OPTIMUM VIP

Offers protection for specific chronic conditions up to
US$1 million annually.

OPTIMUM VIP

Offers protection for specific chronic conditions up to US$1 million annually.

DEDUCTIBLE OPTIONS*

Option IOption IIOption IIIOption IVOption VOption VI
US$1,000US$2,000US$5,000US$10,000US$20,000US$50,000
US$1,000US$2,000US$5,000US$10,000US$20,000US$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 policy’s Conditions of Coverage.

TABLE OF BENEFITS

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General Information

DescriptionCoverage
Maximum coverage per person, per policy year US$1,000,000
Maximum age to apply for coverageUp to 75 years old
Waiting period30 days
Coverage outside USA100% UCR with free choice of hospitals and doctors
Coverage inside USA

• 100% UCR within the USA Special Network ®
• Outside the USA Special Network®
, the coverage will be at 60%,
with a maximum daily room rate of up to US$700 for a standard room
and up to US$1,400 for intensive care
• Emergency medical treatment will be covered 100% UCR,
up to the benefits limits

Covered Conditions

DescriptionCoverage
Neurological diseases (including cerebrovascular accidents)US$150,000
Cardiac surgery for revascularization and angioplastyUS$150,000
Cancer (tests, medication, chemotherapy, radiotherapy, gene therapy, surgery for tumor and reconstructive surgery)US$200,000
Polytrauma (including rehabilitation)US$200,000
Chronic kidney failure (dialysis or hemodialysis)US$150,000
Severe burns (including reconstructive surgery)US$300,000
SepticemiaUS$150,000
Organ and tissue transplantUS$500,000 per lifetimeIncludes US$50,000 benefit for expenses of the live donor

Inpatient Benefits

DescriptionCoverage
Standard hospital room100% UCR
Use of intensive care unit100% UCR
Adult companion accommodation expenses of a hospitalized insured under 18 years oldUS$100 per night, max. of 30 nights
Adult companion accommodation expenses of a hospitalized insured over 18 years old100% UCR, max. of 21 nights
Prescribed medications while hospitalized100% UCR for covered conditions
Physical therapy and rehabilitation100% UCR for covered conditions

Outpatient Benefits

DescriptionCoverage
Emergency room care100% UCR
Physician and specialist visits100% UCR for covered conditions
Physician and specialist home visits (where available)100% UCR for covered conditions
Outpatient prescription medicationUS$5,000 for covered conditions
Nurse or therapist care at homeUS$7,000 for covered conditions
Physical therapy and rehabilitationUS$7,000 for covered conditions

General Benefits

DescriptionCoverage
Surgeon and anesthesiologist fees100% UCR for covered conditions
Diagnostic study services (laboratory tests, biopsies, X-rays, MRI/CT/PET scans)100% UCR for covered conditions
Durable medical equipmentUS$7,000 for covered conditions
Congenital and/or hereditary conditions diagnosed before age 1810% of the benefit for covered conditions, per lifetime
Congenital and/or hereditary conditions diagnosed after age 1850% of the benefit for covered conditions, per lifetime
Reconstructive surgery after an accident or illnessUp to the maximum benefit

Medical Evacuation

DescriptionCoverage
Emergency transportation - Ground ambulance100% UCR for covered conditions, without deductible
Emergency transportation - Air ambulanceUS$30,000 for covered conditions, without deductible
Repatriation or cremation of mortal remainsUS$10,000

Other Benefits

DescriptionCoverage
Treatment for injuries during the training or practice of hazardous hobbies and/or non-professional sportsUS$100,000 per lifetime, for polytrauma or severe burns
Palliative care100% UCR for covered conditions
Temporary coverage for polytrauma while application is being underwrittenUS$30,000
Second Medical Opinion VIP®Access to a second medical opinion of renowned experts from around the world, no deductible applies