not included | 100%, Maximum 10 Visits after one year but included within the annual limit for Doctors' fees | 100%, Maximum 15 Visits after one year but included within the annual limit for Doctors' fees | 100%, Maximum 30 Visits after 1 year |
CHRONIC TREATMENT BENEFIT (90 Day Exclusion.)
If any investigation or treatment occurs in the first 90 days the condition is regarded as a Pre-Existing Condition
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| In-Patient, Day-Care and Out-Patient Treatment for Acute Treatment and Diagnosis of a Chronic Condition | 100% | 100% | 100% | 100% |
| In-Patient, Day-Care and Out-Patient Treatment for Routine Management and Palliative Treatment for each Chronic Condition | not included | not included | not included | Within Outpatient Physician and Drugs Limit |
| Hospice Accommodation (Maximum 14 Nights) | 100%, Maximum $100 per night | 100%, Maximum $150 per night | 100%, Maximum $200 per night | 100%, Maximum $250 per night |
| HIV/Aids (Where contracted as a result of a Blood Transfusion – Cover available after 2 consecutive years cover – Maximum Lifetime Limit $37,500) | not included | 100%, Maximum $2,500 | 100%, Maximum $5,000 | 100%, Maximum $7,500 |
CASH BENEFIT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Hospital Cash Benefit for In-Patient Treatment received Free of Charge in a Public Hospital where the treatment is a covered benefit under the policy (Maximum 30 Nights) | 100%, Maximum $100 per night | 100%, Maximum $100 per night | 100%, Maximum $200 per night | 100%, Maximum $200 per night |
| Convalescence Cash Benefit for each complete week of confinement to Home (excluding the first week) (Maximum 4 Weeks) | not included | not included | not included | 100%, Maximum $500 |
DENTAL BENEFIT (6-month waiting period applies)
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Routine dental treatment | not included | not included | 50%, maximum $1,000 | 80%, maximum $3,000 |
| Routine Exam (2 per Policy Year) | not included | not included | Covered but included within the Routine Dental annual limit | Covered but included within the Routine Dental annual limit |
| Cleaning & Polishing (2 per Policy Year) | not included | not included | Covered but included within the Routine Dental annual limit | Covered but included within the Routine Dental annual limit |
| Fillings (each tooth) and Extractions (each tooth) | 50%, maximum $500 | 50%, maximum $500 | Covered but included within the Routine Dental annual limit | Covered but included within the Routine Dental annual limit |
| Extraction of wisdom teeth as an in-patient, out-patient or day-care | not included | not included | Covered but included within the Routine Dental annual limit | Covered but included within the Routine Dental annual limit |
OUT OF AREA EMERGENCY COVER
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Emergency Treatment outside Area of Cover (Maximum 30 days) only In-patient and day- patient treatment and Ambulance transport to or between hospitals which arises suddenly. We not cover Emergency out-patient treatment whilst you are in the USA | 100%, Maximum $35,000 | 100%, Maximum $35,000 | 100%, Maximum $35,000 | 100%, Maximum $50,000 |
WELLNESS BENEFIT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Wellness Screening including Cancer Screening and Routine Health Tests | not included | 100%, Maximum $200 | 100%, Maximum $500 | 100%, Maximum $750 |
| Vaccinations | not included | 100%, Maximum $200 | 100%, Maximum $300 | 100%, Maximum $500 |
| One Annual Eye Exam | not included | 100%, Maximum $150 | 100%, Maximum $150 | 100%, Maximum $320 |
MATERNITY BENEFIT (10-month waiting period applies)
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Complications of Pregnancy and Childbirth | not included | 100%, Maximum $10,000 | 100%, Maximum $15,000 | 100% |
| Routine Pregnancy and Child Birth | not included | not included | 100%, Maximum $7,500 | 100%, Maximum $19,200 |
| Initial Paediatric Check Up | not included | not included | 100%, Maximum $150 | 100%, Maximum $300 |
CONGENITAL BENEFIT
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| Care + | Comfort + | Executive + | Elite + | |
|---|---|---|---|---|
| Congenital abnormalities not discovered at Birth but which can subsequently be corrected with Surgery (Lifetime Maximum Limit of $50,000 per congenital condition | not included | not included | not included | 100%, Maximum $20,000 |
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