BUPA GROUP. ADMINISTRATION
BUPA GROUP. The premium for the addition is due at the time of the notification of birth. If such notification is not received within 90 days of birth, then an application for insurance is required on the addition and will be subject to underwriting.
BUPA GROUP. (f) No obstante lo anterior, la aseguradora podrá llevar a cabo los procedi- mientos de suscripción correspondientes cuando el asegurado principal solicite cambio de producto, plan, beneficios, o suma asegurada. obstante lo anterior, la aseguradora podrá llevar a cabo los procedimientos de suscripción correspondientes cuando el asegurado principal solicite cambio de producto, plan, beneficios, o suma asegurada.
BUPA GROUP. ACUERDO BUPA INSURANCE COMPANY (De ahora en adelante denominada el “Asegurador”) acuerda pagar al “Titular del Certificado” los beneficios estipulados en esta póliza. Todos los beneficios están sujetos a los términos y condiciones de esta póliza
BUPA GROUP. AGREEMENT BUPA INSURANCE COMPANY (hereinafter referred to as the “Insurer”) agrees to pay to the “Certificate Holder”, the benefits provided by this policy. All benefits are subject to the terms and conditions of this policy.
BUPA GROUP. USA Medical Services can be contacted 24 hours a day, 365 days a year at the following telephone numbers: In the U.S.A.: (000) 000-0000 Free of charge from the U.S.A.: 0-000-000-0000 Fax: (000) 000-0000 Visit My Bupa in our display options: xxx.xxxxxxxxx.xxx/XxXxxx Outside the USA: Phone number can be located on your ID card, or at xxx.xxxxxxxxx.xxx ONLINE TO MAKE YOUR LIFE EASIER! Log in to xxx.xxxxxxxxx.xxx, search for "My Bupa" in our display options and follow the registration steps with your email to manage your policy from the comfort of your home or office. Enjoy our online services: • Access to your policy documents and ID cards • Payments • Changes request • Claim request and update information • Pre-authorization services request • Costumer Service • Virtual Care (Telemedicine) You are responsible for checking all documents and correspondence online.
BUPA GROUP. BENEFICIOS • Vea la sección correspondiente de la póliza para detalles, limitaciones y restricciones • El plan Bupa Group proporciona cobertura solamente en la red de proveedores preferidos. Ningún beneficio es pagable por servicios prestados fuera de la red de proveedores preferidos excepto bajo la provisión de cobertura médica de emergencia. • El beneficio máximo es de cinco millones de dólares ($5,000,000) por asegurado, de por vida por todos los gastos médicos y de hospitales cubiertos durante la vigencia de la póliza, sujeto a los limites que se indican en la Tabla de Beneficios. • Ni el Asegurador, ni USA Medical Services, ni ninguna de sus filiales o subsi- diarias pertinentes relacionadas participarán en transacciones con cualquier parte o país donde dichas transacciones estén prohibidas por las leyes de los Estados Unidos de América. Por favor comuníquese con USA Medical Services para obtener más información sobre esta restricción.
BUPA GROUP. BENEFITS See applicable sections of the policy for details, limitations, and restrictions. The plan Bupa Group policy provides coverage in the Preferred Provider Network only. No benefits are payable for service rendered outside the Preferred Provider Network, except under the emergency medical treatment provision. Maximum coverage is five million dollars ($5,000,000) per insured, per lifetime for all covered medical and hospital charges while the policy is in force, subject to the limitations herein. The insurer, USA Medical Services, and/or any of their applicable related subsidiaries and affiliates will not engage in any transactions with any parties or in any countries where otherwise prohibited by the laws in the United States of America. Please contact USA Medical Services for more information about this restriction. SCHEDULE OF BENEFITS BENEFITS Coverage (per Insured, per Policy Year) Maximum benefit Private or semi-private hospital room and board No limit Intensive care room and board No limit Maternity care benefit (Except Plans IV, V and VI) (No deductible or coinsurance applies) $2,500 Newborn coverage (No deductible or coinsurance applies) $25,000 Congenital and hereditary disorders: Manifested before age 18 Manifested on or after age 18 (per Insured, per lifetime) $100,000 $5,000,000 Organ transplant (per Insured, per lifetime) $250,000 Air ambulance transportation (per Insured, per lifetime) $25,000 Ground ambulance transportation (per incident) $1,000 Repatriation of mortal remains $5,000 Emergency treatment outside the Preferred Provider Network (per incident) $25,000 Disclosed pre-existing conditions (Lifetime maximum, per Insured after twenty-four (24) months of continuous coverage) $25,000 DEDUCTIBLE COINSURANCE All insureds under the Certificate have a deductible responsibility per policy year according to the plan selected by the Certificate Holder. When applicable, the corresponding deductible amount is applied per insured, per policy year before benefits are paid or reimbursed to the insured. All deductible amounts paid accumulate towards the corre- sponding maximum deductible per Certificate, which is equivalent to the sum of two individual deductibles. All insureds under the Certificate contribute to meeting the maximum deductible amount of the policy. Once the maximum deductible amount of the Certificate is met, the insurer will consider all individual deductible responsibilities as met. Any eligible charges incurred by an insured...
BUPA GROUP. COMIENZO Y TERMINACIÓN DE LA COBERTURA La cobertura comienza a las 00:01 horas Estándar del Este (EE.UU.) en la fecha efectiva de la póliza y termina a las 24:00 horas Estándar del Este (EE.UU.):
BUPA GROUP. PREFERRED PROVIDER NET-WORK: A group of hospitals and physicians approved and contracted to treat Insureds on behalf of the Insurer. The list of hospitals The list of hospitals and physicians in the Preferred Provider Network is available from USA Medical Services and may change at any time without prior notice PRIVATE AIRCRAFT: Any aircraft in a flight that is not regularly scheduled or chartered by a commercial airline.
