PRIME
CARE™
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PRIME CARE™
EXCLUSIVELY FOR CHILE
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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% |
| Maternity (Available in deductibles $1000/$1000 and $2000/$2000) | • $3.500 per pregnancy, includes newborn care No deductible applies A 10-month Waiting Period applies |
| Complications of Maternity and Birth (Available in deductibles $1000/$1000 and $2000/$2000) | 75.000 lifetime per policy No deductible applies A 10-month Waiting Period applies |
| 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% |
| Routine Health Check Up (Available in deductibles $1000/$1000, $2000/$2000 and $5000/$5000) Includes laboratory teats, X-rays, and any other medical expense related to the checkup | $150 No deductible applies No waiting period |
| Preventive Care (Available in deductibles $1000/$1000, $2000/$2000 and $5000/$5000) | Colon cancer screening (50 years or older): $1.200 per insured every ten years Mammogram (from 40 years or older): $400 per insured policy year Pap Smear (Papanicolaou) (21 to 65 years old): $150 per insured every three years Prostate cancer screening (50 years or older): $300 per insured per policy year No deductible applies No waiting period |
| Alternative and/or Complementary Treatments (Acupuncture, Hypnosis, Massage Therapy, and Reflexology) | $100 per insured, per policy year No deductible applies |
| 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 | |
| Individual Case Management A program to coordinate, supervise and manage complex cases of long duration. |
|
| 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 (Riders) | |
| Complications of Maternity and Birth | Up to $500.000 lifetime cover with an annual premium of $300 Available in deductibles $1000/$1000 and $2000/$2000 No deductible applies 10-month waiting period |
| 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 |
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