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Visitors Care Benefits

Plan A - US$25,000 maximum benefit per life of plan

Inpatient Treatment

Max Benefit
Hospital Room and Board Up to US$825 per day, 30 day maximum per period of coverage
Intensive Care Additional US$400 per day, 8 day maximum per period of coverage
Surgical Treatment US$2,000 per surgical session
Consult physician US$350 per period of coverage
Pre-admission tests US$750 per period of coverage
Private duty nurse US$400 per period of coverage
Physician Visits US$40 allowable charge per visit, 30 visits per period of coverage

Outpatient Treatment Max Benefit
Surgical treatment US$2,000
per surgical session
Diagnostic x-ray & lab US$650 per period of coverage, (US$325 allowable charge per procedure)
Hospital emergency room 75% of URC to US$200
Prescription drugs US$150 per period of coverage
Physician visits US$50 allowable charge per visit, 10 visits per period of coverage

Miscellaneous Inpatient & Outpatient Services Max Benefit
Anesthetist 25% of surgical benefit
Assistant surgeon 25% of surgical benefit

Other Coverage Max Benefit
Ambulance US$250 per period of coverage
Dental for accident to sound natural teeth US$350 per period of coverage
Physiotherapy US$25 per visit per day, 12 visits per period of coverage.

 


Plan B - US$50,000 maximum benefit per life of plan

Inpatient Treatment

Max Benefit
Hospital Room and Board Up to US$1,400 per day, 30 day maximum per period of coverage
Intensive Care Additional US$660 per day, 8 day maximum per period of coverage
Surgical Treatment US$3,300 per surgical session
Consult physician US$450 per period of coverage
Pre-admission tests US$1,100 per period of coverage
Private duty nurse US$550 per period of coverage
Physician Visits US$55 allowable charge per visit, 30 visits per period of coverage

Outpatient Treatment Max Benefit
Surgical treatment US$3,300
per surgical session
Diagnostic x-ray & lab US$800 per period of coverage, (US$400 allowable charge per procedure)
Hospital emergency room 75% of URC to US$300
Prescription drugs US$250 per period of coverage
Physician visits US$55 allowable charge per visit, 10 visits per period of coverage

Miscellaneous Inpatient & Outpatient Services Max Benefit
Anesthetist 25% of surgical benefit
Assistant surgeon 25% of surgical benefit

Other Coverage Max Benefit
Ambulance US$450 per period of coverage
Dental for accident to sound natural teeth US$550 per period of coverage
Physiotherapy US$40 per visit per day, 12 visits per period of coverage.

 


Plan C - US$100,000 maximum benefit per life of plan

Inpatient Treatment

Max Benefit
Hospital Room and Board Up to US$1,950 per day, 30 day maximum per period of coverage
Intensive Care Additional US$850 per day, 8 day maximum per period of coverage
Surgical Treatment US$5,500 per surgical session
Consult physician US$500 per period of coverage
Pre-admission tests US$1,100 per period of coverage
Private duty nurse US$550 per period of coverage
Physician Visits US$85 allowable charge per visit, 30 visits per period of coverage

Outpatient Treatment Max Benefit
Surgical treatment US$5,500
per surgical session
Diagnostic x-ray & lab US$950 per period of coverage, (US$475 allowable charge per procedure)
Hospital emergency room 75% of URC to US$550
Prescription drugs US$250 per period of coverage
Physician visits US$85 allowable charge per visit, 10 visits per period of coverage

Miscellaneous Inpatient & Outpatient Services Max Benefit
Anesthetist 25% of surgical benefit
Assistant surgeon 25% of surgical benefit

Other Coverage Max Benefit
Ambulance US$450 per period of coverage
Dental for accident to sound natural teeth US$550 per period of coverage
Physiotherapy US$40 per visit per day, 12 visits per period of coverage.




Visitors Care

 

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