Global Basic Insurance is designed to provide coverage similar to Global
Medical Insurance, however, it features specific dollar limits on most benefits.
This is the perfect plan for those who want coverage for a variety of medical
services, but are seeking to reduce their premium costs.
You also have the option of adding Global Term Life InsuranceSM
and Global Daily IndemnitySM to your Global Basic Insurance
coverage.
MEDICAL INSURANCE
|
BENEFIT
Subject to deductible and
coinsurance
|
| Coverage area |
Worldwide
|
| Policy maximum per individual |
US$5,000,000 lifetime maximum benefit
|
| Hospital room & board |
US$600 per day
(maximum of 240 consecutive days per covered event)
|
| Intensive care unit |
US$1,500 per day
(maximum of 180 consecutive days per covered event)
|
| Inpatient or outpatient surgery |
URC up to lifetime maximum benefit
|
| Anesthetist's charges associated with surgery |
20% of the surgery benefit payable
|
| Laboratory tests, X-rays, & other treatment associated with an inpatient covered event |
URC up to lifetime maximum benefit
|
| Emergency medical evacuation |
US$50,000 per coverage period (not subject to deductible or coinsurance)
|
| Local ground ambulance |
US$1,500 per covered event (not subject to deductible or coinsurance)
|
| Emergency room treatment due to an accident |
URC up to lifetime maximum benefit
|
| Emergency dental due to an accident |
US$1,000 per coverage period
|
Maternity
Available only after 12 months of continuous coverage
|
Limited to US$5,000 per pregnancy (not subject to coinsurance)
|
|
Professional services related to inpatient maternity expenses
|
US$200 per day (not subject to coinsurance)
|
|
Newborn care and treatment
|
US$15,000 lifetime maximum for the first 31 days after birth
|
|
Well child care
|
3 visits per coverage period (maximum limit of $200 per period of coverage)
|
Outpatient visits or exams
25 visits, including prenatal and postnatal care, per insured person per
coverage period reimbursed to the maximum limit as outlined below:
|
|
| Physician |
US$70 per visit/exam |
| Specialist |
US$70 per visit/exam |
| Psychiatrist |
US$60 per visit/exam |
| Chiropractor |
US$50 per visit/exam |
| Surgical intervention consultation |
US$500 per visit/exam |
| |
|
|
Outpatient X-rays
|
US$250 per exam maximum limit
|
|
Outpatient lab tests
|
US$300 per exam maximum limit
|
Pre-existing Conditions
Available after 24 months of continuous coverage
|
US$50,000 lifetime maximum benefit
(maximum of US$5,000 per period of coverage)
|
|
Prescription medication related to a covered event
|
URC up to lifetime maximum benefit
|
|
Extended care facility services
|
Limited to the first 30 days of convalescent confinement
|
|
Home nursing care services
|
Limited to 30 days per covered event
|
|
Inpatient hospice care
|
Limited to the first 30 days of hospice confinement
|
|
Chemotherapy & radiation therapy
|
URC up to lifetime maximum benefit
|
|
Physical therapy
|
30 visits per coverage period (maximum limit of $40 per visit)
|
|
MRI, CAT scan, endoscopy, echocardiography, gastroscopy,
colonoscopy & cystoscopy
|
US$600 per exam limit
|
Transplants
Certain precertification provisions must be met
|
US$250,000 all inclusive per transplant
|
|
Return of mortal remains
|
US$25,000 lifetime maximum (not subject to deductible or coinsurance)
|