Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • the damage was caused by normal wear and tear • the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • the damage was caused by tooth brushing or any other oral hygiene procedure • the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - Surgical removal of complicated buried roots which are diseased or causing symptoms - Enucleation (removal) of cysts of the jaw - Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - Evacuation where the local medical facilities are not adequate according to our appointed doctor - Evacuation will be to the nearest medical facility where treatment is adequate - Transportation for returning to the principal country of residence following the evacuation - Cost of one accompanying person while the covered person is being evacuated - Hotel accommodation of one accompanying person up to 10 days - Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admissionbeforeadmission) We will pay for consultation, prescribed investigations and essential medications received as an out-out- patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized Computerised tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized computerised tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption insurance option is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,, we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption insurance option is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - theevacuation d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not ApplicableApplicable Acute medical condition (excluding congenital conditions) This benefit pays for the treatment of acute medical condition, providing there is no underlying congenital condition, developed in a new born baby including nursing of pre-mature baby (i.e. where birth is prior to 37 weeks gestation) in Neonatal Intensive Care Unit (NICU). Common acute medical conditions for new born babies include neonatal jaundice, colic, diarrhea, constipation, vomiting and ear infection. This benefit is only available if: a) the parent of the new born baby has been covered under consecutive days or more when the baby is born; and for 365 consecutive days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. This benefit covers treatment received by a new born baby during the first 30 days after birth. After 30 days, treatment can be covered under the main benefits of the insured baby’s plan. Included Annual Deductible Treatment of congenital conditions This benefit pays for treatment of congenital conditions. The benefit becomes available if: a) the parent of the new born baby has been covered under consecutive days or more when the baby is born; and Plan A for 365 days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. Please note: 1) Treatment for congenital conditions which do not fulfill all above criteria will be paid from ‘Pre-existing Condition/Congenital Conditions’ benefit. 2) Once the limit for this benefit is reached, no other benefit (including ‘Pre-existing Conditions/ Congenital Conditions’ benefit) will be payable for the congenital condition(s) which was (were) claimed from this benefit for the remaining policy year. No benefit Annual Deductible
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$140 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included if it is part of pre-hospitalisation treatment or post hospitalisation treatment Subject to the limitations applied for ‘Pre-hospitalisation treatment’ or ‘Post-hospitalisation treatment’ benefit 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included This benefit includes one post-surgery consultation within 90 days from the date of the surgical procedure 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Benefits Table Plan C Only applicable when Annual Deductible/ Co-insuranceoption is chosen Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,, we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy if it is part of post-hospitalisation treatment Subject to the limitations applied for relief of menopausal symptoms - up to S$200) ‘Post-hospitalisation treatment’ benefit 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included if it is part of post-hospitalisation treatment Subject to the limitations applied for ‘Post-hospitalisation treatment’ benefit 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 No benefit 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year No benefit 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 No benefit 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 No benefit 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B C Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,, we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not ApplicableApplicable Acute medical condition (excluding congenital conditions) This benefit pays for the treatment of acute medical condition, providing there is no underlying congenital condition, developed in a new born baby including nursing of pre-mature baby (i.e. where birth is prior to 37 weeks gestation) in Neonatal Intensive Care Unit (NICU). Common acute medical conditions for new born babies include neonatal jaundice, colic, diarrhea, constipation, vomiting and ear infection. This benefit is only available if: a) the parent of the new born baby has been covered under InternationalExclusive for 365 consecutive days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. This benefit covers treatment received by a new born baby during the first 30 days after birth. After 30 days, treatment can be covered under the main benefits of the insured baby’s plan. Included Annual Deductible Treatment of congenital conditions This benefit pays for treatment of congenital conditions. The benefit becomes available if: a) the parent of the new born baby has been covered under InternationalExclusive Plan A for 365 days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. Please note: 1) Treatment for congenital conditions which do not fulfill all above criteria will be paid from ‘Pre-existing Condition/Congenital Conditions’ benefit. 2) Once the limit for this benefit is reached, no other benefit (including ‘Pre-existing Conditions/ Congenital Conditions’ benefit) will be payable for the congenital condition(s) which was (were) claimed from this benefit for the remaining policy year. No benefit Annual Deductible
