UNIVERSAL VIP
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.
**Excludes Venezuela.
TABLE OF BENEFITS
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| Description | Coverage |
|---|---|
| Lifetime coverage | Unlimited |
| Maximum coverage per person, per policy year | US$7,000.000 |
| Age limit to apply | 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 | US$5,000 |
| 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, osteopathy, acupuncture, psychology and/or outpatient mental health prescription medication | US$7,500, all therapies combined |
| Nurse or therapist care at home | 100% UCR |
| Preventive health checkup. No deductible applies (after a 3-month waiting period) | Options I & II: • 100% UCR for insureds from 0 to 6 months of age, up to 5 visits • US$300 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$300 per policy year for all ages |
| Hearing aids | US$2,000 per lifetime |
| Treatment for Alzheimer’s disease | 100% UCR |
| Allergy treatment | 100% UCR |
| 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 |
| Surgery to reduce the risk of cancer or prophylactic surgery | 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: autism, sleep apnea and other sleep disorders | US$3,000 |
| Congenital and/or hereditary conditions diagnosed before age 18 | US$2,000,000 per lifetime |
| Congenital and/or hereditary conditions diagnosed after age 18 | 100% UCR |
| 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 and its complications or treatments | 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 benefit limit |
| Description | Coverage |
|---|---|
| Maternity | Option I: • US$8,500, no deductible applies Option II: • US$8,500, after deductible (After a 10-month waiting period) |
| Extraction and storage of newborn stem cells (option I) | US$1,000 per covered pregnancy (After a 10-month waiting period) |
| Maternity and newborn complications | Option I: • US$1,000,000 per lifetime, no deductible applies Option II: • US$500,000 per lifetime, after deductible (After a 10-month waiting period) |
| 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) Included in the policy within 90 days from birth. After 90 days, premium payment will be required. | • 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 |
| 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$2,000 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 thecovered 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 no claims during the last 3 years | Options I & II: • Elimination for 1 year after the 3rd year without claims • Reduction of 50% of the deductible for 1 year after the 3rd year, if the deductible was not met in any of the years Options III & IV: • Reduction of 50% of the deductible for 1 year after the3rd year without claims |
| Second Medical Opinion VIP® | Access to a second medical opinion of renowned experts from around the world, no deductible applies |
| Travel VIP Light | Up to US$5,000 for emergency medical treatment while travelingabroad (with rider) |