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PRIME
CARE™
All Health Plans
PRIME CARE™
EXCLUSIVELY FOR CHILE
ACCESS TO THE BEST HOSPITALS IN THE U.S.A.
This plan provides members with great solutions for major impact illnesses.
| ITEM/SERVICE | COVERAGE |
|---|---|
| Maximum Annual Benefit | $2,000.000 per Insured per Policy Year |
| Eligibility | Up to age 74 |
| Renewal | Lifetime guarantee |
| Coverage | Worldwide. Free choice of Providers anywhere in the world |
| Private and Semi-Private Room | 100% |
| Intensive Care Unit | 100% |
| Surgery (Including Outpatient Surgery) | 100% |
| Emergency Room | 100% |
| Surgeon and Anesthetist Fees | 100% |
| Major Diagnostic Services | 100% |
| Cancer Treatment | 100% |
| Dialysis | 100% |
| Congenital and Hereditary Disorders | $100,000 per Insured per lifetime (When the condition is diagnosed before age 18) 100% (When the condition is diagnosed at age 18 or after) |
| Organ and Tissue Transplant | $300,000 per Organ(s) or Tissue per Insured per lifetime $20,000 for Living Donor |
| Outpatient Physical Therapy, Rehabilitation and Home Health Care (Private nurse) | $4,000 per Insured per Policy Year after deductible |
| Surgical treatment for symptomatic disorders of the feet | 100% |
| Emergency Dental Coverage | 100% |
| Physicians and Specialists Visits | 100% |
| Reconstructive Surgery in case of illness or accident | 100% |
| Durable Medical Equipment Special Devices, External prosthesis, Orthotic devices | $6,500 per Insured per Policy Year, after deductible. |
| Surgical Implants or prosthesis (Excluding dental) | 100% |
| Prescribed Medications | $6,500 per Insured per Policy Year (outside hospitalization) after deductible 100% during hospitalization |
| Prophylactic surgery for reduction of cancer risk | $10,000 per Insured per lifetime after deductible |
| Emergency Transportation | |
| Air Ambulance | $30,000 per Insured per Policy year to the closest Hospital of qualified treatment. No deductible applies |
| Ground Ambulance | 100% to the closest Hospital of qualified treatment. No deductible applies |
| Repatriation of Mortal Remains or Cremation Services | $5,000 per Insured per Policy Year, after deductible, in the event of death resulting from a covered Accident or condition |
| Coverage for accidents that occurred during the practice of high risk activities | 100% |
| Additional Benefits | Deductible will be waived up to a USD $5,000 maximum in case of an Emergency or Accident that occurs while the Insured is travelling outside of his/her country of residence |
| In case of Serious Accident, as defined in this Policy, not deductible will apply for the first Medically Necessary Hospitalization, following said Serious Accident. Any subsequent treatment will incur the deductible | |
| Unique Services | InterConsultation®: Confirmation of diagnosis and recommendation of the best treatment and specialists. Immediate access to this benefit available regardless of any exclusion applicable under this Policy |
| Best Doctors Concierge™: Coordination of medical appointments, hospital admission, travel arrangements, accommodation and transportation when services are rendered outside of the Insured’s Country of Residence | |
| THINGS YOU SHOULD KNOW | • Unless otherwise stated, the benefits are on a per Insured, per Policy Year basis in which the chosen deductible applies • All benefits are in US Dollars (USD) • Cumulative deductible per Insured, per Policy Year. Maximum two deductibles per family per Policy Year • Costs are subject to being usual, customary and reasonable |
| ADDITIONAL COVERAGE AVAILABLE (RIDER) | |
| CriticalSelect ™ Eligibility: Age 3–59, renewable cover up to age 65 | Monetary benefit to pay for incidentals when being diagnosed with a covered illness or surgery Covered conditions and surgeries: Cancer, stroke, heart attack (myocardial infarction), coronary artery by-pass surgery, kidney/renal failure, multiple sclerosis, benign brain tumor, paralysis (paraplegia), organ transplant (kidney, heart, lung, liver, pancreas or bone marrow), blindness, deafness |
