UNIVERSAL VIP CHOICE
The most comprehensive
plan with annual coverage
of US$5 million
DEDUCTIBLE OPTIONS*
| Option I | Option II | Option III | Option IV | Option V |
|---|---|---|---|---|
| US$2,000 | US$5,000 | US$10,000 | US$20,000 | US$50,000 |
*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.
TABLE OF BENEFITS
| Description | Coverage |
|---|---|
| Lifetime coverage | Unlimited |
| Maximum coverage per person, per policy year | US$7,000,000 |
| Maximum age to apply for coverage | Up to 75 years old |
| Waiting period | 30 days |
| Geographical coverage | Worldwide, without restrictions of doctors and hospitals |
| Description | Coverage |
|---|---|
| Standard private hospital room | 100% UCR |
| Special benefit for suite accommodation (subject to availability) | Up to US$2,000 per day within the USA Special Network® |
| Use of intensive care unit | 100% UCR |
| Companion accommodation expenses of a hospitalized insured | 100% UCR, max. of 21 nights |
| Prescribed medications while hospitalized | 100% UCR |
| Inpatient mental health treatment and medication | 100% UCR max. of 30 days |
| Description | Coverage |
|---|---|
| Emergency room care | 100% UCR |
| Physician and specialist visits | 100% UCR |
| Physician and specialist home visits (where available) | 100% UCR |
| Outpatient prescription medication | 100% UCR |
Complementary therapy: chiropractic, psychiatry, speech, occupational, | US$7,500, all therapies combined |
| Nurse or therapist care at home | 100% UCR |
| Preventive health checkup. No deductible applies | Options I & II: • 100% UCR for insureds from 0 to 6 months of age, up to 5 visits • US$600 per policy year for insureds from 6 months to 17 years of age • US$600 per policy year for insureds from 18 years of age and older Options III & IV: • US$600 per policy year for all ages Preventive care benefit (options I, II, III & IV): • Colon cancer screening (at 45 years and older): US$1,200 every 10 years (after a 12-month waiting period) |
| Hearing aids | US$2,000 per lifetime |
| Treatment for Alzheimer’s disease | 100% UCR |
| Allergy treatment | 100% UCR |
| Autism treatment | US$5,000 |
The following benefits offer the same coverage for both inpatient and outpatient procedures.
| Description | Coverage |
|---|---|
| Emergency medical services | 100% UCR |
| Surgeon and anesthesiologist fees | 100% UCR |
| Diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/PET scans) | 100% UCR |
| Oncology: tests, treatment (chemotherapy and/or radiotherapy) and medication | 100% UCR |
| Prophylactic surgery to reduce the risk of cancer | US$25,000 per lifetime (after a 12-month waiting period) |
| Dialysis services | 100% UCR |
| Prostheses and medical appliances implanted during surgery | 100% UCR |
| Organ transplant (per organ/tissue) | US$1,100,000 per lifetime Includes US$60,000 benefit for expenses of the live donor |
| Durable medical equipment | 100% UCR |
| Physical therapy and rehabilitation | 100% UCR |
| Specialized treatments: sleep apnea and other sleep disorders | US$3,000 |
| Congenital conditions diagnosed before age 18 (including US$30,000 for cochlear implants) | US$2,000,000 per lifetime |
| Congenital conditions diagnosed after age 18 (including US$30,000 for cochlear implants) | 100% UCR |
| Gene therapy | US$1,000,000 |
| HIV-AIDS Treatment | US$1,000,000 per lifetime (after a 24-month waiting period) |
| Gastric bypass bariatric surgery and any type of surgical procedure for weight loss, its complications or treatments, and/or weight loss medication | US$10,000 per lifetime (after a 24-month waiting period) |
| Surgical treatment of symptomatic foot disorders | 100% UCR (after a 24-month waiting period) |
| Reconstructive surgery after an accident or illness (covered by this plan) | Up to the maximum benefit |
10-month waiting period, no deductible applies.
| Description | Coverage |
|---|---|
| Maternity | Option I: US$8,500, no deductible applies Option II: US$8,500, after deductible Includes deliveries for pregnancies that are a result of any type of fertility treatments |
| Extraction and storage of newborn stem cells (option I) | US$1,000 per covered delivery |
| Maternity and birth complications | Option I: US$1,000,000 per lifetime, no deductible applies |
| Inclusion of the newborn within 90 days after the birth (options I & II) | Without underwriting, if born from a covered maternity |
| Free coverage for dependents up to 5 years old (option I)* | • Max. of 2 children born from a covered maternity, if both parents are insured in the policy • Max. of 1 child born from a covered maternity, if only the mother is insured in the policy |
*Included in the policy within 90 days from birth. After 90 days, premium payment will be required.
| Description | Coverage |
|---|---|
| Emergency transportation by ground ambulance | 100% UCR, no deductible applies |
| Emergency transportation by air ambulance | 100% UCR , no deductible applies |
| Cost of return ticket for the insured and one companion after an evacuation by air ambulance | Up to US$1,000 per ticket |
| Repatriation or cremation of mortal remains | 100% UCR |
| Description | Coverage |
|---|---|
| Treatment for injuries during the training or practice of hazardous hobbies and/or professional sports | 100% UCR |
| Emergency dental coverage | 100% UCR for treatment within the first 180 days of the covered accident |
| Refractive eye surgery | US$500 per eye, per lifetime (after a 24-month waiting period) |
| Palliative care | 100% UCR |
| Temporary coverage for accidents while application is being underwritten | US$30,000 |
| Free extended coverage for eligible dependents after the policyholder’s death as a result of a covered accident or condition | 2 years |
| Elimination/reduction of the policy deductible for not meeting the deductible during the last 3 years | Options I & II: |
| Second Medical Opinion VIP® | Access to a second medical opinion of renowned experts from around the world, without deductible |
| Description | Coverage |
|---|---|
| Maternity and birth complications (option II) | US$500,000 per lifetime, after deductible |
| Emergency coverage when traveling abroad | Up to US$5,000 for emergency medical treatment |
*Coverage subject to the purchase of the riders.
All benefits with 100% coverage are up to the policy limit. Benefits with established coverage will be up to the limits stated in each of them.