PRIME VIP
Offers a wide range of benefits with a lifetime coverage of US$5 million
PRIME VIP
Offers a wide range of benefits with a lifetime coverage of US$5 million
DEDUCTIBLE OPTIONS*
| Option I | Option II | Option III | Option IV | Option V | |
|---|---|---|---|---|---|
| US$1,500 | US$3,000 | US$5,000 | US$10,000 | US$20,000 | |
| US$1,500 | US$3,000 | US$5,000 | US$10,000 | US$20,000 |
*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
| Description | Coverage |
|---|---|
| Maximum coverage per person, per lifetime | US$5,000,000 |
| Maximum coverage per person, per policy year | US$1,500,000 |
| Maximum coverage per person, per policy year at 70 years and older | US$500,000 |
| Maximum age to apply for coverage | Up to 75 years old |
| Waiting period | 60 days |
| Coinsurance (inside USA) | 20% of the first US$5,000 after the deductible; 1 per insured, per policy year; max. of 2 per policy, per policy year |
| Coverage outside USA | 100% UCR with free choice of hospitals and doctors* |
| Coverage inside USA | • 100% UCR within the Prime Network® • Outside the Prime Network®, the coverage will be at 60% • Emergencies will be covered at 100% UCR, up to the policy limits |
*Excluding the Hospitales Star Médica hospitals in Mexico.
| Description | Coverage |
|---|---|
| Standard private hospital room | • 100% UCR within the Prime Network® • Up to US$500 daily, max. of 180 days outside the Prime Network® |
| Use of intensive care unit | • 100% UCR within the Prime Network®® • Up to US$1,400 daily, max. of 60 days outside the Prime Network® |
| Adult companion accommodation expenses of a hospitalized insured under 18 years old | US$150 per night, max. of 100 nights per policy year |
| Prescribed medication while hospitalized | 100% UCR |
| Inpatient laboratory tests and X-rays | 100% UCR |
| Description | Coverage |
|---|---|
| Emergency room care | 100% UCR |
| Physician and specialist visits (including home visits where available) | US$80 per visit, max. of 30 visits |
| Outpatient surgery | US$12,000 |
| Prescribed medication following a hospitalization | 100% UCR for up to 6 months |
| Outpatient or non-hospitalization prescription medication | US$3,000 |
| Outpatient diagnostic study services (laboratory tests, pathology, X-rays, MRI/CT/PET scans) | US$600 per exam, per insured; max. of US$1,800 per policy year |
| Nurse or therapist care at home | US$5,000 |
| Preventive health checkup per insured, no deductible applies (options I & II) | US$100 (after a 12-month waiting period) |
| Description | Coverage |
|---|---|
| Surgeon and anesthesiologist fees | 100% UCR |
| Oncology: tests, treatment (chemotherapy and/or radiotherapy) and medication | 100% UCR, max. of US$125,000 per policy year |
| Dialysis services | 100% UCR |
| Prostheses and medical appliances implanted during surgery | 100% UCR |
| Durable medical equipment | US$1,000 |
| Physical therapy and rehabilitation | US$5,000 |
| Congenital and/or hereditary conditions diagnosed before age 18 | US$125,000 per lifetime |
| Congenital and/or hereditary conditions diagnosed after age 18 | US$500,000 per lifetime |
| Reconstructive surgery after an accident or illness | Up to the maximum benefit |
| Description | Coverage |
|---|---|
| Maternity (options I & II) | US$3,000 Includes deliveries for pregnancies that are a result of any type of fertility treatments |
| Maternity and newborn complications (options I & II) | US$25,000 |
| Inclusion of the newborn within 90 days after the birth (options I & II) | Without underwriting, if born from a covered maternity |
| Description | Coverage |
|---|---|
| Emergency transportation - Ground ambulance | 100% UCR, no deductible applies |
| Emergency transportation - Air ambulance | US$35,000, no deductible applies |
| Repatriation or cremation of mortal remains | 100% UCR |
| Description | Coverage |
|---|---|
| ncy dental coverage | 100% UCR for treatment within the first 30 days of the covered accident, max. of US$6,000 per policy year |
| Palliative care | US$7,500 |
| Temporary coverage for accidents while application is being underwritten | US$30,000 |
| Second Medical Opinion VIP® | Access to a second medical opinion of renowned experts from around the world, no deductible applies |
| Description | Coverage |
|---|---|
| Organ/tissue transplant | US$500,000 per lifetime |
| Maternity and newborn complications (options I & II) | Additional US$25,000 |
| Emergency coverage when traveling abroad | Up to US$5,000 for emergency medical treatment |
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.