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$300 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological physio- logical symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 S$2,000 Available only after 90 consecutive days membership in the first policy year year” 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 S$1,350 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • the damage was caused by normal wear and tear • the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • the damage was caused by tooth brushing or any other oral hygiene procedure • the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - Surgical removal of complicated buried roots which are diseased or causing symptoms - Enucleation (removal) of cysts of the jaw - Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 S$2,500 20% co-insurance Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit up to S$380 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - Evacuation where the local medical facilities are not adequate according to our appointed doctor - Evacuation will be to the nearest medical facility where treatment is adequate - Transportation for returning to the principal country of residence following the evacuation - Cost of one accompanying person while the covered person is being evacuated - Hotel accommodation of one accompanying person up to 10 days - Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Benefits Table (Plan A) (Continued) Benefits Table Plan A Only applicable when Annual Deductible/ Co-insurance option is chosen In-patient and Daycare Treatment Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$300 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 60 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 60 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Out-patient Treatment Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Benefits Table (Plan A) (Continued) Benefits Table Plan A Only applicable when Annual Deductible/ Co-insurance option is chosen Alternative and Well-being Medicine Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year S$2,000 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 S$1,350 20% co-insurance Dental Treatment Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • the damage was caused by normal wear and tear • the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • the damage was caused by tooth brushing or any other oral hygiene procedure • the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - Surgical removal of complicated buried roots which are diseased or causing symptoms - Enucleation (removal) of cysts of the jaw - Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 S$2,500 20% co-insurance Optical Benefit Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit up to S$380 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Emergency Evacuation and Repatriation International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - Evacuation where the local medical facilities are not adequate according to our appointed doctor - Evacuation will be to the nearest medical facility where treatment is adequate - Transportation for returning to the principal country of residence following the evacuation - Cost of one accompanying person while the covered person is being evacuated - Hotel accommodation of one accompanying person up to 10 days - Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$140 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included if it is part of pre-hospitalisation treatment or post hospitalisation treatment Subject to the limitations applied for ‘Pre-hospitalisation treatment’ or ‘Post-hospitalisation treatment’ benefit 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included This benefit includes one post-surgery consultation within 90 days from the date of the surgi- cal procedure 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Benefits Table Plan C Only applicable when Annual Deductible/ Co-insuranceoption is chosen Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy if it is part of post-hospitalisation treatment Subject to the limitations applied for relief of menopausal symptoms - up to S$200) ‘Post-hospitalisation treat- ment’ benefit 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included if it is part of post-hospitalisation treatment Subject to the limitations applied for ‘Post-hospitalisation treat- ment’ benefit 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 No benefit 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year No benefit 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 No benefit 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • the damage was caused by normal wear and tear • the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • the damage was caused by tooth brushing or any other oral hygiene procedure • the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - Surgical removal of complicated buried roots which are diseased or causing symptoms - Enucleation (removal) of cysts of the jaw - Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 No benefit 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B C Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - Evacuation where the local medical facilities are not adequate according to our appointed doctor - Evacuation will be to the nearest medical facility where treatment is adequate - Transportation for returning to the principal country of residence following the evacuation - Cost of one accompanying person while the covered person is being evacuated - Hotel accommodation of one accompanying person up to 10 days - Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$300 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-out- patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare ordaycare surgery when such consultation is carried out by the bythe in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury bodilyinjury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney forkidney