PROTECT VIP
Is a modular plan that provides flexibility to choose the coverage you need
DIRECT VIP
Offers an annual coverage of US$5 million for hospitalization and essential outpatient treatments.
HOSPITALIZATION MODULE (BASE PLAN) DEDUCTIBLE OPTIONS* (INSIDE** OR OUTSIDE THE U.S.)
| Option I | Option II | Option III | Option IV | Option V |
|---|---|---|---|---|
| US$500 | US$1,000 | US$2,000 | US$5,000 | US$10,000 |
*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 Conditions of Coverage of the policy.
**For coverage in the United States, the U.S. Coverage Module must be acquired.
TABLE OF BENEFITS
| Description | Coverage |
|---|---|
| Maximum coverage per person, per policy year | US$5,000,000 |
| Age limit to apply | Up to 75 years old |
| Waiting Period | 30 days |
| Geographical coverage | Worldwide without restrictions of doctors and hospitals (excluding the U.S., unless the optional U.S. Coverage Module is acquired) |
| Description | Coverage |
|---|---|
| Standard private/semi-private hospital room | 100% UCR |
| Intensive care unit | 100% UCR |
| Emergency room care | 100% UCR (if admitted immediately as an inpatient) |
| Surgeon and anesthesiologist fees | 100% UCR |
| Adult companion accommodation (Of a hospitalized insured under 18 years old) | US$175 per night, max. of 30 nights |
| Adult companion accommodation (Of a hospitalized insured over 18 years old) | 100% UCR, max. of 21 nights |
| Prescribed medications while hospitalized | 100% UCR |
| Prescribed medications following a hospitalization or outpatient surgery | 100% UCR for up to 6 months after discharge, max. of US$3,500 per policy year |
| Dialysis services inpatient or outpatient | 100% UCR |
| Laboratory tests and X-rays | 100% UCR |
| Oncology: inpatient or outpatient cancer treatment (chemotherapy and radiotherapy) | 100% UCR |
| Physician and specialist visits | 100% UCR |
| Physical therapy and rehabilitation | 100% UCR (during a hospitalization) |
| Prostheses and medical appliances implanted during surgery | 100% UCR |
| Organ transplant (per organ/tissue) | US$1,100,000 |
| Benefits for live donors | US$60,000 (included in the organ transplant benefit) |
| HIV/AIDS | US$50,000 (if admitted as an inpatient and after a 12-month waiting period) |
| Bariatric surgery | US$10,000 per lifetime (after a 24-month waiting period) |
| Durable medical equipment | 100% UCR (as follow-up care to a covered hospitalization) |
| Emergency dental coverage | 100% UCR for treatment within the first 180 days of the covered accident |
| Emergency transportation by ground ambulance | 100% UCR, no deductible applies (if admitted immediately as an inpatient) |
| Emergency transportation by air ambulance | 100% UCR, no deductible applies |
| Nurse or therapist care at home | 100% UCR (as follow-up care to a covered hospitalization) |
| Palliative care | 100% UCR |
| Repatriation of mortal remains | US$25,000 (must be pre-approved and coordinated by the company) |
| Temporary coverage for accidents while application is being underwritten | US$30,000 |
| Injuries during the training or practice of hazardous hobbies and/ornon-professional sports | 100% UCR |
| Deductible elimination/reduction for no claims made fir 3 years | • Elimination for 1 year after the 3rd year without claims(options II & III) • Reduction of up to 50% for 1 year after the 3rd year withoutclaims (options IV & V) |
| Second Medical Opinion VIP® | Access to the medical opinion of internationally renowned experts from around the world regarding a condition, without deductible |
| Description | Coverage |
|---|---|
| Outpatient benefits additional deductible | US$500 or US$1,000 |
| Outpatient benefits maximum coverage per person, per policy year | US$10,000 |
| Diagnostic study services (pathology, X-rays, MRI/CT/PET scans, etc.) Pre-surgical testing only. Pre-authorization required | 100% UCR |
| Prescription medication | US$4,000 |
| Physician and specialist visits | 100% UCR |
| Outpatient surgery | 100% UCR |
| Physical therapy and rehabilitation | 100% UCR, max. of 60 visits (following a covered hospitalization) |
| Speech therapy | 100% UCR |
| Occupational therapy | 100% UCR |
| Sleep apnea and other sleep disorders | 100% UCR |
| Autism treatment | 100% UCR |
| Allergy treatment | 100% UCR |
| Description | Coverage |
|---|---|
| Maximum coverage per person, per policy year within the U.S | Up to policy limits |
| Coverage inside USA | Inside the Protect VIP USA Network®: • 100% UCR Outside the Protect VIP USA Network®: • 60% of the covered expenses (with a maximum daily room rate of up to US$700 for a standard room and up to US$1,400 for intensive care unit) • Emergency medical treatment: 100% UCR |
| Special benefit for suite | Up to US$2,000 per day within the Protect VIP USA Network®. (no coverage available outside the Protect VIP USA Network®) |
*The Hospitalization Benefits Module (Base Plan) must be chosen before any other optional module can be added.
All benefits with 100% coverage are up to the policy limit.
