GROUP GLOBAL
FLEX VIP ULTRA
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 pervisit excess | 10% outpatient coinsurance, up to amaximum out of pocketof US$2,000 | 20% outpatient coinsurance, up to amaximum out of pocketof US$4,000 | 30% outpatient coinsurance, up to amaximum out of pocketof US$6,000 |
TABLE OF BENEFITS
| Description | Coverage |
|---|---|
| Maximum coverage per person, per policy year | US$4,500,000 |
| 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 coverage is
For insureds residing in Africa, the area of cover will be restricted to:
For insureds residing in Armenia, Azerbaijan, Brunei, Cambodia,
|
| Description | Coverage |
|---|---|
| Adult companion accommodation (related to a coveredhospitalisation of an insured child under age 18) | Up to the maximum benefit |
| Psychiatric treatment | Up to the maximum benefit, max. of 30 days |
| Standard private room (room and board) | 100% UCR, up to the maximum benefit |
Inpatient benefits include but are not limited to the following treatments when admitted to hospital: specialists, surgeon and anesthesiologist fees, drugs, 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 ChineseMedicine (TCM) and Ayurvedic treatment | Up to the maximum benefit, pre-authorisation requiredafter 10 sessions |
| Day-care treatment | Up to the maximum benefit |
| General practitioner and specialist fees | Up to the maximum benefit |
| Hormone replacement therapy to relieve the symptoms of menopause | Up to US$350 |
| Nursing care at home | Up to the maximum benefit, max. of 120 days |
| Out-patient surgery | Up to the maximum benefit |
| Out-patient prescription drugs | Up to the maximum benefit |
| Psychiatric treatment | Up to US$7,500 |
| Travel vaccinations and preventive medication, e.g., against malaria | Up to US$350 |
| Description | Coverage |
|---|---|
| Congenital and/or hereditary conditions from birth up to 30 days | Covered under the newborn benefit |
| Congenital and/or hereditary conditions after 30 days from birth | Up to US$125,000 |
| Diagnostic study services (laboratory tests, X-rays, CT, PET and MRIscans) | Up to the maximum benefit |
| External prostheses | Up to US$2,500 per policy year |
| Gene therapies | Up to US $500,000 |
| HIV-AIDS treatment | Up to US$50,000 |
| Oncology (tests, drugs and treatments approved by the FDA orequivalent domestic/ international regulatory body) | Up to the maximum benefit |
| Organ Transplant (per organ/tissue, per lifetime) | Up to the maximum benefit,including up to US$50,000 for donor costs |
| Prescribed rehabilitation therapies | Up to the maximum benefit, max. of 120 days per medical condition |
| Reconstructive surgery | Up to the maximum benefit |
| Renal failure and dialysis | Up to the maximum benefit |
| Routine management of chronic conditions | Up to the maximum benefit |
| Surgical procedures | Up to the maximum benefit |
| Terminal illness / palliative care | Up to US$125,000 per lifetime |
| Description | Coverage |
|---|---|
| Maternity and birth complications | Up to the maximum benefit |
| Maternity care | Up to US$15,000 |
| Newborn cover | Up to US$125,000 |
| Description | Coverage |
|---|---|
| Emergency transportation by air ambulance & emergency medicalevacuation | Up to the maximum benefit |
| Repatriation of mortal remains | Up to the maximum benefit, US$15,000 for burial or cremation costs |
| Description | Coverage |
|---|---|
| Emergency dental treatment | Up to the maximum benefit |
| Emergency non-elective treatment outside the geographical area ofcoverage | • Up to the maximum benefit for injuries • Up to US$50,000 for illnesses • Up to US$500 for out-patient hospital visits |
| Emergency transportation by ground ambulance | Up to the maximum benefit |
| Hospital cash benefit | Up to US$400 per night, max. of 30 nights |
| Passive war and terrorism | Up to the maximum benefit |
| Routine and major dental treatment cover | Up to US$1,000 for routine and up to US$2,000 for complex,subject to a 20% co-insurance |
| Second Medical Opinion VIP® | Access to the medical opinion of internationally renownedexperts from around the world regarding a condition, nodeductible applies |
| USA elective treatment (only available for insureds who chose theworldwide including USA elective treatment geographical area ofcover) | Up to US$3,000,000 |
| Description | Coverage |
|---|---|
| Evacuation to country of choice, country of residence or homecountry | Up to the maximum benefit |
| Medical history disregarded | For compulsory group policies of 10 employees or more |
| Non-emergency evacuation | Up to US$2,000 |
| Semi-private room | Hospital room equipped to accommodate two (2) or more patients, with shared bathroom. If shared rooms are not available in the country where the insured is staying in the event of a medical emergency or an accident making it impossible to transfer to a facility offering shared rooms, this benefit will cover the cost of a standard private room (based on UCR costs charged locally). This benefit does not cover the cost of a private room for scheduled hospitalisation. |
| 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 |
| Maternity and new-born complications | 12 months |
| Maternity care | 12 months |
Effective from 1 July 2025, or after the renewal.