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PRIME
CARE™
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PRIME CARE™
EXCLUSIVELY FOR CHILE
ACCESS TO THE BEST HOSPITALS IN THE U.S.A.
This plan provides members with great solutions for major impact illnesses.
| ITEM/SERVICE | COVERAGE |
|---|---|
| Maximum Benefit | • $3.000.000 per Insured per Policy Year |
| Eligibility to Apply | • From 18 to 74 years old |
| Renewal | • Lifetime guarantee |
| Coverage | • Worldwide. Free choice of Providers anywhere in the world |
| Private and Semi-Private Room | • 100% |
| Intensive Care Unit | • 100% |
| Surgery (Including Outpatient Surgery) | • 100% |
| Emergency Room | • 100% |
| Surgeon and Anesthetist Fees | • 100% |
| Major Diagnostic Services | • 100% |
| Cancer Treatment | • 100% |
| Dialysis | • 100% |
| Maternity (Available in deductibles $1000/$1000 and $2000/$2000) | • $3.500 per pregnancy, includes newborn care • No deductible applies • A 10-month Waiting Period applies |
| Complications of Maternity and Birth (Available in deductibles $1000/$1000 and $2000/$2000) | • $75.000 lifetime per policy • No deductible applies • A 10-month Waiting Period applies |
| Inclusion of Newborn | • Automatically included without underwriting if born from a covered maternity |
| Congenital and Hereditary Disorders | • $100.000 per Insured per lifetime (When the condition is diagnosed before age 18) • 100% (When the condition is diagnosed at age 18 or after) |
| Organ and Tissue Transplant | • $300.000 per Organ or tissue, lifetime per Insured, after deductible, including $20.000 for living donor |
| Outpatient Physical Therapy, Rehabilitation and Home Health Care (Private nurse) | • $4.000 per Insured per Policy Year after deductible |
| Surgical treatment for symptomatic disorders of the feet | • 100% |
| Emergency Dental Coverage | • 100% |
| Physicians and Specialists Visits | • 100% |
| Reconstructive Surgery in case of illness or accident | • 100% |
| Durable Medical Equipment Special Devices, External prosthesis, Orthotic devices | • $8.000 per Insured per Policy Year, after deductible. |
| Surgical Implants or prosthesis (Excluding dental) | • 100% |
| Prescribed Medications | • $30.000 per Insured per Policy Year (outside hospitalization) after deductible, including medications for allergy treatment • 100% during hospitalization |
| Prophylactic surgery for reduction of cancer risk | • $10.000 per Insured per lifetime after deductible • 12-month Waiting Period |
| Emergency Transportation | |
| Air Ambulance | • $30.000 per Insured per Policy year to the closest hospital of qualified treatment • No deductible applies |
| Ground Ambulance | • 100% to the closest hospital of qualified treatment • No deductible applies |
| Repatriation of Mortal Remains or Cremation Services | • $5.000 per Insured per Policy Year, after deductible, in the event of death resulting from a covered Accident or condition |
| Coverage for accidents that occurred during the practice of high risk activities | • 100% |
| Routine Health Check Up (Available in deductibles $1000/$1000, $2000/$2000 and $5000/$5000) Includes laboratory teats, X-rays, and any other medical expense related to the checkup | • $150 • No deductible applies • No waiting period |
| Preventive Care (Available in deductibles $1000/$1000, $2000/$2000 and $5000/$5000) | • Colon cancer screening (50 years or older): $1.200 per insured every ten years • Mammogram (from 40 years or older): $400 per insured policy year • Pap Smear (Papanicolaou) (21 to 65 years old): $150 per insured every three years • Prostate cancer screening (50 years or older): $300 per insured per policy year • No deductible applies • No waiting period |
| Specialized Treatments (Psychiatrist, autism, occupational therapies, sleep apnea and other sleep disorders) | • $2.000 per Insured, per Policy Year after Deductible |
| Alternative and/or Complementary Treatments (Acupuncture, Hypnosis, Massage Therapy, and Reflexology) | • $100 per insured, per policy year • No deductible applies |
| Additional Benefits | • Deductible will be waived up to a USD $5.000 maximum in case of an Emergency or Accident that occurs while the Insured is travelling outside of his/her country of residence. |
| • In case of Serious Accident, as defined in this Policy, not deductible will apply for the first Medically Necessary Hospitalization, following said Serious Accident. Any subsequent treatment will incur the deductible. | |
| Unique Services | InterConsultation® Confirmation of diagnosis and recommendation of the best treatment and specialists. Immediate access to this benefit available regardless of any exclusion applicable under this Policy. |
| Best Doctors Concierge™ Coordination of medical appointments, hospital admission, travel arrangements, accommodation and transportation when services are rendered outside of the Insured’s Country of Residence. | |
| Individual Case Management A program to coordinate, supervise and manage complex cases of long duration. |
|
| Things You Should Know | • Unless otherwise stated, the benefits are on a per Insured, per Policy Year basis in which the chosen deductible applies. • All benefits are in US Dollars (USD). • Cumulative deductible per Insured, per Policy Year. Maximum two deductibles per family per Policy Year. • Costs are subject to being usual, customary and reasonable. |
| Additional Coverage Available (Riders) | |
| Complications of Maternity and Birth | • Up to $500.000 lifetime cover with an annual premium of $300 • Available in deductibles $1000/$1000 and $2000/$2000 • No deductible applies • 10-month waiting period |
| CriticalSelect™ Eligibility: Age 3–59, renewable cover up to age 65 | • Monetary benefit to pay for incidentals when being diagnosed with a covered illness or surgery • Covered conditions and surgeries: Cancer, stroke, heart attack (myocardial infarction), coronary artery by-pass surgery, kidney/renal failure, multiple sclerosis, benign brain tumor, paralysis (paraplegia), organ transplant (kidney, heart, lung, liver, pancreas or bone marrow), blindness, deafness |
At Best Doctors Insurance, we are proud to help our members enjoy better and healthier lives.
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