dialysis received as an out-patient for an xxxxx eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 S$5,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 S$1,800 Available only after 90 consecutive days membership in the first policy year year” 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 S$1,900 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not ApplicableApplicable Acute medical condition (excluding congenital conditions) This benefit pays for the treatment of acute medical condition, providing there is no underlying congenital condition, developed in a new born baby including nursing of pre-mature baby (i.e. where birth is prior to 37 weeks gestation) in Neonatal Intensive Care Unit (NICU). Common acute medical conditions for new born babies include neonatal jaundice, colic, diarrhea, constipation, vomiting and ear infection. This benefit is only available if: a) the parent of the new born baby has been covered under InternationalExclusive for 365 consecutive days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. This benefit covers treatment received by a new born baby during the first 30 days after birth. After 30 days, treatment can be covered under the main benefits of the insured baby’s plan. Included Annual Deductible Treatment of congenital conditions This benefit pays for treatment of congenital conditions. The benefit becomes available if: a) the parent of the new born baby has been covered under InternationalExclusive Plan 4 for 365 days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. Please note: 1) Treatment for congenital conditions which do not fulfill all above criteria will be paid from ‘Pre-existing Condition/Congenital Conditions’ benefit. 2) Once the limit for this benefit is reached, no other benefit (including ‘Pre-existing Conditions/ Congenital Conditions’ benefit) will be payable for the congenital condition(s) which was (were) claimed from this benefit for the remaining policy year. up to S$65,000 Annual Deductible Home nursing This benefit pays for charges incurred by an attending registered and qualified nurse for a member and only when the following conditions are met: a) after his discharge from hospital which the member has been warded in the intensive care unit for an eligible medical condition or undergone for an eligible daycare surgery, and b) agreed in writing by us beforehand that it is medically necessary and appropriate, and c) it is prescribed by the treating medical practitioner for the continued treatment for the eligible medical condition which the member was hospitalised for, and d) when such services are essential for medical as distinct from domestic reasons. For avoidance of doubt, the charges refer to the fees for the service of the nurse incurred for nursing at home. For terminal medical condition, this benefit is payable under ‘Hospice and Palliative Care’ and subject to the limitations applicable to that benefit. Included 20% co-insurance Local road ambulance transport This benefit pays for medically necessary emergency road ambulance transport to or between hospitals. Included 20% co-insurance Psychiatric treatment This benefit pays for in-patient, daycare and out-patient treatment (subject to availability of out- patient benefit for your plan) of psychiatric illnesses in aggregate. All treatments given by psychologists, psychotherapists or any individuals other than a registered psychiatrist must be pre-authorised by us. up to S$11,000 20% co-insurance Pre-existing conditions and congenital conditions This benefit pays for: a) treatment of congenital conditions (whether existing before or after the commencement of cover), and/or b) allother declared and accepted eligible conditions that existed or forwhich there were symptoms before the commencement of cover, or reinstatement date, or the introduction of this benefit, whichever is later. Years 1 & 2 : up to S$3,000 Available only after 270 consecutive days membership Subsequent years: up to S$6,000 Whether it is co-insurance or annual deductible will depend on the treatment received and what is stated on each benefit. Treatment for HIV/AIDS as a result of occupational accident or blood transfusion This benefit becomes available when signs or symptoms are present for the first time after 36 months of continuous membership. up to S$13,000 Available after 36 consecutive months membership 20% co-insurance Artificial limbs This benefit pays for all the costs associated with fitting artificial limbs, including the artificial limbs, its maintenance, consultations and necessary medical or surgical procedures. Benefit is only payable following a surgery or an accident for an eligible medical condition provided that the member has been continuously covered under the policy since before the accident or surgery happened. up to S$3,800 every 3 years 20% co-insurance Medical aids and durable medical equipments This benefit pays for instruments or devices or durable medical equipments which are prescribed by the medical practitioner as a medically necessary aid to the function or capacity such as and limited to compression stockings, hearing aids, speaking aids (electronic larynx), wheelchairs, crutches, corrective splint and orthopaedic supports. up to S$600 20% co-insurance Hospice and palliative care This benefit becomes available when the member is admitted to a specialist palliative care centre or hospice, recognised by us, following diagnosis, written confirmation (including medical evidence) by a medical practitioner that the member is suffering from an eligible terminal medical condition or conditions. up to S$52,000 in a member’s lifetime Available only after 365 consecutive days membership Annual deductible Investigation into infertility This benefit pays for investigation and treatment of the cause of infertility. up to S$2,500 in a member’s lifetime Available only after 18 consecutive months membership 20% co-insurance
