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 IOption IIOption IIIOption IVOption V
Outside USAUS$1,500US$3,000US$5,000US$10,000US$20,000
Inside USAUS$1,500US$3,000US$5,000US$10,000US$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.

**Excludes Venezuela.

TABLE OF BENEFITS

DescriptionCoverage
Maximum coverage per person, per lifetimeUS$5,000,000
Maximum coverage per person, per policy yearUS$1,500,000
Maximum coverage per person, per policy year at 70 years and olderUS$500,000
Age limit to apply Up to 75 years old
Waiting Period60 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 USA100% UCR with free choice of hospitals and doctors*
Coverage inside USA• 100% through 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
DescriptionCoverage
Standard private hospital room• 100% UCR within the Prime Network®
• Up to US$500 daily, max. of 180 days outside the Prime Network®
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 oldUS$150 per night, max. of 100 nights per policy year
Prescribed medication while hospitalized100% UCR
Inpatient laboratory tests and X-rays 100% UCR
DescriptionCoverage
Emergency room care100% UCR
Physician and specialist visits (including home visits)US$80 per visit, max. of 30 visits
Outpatient surgeryUS$12,000
Prescribed medication following a hospitalization100% UCR for up to 6 months
Outpatient or non-hospitalization prescription medicationUS$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 homeUS$5,000
Preventive health checkup per insured, no deductible applies (options I & II)US$100 (after a 12-month waiting period)
DescriptionCoverage
Surgeon and anesthesiologist fees 100% UCR
Oncology: cancer tests, treatment (chemotherapy and/or radiotherapy) and medication100% UCR, max. of US$125,000 per policy year
Dialysis services100% UCR
Prostheses and medical appliances implanted during surgery 100% UCR
Organ transplant (per organ/tissue)US$500,000 per lifetime (with rider)
Includes US$30,000 benefit for expenses of the live donor
Durable medical equipment US$1,000
Physical therapy and rehabilitation US$5,000
Congenital conditions diagnosed before age 18 US$125,000 per lifetime
Congenital conditions diagnosed after age 18 US$500,000 per lifetime
Reconstructive surgery after an accident or illnessUp to the benefit limit
DescriptionCoverage
Maternity (options I, II)US$3,000, no deductible applies
Maternity and newborn complications (options I & II)• US$25,000
• Additional US$25,000 with optional rider
Inclusion of the newborn within 90 days after the birth (options I & II)Without underwriting if born from a covered maternity
DescriptionCoverage
Emergency transportation by ground ambulance100% UCR, no deductible applies
Emergency transportation by air ambulance US$35,000, no deductible applies
Repatriation or cremation of mortal remains100% UCR
DescriptionCoverage
Emergency dental coverage 100% UCR for treatment within the first 30 days of the covered accident, max. of US$6,000 per policy year
Palliative careUS$7,500
Temporary coverage for accidents while application is being underwritten US$30,000
Travel VIP LightUp to US$5,000 for emergency medical treatment abroad (with rider)
Second Medical Opinion VIP®Access to a second medical opinion of renowned experts from around the world, without deductible