DEDUCTIBLE OPTIONS
|
I |
II |
III |
IV |
V |
VI |
| Outside USA |
US$500 |
US$2,000 |
US$3,000 |
US$5,000 |
US$10,000 |
US$20,000 |
| Inside USA |
US$1,000 |
PLAN INFORMATION
| BENEFIT |
COVERAGE |
| Maximum coverage per insured, per policy year |
US$8,000,000 |
| Age limit |
Up to 79 years old |
| Waiting period |
30 days |
| Geographic coverage |
Worldwide, with no restrictions of doctors and hospitals |
HOSPITAL BENEFITS
| BENEFIT |
COVERAGE |
| Standard private/semi-private hospital room |
100%* |
| Special benefit for suite room use (subject to availability) |
Up to US$3,000 per day within the EVER® US Network |
| Intensive care unit |
100%* |
| Expenses for an accompanying adult of a hospitalized insured |
Under 18 years old |
US$350 per night, max. of 30 nights |
| Over 18 years old |
100%*, max. of 30 nights |
| Prescribed medications during hospitalization |
100%* |
| Psychiatric treatments |
US$3,000 |
OUTPATIENT BENEFITS
| BENEFIT |
COVERAGE |
| Emergency room care |
100%* |
| Visits to doctors and specialists |
100%* |
| Home visits by doctors and specialists |
100%* |
| Prescribed medications |
100%* |
| Complementary therapies (chiropractor, psychologist, psychiatrist, osteopathy, acupuncture) |
US$5,000 |
| Home nurse or therapist care |
100%* |
| Preventive medical check-up per insured, no deductible (after a 10-month waiting period) |
OPTIONS I, II & III:- US$150 up to 17 years old
- US$350 from 18 years old
OPTIONS IV, V & VI: |
| Hearing aids |
US$2,500 lifetime |
| Alzheimer’s disease treatment |
100%* |
| Allergy treatment |
100%* |
GENERAL BENEFITS
The following benefits offer the same coverage for both inpatient and outpatient procedures.
| BENEFIT |
COVERAGE |
| Surgeon and anesthesiologist fees |
100%* |
| Laboratory tests and diagnostic services (blood tests, pathology, X-rays, MRI/CT/PET scans) |
100%* |
| Oncology (cancer tests, chemotherapy/radiotherapy, medications) |
100%* |
| Cancer risk-reduction surgery or prophylactic surgery |
US$35,000 lifetime (after a 12-month waiting period) |
| Dialysis services |
100%* |
| Prosthetics and implanted medical devices during surgery |
100%* |
| Organ transplant (per organ/tissue) |
US$1,500,000 lifetime (including live donor expenses) |
| Durable medical equipment |
100%* |
| Physical therapy and rehabilitation |
100%* |
| Specialized treatments (occupational therapy, speech therapy, sleep apnea and other sleep disorders) |
US$4,000 |
| Congenital conditions |
Diagnosed before age 18 |
US$2,100,000 lifetime |
| Diagnosed after age 18 |
100%* |
| HIV/AIDS |
US$1,000,000 lifetime (after a 24-month waiting period) |
| Bariatric surgery |
US$15,000 lifetime (after a 24-month waiting period) |
| Surgical treatment of symptomatic foot disorders |
100%* (after a 24-month waiting period) |
| Reconstructive surgery after an accident or illness |
Up to the benefit limit |
MATERNITY BENEFITS
10-month waiting period, no deductible applies.
| BENEFIT |
COVERAGE |
| Maternity (options I, II & III) |
- US$8,500 per normal delivery or C-section (if only the mother is insured)
- US$10,000 per normal delivery or C-section (if both parents are insured)
|
| Stem cell extraction and storage (options I, II & III) |
US$1,000 per covered pregnancy |
| Maternity and newborn complications (options I, II & III) |
US$1,000,000 lifetime |
| Newborn inclusion within 90 days after birth (options I, II & III) |
No medical evaluation if born in a covered maternity |
MEDICAL EVACUATION BENEFITS
| BENEFIT |
COVERAGE |
| Emergency transportation |
Ground ambulance |
100%*, no deductible applies |
| Air ambulance |
100%*, no deductible applies |
| Return ticket cost for insured and companion after an air ambulance evacuation |
US$1,200 per insured |
| Repatriation or cremation of mortal remains |
100%* |
OTHER BENEFITS
| BENEFIT |
COVERAGE |
| High-risk activities and sports |
100%* |
| Emergency dental treatment due to an accident |
100%* (treatment within the first 180 days of a covered accident) |
| Refractive eye surgery |
US$550 per eye, per lifetime (after a 24-month waiting period) |
| Palliative care |
100%* |
| Temporary accident coverage while application is being processed |
US$35,000 |
| Extended free coverage for policy dependents after the policyholder’s death |
2 years |
| Deductible waiver/reduction after 3 years without claims |
OPTIONS I, II, III & IV:- Elimination for 1 year after the third year without claims
- 50% reduction of the deductible for 1 year after the third year, if the deductible has not been met in any of the years
OPTIONS V & VI- 50% deductible reduction for 1 year after the third claim-free year
|
| Executive checkup |
Up to US$1,000 (after a 24-month waiting period within the EVER® Prevent network) |
| Nutritionist visits |
Up to 5 visits per policy year |
| EVER Expert Medical Review® |
Unlimited access to world-renowned medical expert second opinions, no deductible applies |
| ForEVER Fit |
Up to US$100 per insured, per policy year, via reimbursement |