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$140 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included if it is part of pre-hospitalisation treatment or post hospitalisation treatment Subject to the limitations applied for ‘Pre-hospitalisation treatment’ or ‘Post-hospitalisation treatment’ benefit 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included This benefit includes one post-surgery consultation within 90 days from the date of the surgi- cal procedure 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B C Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy if it is part of post-hospitalisation treatment Subject to the limitations applied for relief of menopausal symptoms - up to S$200) ‘Post-hospitalisation treat- ment’ benefit 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included if it is part of post-hospitalisation treatment Subject to the limitations applied for ‘Post-hospitalisation treat- ment’ benefit 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 No benefit 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year No benefit 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 No benefit 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • the damage was caused by normal wear and tear • the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • the damage was caused by tooth brushing or any other oral hygiene procedure • the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - Surgical removal of complicated buried roots which are diseased or causing symptoms - Enucleation (removal) of cysts of the jaw - Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 No benefit 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B C Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - Evacuation where the local medical facilities are not adequate according to our appointed doctor - Evacuation will be to the nearest medical facility where treatment is adequate - Transportation for returning to the principal country of residence following the evacuation - Cost of one accompanying person while the covered person is being evacuated - Hotel accommodation of one accompanying person up to 10 days - Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$300 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 S$2,000 Available only after 90 consecutive days membership in the first policy year year” 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 S$1,350 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 S$2,500 20% co-insurance Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit up to S$380 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not ApplicableApplicable Acute medical condition (excluding congenital conditions) This benefit pays for the treatment of acute medical condition, providing there is no underlying congenital condition, developed in a new born baby including nursing of pre-mature baby (i.e. where birth is prior to 37 weeks gestation) in Neonatal Intensive Care Unit (NICU). Common acute medical conditions for new born babies include neonatal jaundice, colic, diarrhea, constipation, vomiting and ear infection. This benefit is only available if: a) the parent of the new born baby has been covered under InternationalExclusive for 365 consecutive days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. This benefit covers treatment received by a new born baby during the first 30 days after birth. After 30 days, treatment can be covered under the main benefits of the insured baby’s plan. Included Annual Deductible Treatment of congenital conditions This benefit pays for treatment of congenital conditions. The benefit becomes available if: a) the parent of the new born baby has been covered under InternationalExclusive Plan A for 365 days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. Please note: 1) Treatment for congenital conditions which do not fulfill all above criteria will be paid from ‘Pre-existing Condition/Congenital Conditions’ benefit. 2) Once the limit for this benefit is reached, no other benefit (including ‘Pre-existing Conditions/ Congenital Conditions’ benefit) will be payable for the congenital condition(s) which was (were) claimed from this benefit for the remaining policy year. up to S$65,000 Annual Deductible Home nursing This benefit pays for charges incurred by an attending registered and qualified nurse for a member and only when the following conditions are met: a) after his discharge from hospital which the member has been warded in the intensive care unit for an eligible medical condition or undergone for an eligible daycare surgery, and b) agreed in writing by us beforehand that it is medically necessary and appropriate, and c) it is prescribed by the treating medical practitioner for the continued treatment for the eligible medical condition which the member was hospitalised for, and d) when such services are essential for medical as distinct from domestic reasons. For avoidance of doubt, the charges refer to the fees for the service of the nurse incurred for nursing at home. For terminal medical condition, this benefit is payable under ‘Hospice and Palliative Care’ and subject to the limitations applicable to that benefit. Included 20% co-insurance Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Local road ambulance transport This benefit pays for medically necessary emergency road ambulance transport to or between hospitals. Included 20% co-insurance Psychiatric treatment This benefit pays for in-patient, daycare and out-patient treatment (subject to availability of out-patient benefit for your plan) of psychiatric illnesses in aggregate. All treatments given by psychologists, psychotherapists or any individuals other than a registered psychiatrist must be pre-authorised by us. up to S$11,000 20% co-insurance Pre-existing conditions and congenital conditions This benefit pays for: a) treatment of congenital conditions (whether existing before or after the commencement of cover), and/or b) all other declared and accepted eligible conditions that existed or for which there were symptoms before the commencement of cover, or reinstatement date, or the introduction of this benefit, whichever is later. Years 1 & 2 : up to S$3,000 Available only after 270 consecutive days membership Subsequent years: up to S$6,000 Whether it is co-insurance or annual deductible will depend on the treatment received and what is stated on each benefit. Treatment for HIV/AIDS as a result of