GROUP GLOBAL
FLEX VIP TOTAL
A comprehensive plan
offering superior benefits
and free choice of medical providers
DEDUCTIBLE OPTIONS
| Option I | Option II | Option III | Option IV | Option V | Option VI | Option VII | |
|---|---|---|---|---|---|---|---|
| US$0 deductible | US$1,000 deductible | US$2,000 deductible | US$5,000 deductible | US$10,000 deductible | US$15,000 deductible | US$20,000 deductible |
| Option VIII | Option IX | Option X | Option XI | Option XII | |
|---|---|---|---|---|---|
| US$15 outpatient per visit excess | US$30 outpatient per visit excess | 10% outpatient coinsurance, up to a maximum out of pocket of US$2,000 | 20% outpatient coinsurance, up to a maximum out of pocket of US$4,000 | 30% outpatient coinsurance, up to a maximum out of pocket of US$6,000 |
TABLE OF BENEFITS
| Description | Coverage |
|---|---|
| Maximum cover per person, per policy year | US$5,000,000 |
| Maximum age to apply for coverage | Up to 74 years |
| Geographical cover options | The policyholder can choose geographical area of cover restrictions as follows: Any treatment received outside the geographic area of cover is
For insureds residing in Africa, the area of cover will be restricted to:
For insureds residing in Armenia, Azerbaijan, Brunei, Cambodia,
For insureds residing in Bangladesh, Bhutan, India, Maldives, Nepal, |
| Description | Coverage |
|---|---|
| Adult companion accommodation (related to a coveredhospitalisation of an insured child under age 18) | 100% UCR |
| Psychiatric treatment | 100% UCR, max. of 30 days |
| Private hospital room (room and associated medical costs) | 100% UCR |
Inpatient benefits include but are not limited to the following treatments when admitted to hospital: specialists, surgeon and anesthesiologist fees, drugs and dressings, general nursing, intensive care unit, medical appliances and surgical implants, operating theatre, therapies (if prescribed by a specialist as part of the insured’s hospital stay but are not the primary treatment for which they are in the hospital to receive).
| Description | Coverage |
|---|---|
| Complementary therapy including physiotherapy,Traditional Chinese Medicine (TCM) and Ayurvedic treatment | 100% UCR, pre-authorisation required after 10 sessions |
| Day-care treatment | 100% UCR |
| General practitioner and specialist fees | 100% UCR |
| Hormone replacement therapy to relieve the symptoms of menopause | Up to US$500 |
| Nursing care at home | 100% UCR, max. of 120 days |
| Outpatient surgery | 100% UCR |
| Outpatient prescription drugs | 100% UCR |
| Psychiatric treatment | Up to US$10,000 |
| Travel vaccinations and preventive medication, e.g., against malaria | Up to US$500 |
| Description | Coverage |
|---|---|
| IVF (fertility treatment) | Up to US$10,000 per lifetime, up to US$2,500 per attempt and subject to a 25% coinsurance |
| Maternity and birth complications | 100% UCR |
| Maternity care | Up to US$20,000 |
| Newborn cover | Up to US$150,000 |
| Description | Coverage |
|---|---|
| Emergency transportation by air ambulance & emergency medical evacuation | 100% UCR |
| Repatriation of mortal remains | 100% UCR, US$20,000 for burial or cremation costs |
| Description | Coverage |
|---|---|
| Congenital and/or hereditary conditions after 30 days from birth | Up to US$150,000 |
| Congenital and/or hereditary conditions from birth up to 30 days | Covered under the newborn benefit |
| Diagnostic study services (laboratory tests, X-rays, CT, PET and MRI scans) | 100% UCR |
| Durable medical equipment and external prostheses | Up to US$3,000 per policy year |
| HIV- AIDS treatment | Up to US$50,000 |
| Oncology (tests, drugs and treatments approved by the FDA or equivalent domestic/ international regulatory body) | 100% UCR |
| Organ transplant (per organ/tissue, per lifetime) | 100% UCR,including up to US$50,000 for donor costs |
| Prescribed rehabilitation therapies | 100% UCR, max. of 120 days per medical condition |
| Reconstructive surgery | 100% UCR |
| Renal failure and dialysis | 100% UCR |
| Routine management of chronic conditions | 100% UCR |
| Surgical procedures | 100% UCR |
| Terminal illness / palliative care | Up to US$150,000 per lifetime |
| Description | Coverage |
|---|---|
| Emergency dental treatment | 100% UCR |
| Emergency non-elective treatment outside the geographical area of coverage | • 100% UCR for injuries • Up to US$50,000 for illnesses • Up to US$500 for outpatient hospital visits |
| Emergency transportation by ground ambulance | 100% UCR |
| Hospital cash benefit | Up to US$450 per night, max. of 30 nights |
| Passive war and terrorism | 100% UCR |
| Refractive eye surgery | Up to US$1,000 (per lifetime) |
| Routine and major dental treatment cover | Up to US$1,500 for routine and up to US$3,000 for major,subject to a 20% coinsurance and 50% coinsurance on orthodontic treatments |
| Second Medical Opinion VIP® | Access to the medical opinion of internationally renowned experts from around the world regarding a condition, no deductible applies |
| USA elective treatment (only available for insureds who chose the worldwide including USA elective treatment geographical area of cover) | Up to US$3,000,000 |
| Description | Coverage |
|---|---|
| Evacuation to country of choice, country of residence or homecountry | 100% UCR |
| Medical history disregarded | For compulsory group policies of 10 employees or more |
| Non-emergency evacuation | Up to US$2,000 |
| Semi-private hospital room restriction** | 100% UCR. As a premium-reduction option benefit, coverage for hospital room and board is limited to a semi-private hospital room equipped to accommodate two (2) or more patients, with shared bathroom. Private hospital rooms, VIP rooms, suites, deluxe or luxury rooms, any other higher-tier accommodation and any associated medical cost will not be covered. |
| Wellness and optical | Option I - US$500 Option II - US$1,000 |
*Subject to purchase.
WAITING PERIODS
| Description | Coverage |
|---|---|
| Dental | 9 months |
| HIV-AIDS | 36 months |
| IVF (fertility treatment) | 24 months |
| Refractive eye surgery | 12 months |
| Maternity and birth complications | 12 months |
| Maternity care | 12 months |