occupational accident or blood transfusion This benefit becomes available when signs or symptoms are present for the first time after 36 months of continuous membership. up to S$13,000 Available after 36 consecutive months membership 20% co-insurance Artificial limbs This benefit pays for all the costs associated with fitting artificial limbs, including the artificial limbs, its maintenance, consultations and necessary medical or surgical procedures. Benefit is only payable following a surgery or an accident for an eligible medical condition provided that the member has been continuously covered under the policy since before the accident or surgery happened. up to S$3,800 every 3 years 20% co-insurance Medical aids and durable medical equipments This benefit pays for instruments or devices or durable medical equipments which are prescribed by the medical practitioner as a medically necessary aid to the function or capacity such as and limited to compression stockings, hearing aids, speaking aids (electronic larynx), wheelchairs, crutches, corrective splint and orthopaedic supports. up to S$600 20% co-insurance Hospice and palliative care This benefit becomes available when the member is admitted to a specialist palliative care centre or hospice, recognised by us, following diagnosis, written confirmation (including medical evidence) by a medical practitioner that the member is suffering from an eligible terminal medical condition or conditions. up to S$52,000 in a member’s lifetime Available only after 365 consecutive days membership Annual deductible Investigation into infertility This benefit pays for investigation and treatment of the cause of infertility. up to S$2,500 in a member’s lifetime Available only after 18 consecutive months membership 20% co-insurance
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 S$140 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admissionbeforeadmission) We will pay for consultation, prescribed investigations and essential medications received as an out-out- patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included if it is part of pre-hospitalisation treatment or post hospitalisation treatment Subjecttothelimitationsapplied for ‘Pre-hospitalisation treatment’ or ‘Post-hospitalisation treatment’ benefit 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included This benefit includes one post-surgery consultation within 90 days from the date of the surgical procedure 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Benefits Table Plan C Only applicable when Annual Deductible/ Co-insurance option is chosen Kidney dialysis We will pay for kidney dialysis received as an out-patient for an eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized Computerised tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized computerised tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,, we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy if it is part of post-hospitalisation treatment Subject to the limitations applied for relief of menopausal symptoms - up to S$200) ‘Post-hospitalisation treatment’ benefit 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included if it is part of post-hospitalisation treatment Subject to the limitations applied for ‘Post-hospitalisation treatment’ benefit 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 No benefit 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 Available only after 90 consecutive days membership in the first policy year No benefit 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 No benefit 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 No benefit 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B C Only applicable when Annual Deductible/ Co-insuranceoption insurance option is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - theevacuation d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not Applicable
Appears in 1 contract
Samples: Membership Agreement
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-out- patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such ordaycare surgerywhensuch consultation is carried out by the bythe in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Diagnostic tests include and are limited to laboratory, X-Rays and Ultrasound. Included 20% co-insurance Surgical procedures We will pay for any eligible surgical procedures received as an out-patient for an eligible medical condition. Included 20% co-insurance Emergency treatment due to accident This benefit pays for out-patient treatment due to accident required immediately (within 24 hours) following bodily injury arising from an accident, provided the member has been continuously covered under the policy since before the accident happened. Follow-up treatment for the same bodily injury will be covered up to 30 days from the date of the accident. Included 20% co-insurance Radiotherapy and chemotherapy We will pay for radiotherapy and chemotherapy received as an out-patient for an eligible medical condition at a registered medical facility recognised by us. Included Annual Deductible Kidney dialysis We will pay for kidney forkidney dialysis received as an out-patient for an xxxxx eligible medical condition at registered medical facility recognised by us. Included Annual Deductible Computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans We will pay for computerized tomography, magnetic resonance imaging, positron emission tomography and gait scans received as part of an eligible out-patient treatment. Included 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Hormone replacement therapy (HRT) We will pay for the consultations and the cost of the implants, injections, patches or tablets when it is medically necessary and resulting from a medical intervention rather than for the relief of physiological symptoms. Where hormone replacement therapy is only required for the relief of menopausal symptoms,, we will pay for consultation and prescribed implants, patches or tablets up to the limit shown in the the benefit table applicable to member’s plan. Included (Hormone replacement therapy for relief of menopausal symptoms - up to S$200) 20% co-insurance Physiotherapy, occupational therapy and speech therapy Treatment given by any of these practitioners must be referred by the medical practitioner who has defined a diagnosis. Benefit is payable only following in-patient treatment for an eligible medical condition, provided that the member has been continuously covered under the policy since before the in-patient treatment commenced. Treatment given by any of these practitioners must be under the medical supervision of a medical practitioner. Medical supervision means that the reason for referral, where applicable, has been initiated by the medical practitioner who has defined a diagnosis. There must be a clear treatment plan from the practitioner with an end point and expected outcome. Included 20% co-insurance Consultation and treatment provided and prescribed by a qualified and registered chiropractor, podiatrist, dietitian, nutritionist, naturopath, acupuncturist, homeopath, osteopath, physiotherapist and Traditional Chinese medicine practitioner This benefit pays for the specified complementary and alternative therapist and practitioners. up to S$2,000 S$1,500 20% co-insurance Vaccination This benefit pays for necessary vaccinations. Consultation charge made in conjunction with vaccination can be claimed from this benefit where applicable. up to S$500 S$900 Available only after 90 consecutive days membership in the first policy year 20% co-insurance Health screen This benefit includes the cost of any eligible consultation needed as part of the screening process. up to S$250 S$600 20% co-insurance Accidental damage to natural teeth This benefit pays for dental treatment required within 30 days following accidental damage to natural teeth caused by extra-oral impact. Benefit is not payable if: • a) the damage was caused by normal wear and tear • b) the injury was caused when boxing or playing rugby (except school rugby) unless appropriate mouth protection was worn • c) the damage was caused by tooth brushing or any other oral hygiene procedure • d) the damage is not apparent within seven days of the impact which caused the injury This benefit is available only if the member has been continuously covered under the policy since before the accident happened. Included 20% co-insurance Oral and maxillofacial surgery This benefit pays only for the following procedures performed by an oral and maxillofacial surgeon: - a) Surgical removal of impacted/un-erupted teeth and buried teeth which are diseased or causing symptoms - b) Surgical removal of complicated buried roots which are diseased or causing symptoms - c) Enucleation (removal) of cysts of the jaw - d) Treatment of cancers (For lesion or lump in the mouth) Pre-existing condition limitations apply to this benefit. Included 20% co-insurance Routine dental care This benefit pays for routine dental examination, extraction, fillings, scaling/polishing, x-ray, sealant, fluoride treatment, root canal treatment, implants, bridgework, crowns, treatment of gum disease, dentures, inlays and onlays. Pre-existing condition limitations are not applicable to this benefit. up to S$250 20% co-insurance Routine optical care This benefit pays for corrective spectacle lenses, contact lenses and associated spectacle frames prescribed by an ophthalmologist or optometrist. Ophthalmologist or optometrist eye examination is claimable from this benefit. Lasik/laser surgery and tinted lenses are not covered under this benefit. No benefit 20% co-insurance Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen International Emergency Medical Assistance (IEMA) This benefit pays for the following services: - a) Evacuation where the local medical facilities are not adequate according to our appointed doctor - b) Evacuation will be to the nearest medical facility where treatment is adequate - c) Transportation for returning to the principal country of residence following the evacuation - d) Cost of one accompanying person while the covered person is being evacuated - e) Hotel accommodation of one accompanying person up to 10 days - f) Bringing the body or ashes back to a port or airport in the principal country of residence or home country if the covered person dies abroad as a result of an eligible medical condition. Included Not ApplicableApplicable Acute medical condition (excluding congenital conditions) This benefit pays for the treatment of acute medical condition, providing there is no underlying congenital condition, developed in a new born baby including nursing of pre-mature baby (i.e. where birth is prior to 37 weeks gestation) in Neonatal Intensive Care Unit (NICU). Common acute medical conditions for new born babies include neonatal jaundice, colic, diarrhea, constipation, vomiting and ear infection. This benefit is only available if: a) the parent of the new born baby has been covered under InternationalExclusive for 365 consecutive days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. This benefit covers treatment received by a new born baby during the first 30 days after birth. After 30 days, treatment can be covered under the main benefits of the insured baby’s plan. Included Annual Deductible Treatment of congenital conditions This benefit pays for treatment of congenital conditions. The benefit becomes available if: a) the parent of the new born baby has been covered under InternationalExclusive Plan 4 for 365 days or more when the baby is born; and b) the new born baby is added into the insured parent’s policy within 30 days from birth; and c) both parent and baby have been continuously covered under the policy and the policy is in force when the treatment is received. This benefit is paid from the insured baby’s plan. Please note: 1) Treatment for congenital conditions which do not fulfill all above criteria will be paid from ‘Pre-existing Condition/Congenital Conditions’ benefit. 2) Once the limit for this benefit is reached, no other benefit (including ‘Pre-existing Conditions/ Congenital Conditions’ benefit) will be payable for the congenital condition(s) which was (were) claimed from this benefit for the remaining policy year. No benefit Annual Deductible
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Samples: Membership Agreement
