Maternity Benefit. Investigation into Infertility (Plan A only) We will pay for investigation and treatment of the cause of infertility. This benefit becomes available and eligible claims payable for expenses incurred after the member has been continuously covered under Plan A for at least eighteen (18) months. Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to or after the childbirth. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) days following the childbirth. This benefit does not cover: the costs of any childbirth whether such childbirth is normal, by caesarean section or by any other assisted means, or any pre- and post-complication arising from elective or non-medically necessary caesarean section birth. treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to or after the childbirth if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the “Pregnancy and childbirth” benefit for member insured on Plan A. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available for female member over the age of eighteen (18) years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • policy year, even if there is more than one pregnancy in that policy year, • pregnancy, even if a pregnancy, which is eligible for benefit, falls across the policy anniversary, and provided the policy, including this benefit, has been renewed for the subsequent policy year For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth costs up to the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “Pre- & post-natal complications” benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘Pre- & post-natal complications’ benefit. Please note: this benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is subject to 1) compulsory annual deductible & co-insurance; 2) the male spouse/ partner Plan A membership is in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.
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Samples: myaxa-singapore.cdn.axa-contento-118412.eu, myaxa-singapore.cdn.axa-contento-118412.eu
Maternity Benefit. Investigation into Infertility (Plan A only) We will pay infertility This benefit pays for investigation and treatment of the cause of infertility. This benefit becomes available and eligible claims payable for expenses incurred up to S$2,500 in a member’s lifetime Available only after the member has been continuously covered under 18 consecutive months membership 20% co-insurance Benefits Table (Plan A) (Continued) Benefits Table Plan A for at least eighteen (18) months. Only applicable when Annual Deductible/ Co-insurance option is chosen Maternity Benefit Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to the delivery or after the childbirthdelivery for female member over the age of 18 years. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) 90 days following the childbirthdelivery. This benefit does not cover: - the costs of delivery of any childbirth child whether such childbirth delivery is normal, by caesarean section or by any other assisted means, or - any pre- and post-complication arising from elective or non-non medically necessary caesarean section birth. - treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to the delivery or after the childbirth delivery if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the benefit “Pregnancy pregnancy and childbirth” delivery”. For avoidance of doubt, this benefit for member insured on Plan A. shall not be payable if the: • delivery of birth is through non medically necessary caesarean birth, and/or • conception of the child is conceived by artificial means or any form of assisted conception. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Included Available only after 365 consecutive days membership 20% co-insurance Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. delivery This benefit is only available pays for routine pre-natal care, delivery and routine post-natal care up to 6 weeks following birth for female member over the age of eighteen (18) 18 years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • each policy year, year (even if there is more than one pregnancy) or each pregnancy in that policy year, • pregnancy, (even if a pregnancy, which is an eligible for benefit, pregnancy falls across the policy anniversary, and ) provided the policy, including policy with this benefit, benefit has been renewed renewed. The limit shown applies in aggregate for the subsequent policy year pre-natal, delivery and post-natal care. For birth through vaginal childbirth delivery and medically necessary caesarean section, we will pay for the childbirth delivery costs up to within the limit shown for this benefit in the benefits table. Any complications of pregnancy arising from such delivery will be paid from “‘Pre- & post-natal complications” ’ benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth delivery costs up to the costs of a normal childbirthdelivery. The complications arising from such delivery will be paid up to the remainder of the ‘Pregnancy and Delivery’ limit. Please note: If we are not able to determine that a caesarean section is medically necessary, necessary we will consider it is not medically necessary. up to S$22,000 Available only after 365 consecutive days membership 20% co-insurance New Born Cover 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 complications arising 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 such childbirth 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- & postPre-natal complicationsexisting Condition/Congenital Conditions’ benefit. Please note: 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 Benefits Table (Plan A) (Continued) Benefits Table Plan A Only applicable when Annual Deductible/ Co-insurance option is chosen Other Benefits 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: (i) 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 (ii) agreed in writing by us beforehand that it is medically necessary and appropriate, and (iii) it is prescribed by the treating medical practitioner for the continued treatment for the eligible medical condition which the member was hospitalised for, and (iv) 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$10,000 20% co-insurance Pre-existing conditions and congenital conditions This benefit pays for: a) all 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; or b) treatment of congenital conditions (whether existing before or after the commencement of cover). Years 1 & 2 : up to S$3,000 Available only after 270 consecutive days membership Subsequent years: up to S$6,000 This depends on the treatment received, and whether it is co-insurance or annual deductible will depend on 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 Wellness Assistance This benefit pays for the following services: - Confidential intake assessment/telephone counseling - Confidential scheduled/contracted telephone support - Up to five (5) sessions of face to face counseling and psychological therapy per member policy year Included Not Applicable Benefits Table (Plan B) Benefits Table Plan B Only applicable when Annual Deductible/ Co-insurance option is achieved chosen Please note: Benefit values are per member each year unless otherwise specified and since policy commencement date are reduced each time the member claims only by the net amount (less any annual deductible or co-insurance) we have actually paid. Please refer to the policy wordings on full terms applying to these benefits. Overall Annual Limit Yearly maximum limit This is the maximum we will pay for each member each policy year. All benefits paid during the policy period will count against the yearly maximum. S$3,000,000 Area of cover Area of cover This is the geographical area where you can choose to receive treatment. You can select your area of cover at time of application. Your chosen area of cover has an impact on your premium. Options: 1. Worldwide, or 2. Worldwide excluding USA, or 3. Asia Outside area of cover This benefit pays for emergency treatment, or treatment of a medical condition which arises suddenly whilst outside the selected area of cover. Emergency treatment only up to S$250,000 Annual Deductible In-patient and Daycare Treatment Daily accommodation charges While admitted as an in-patient or day-patient, we will pay for the costs of your accommodation in the type of room shown in your benefits table. Wherever a member receives treatment, if the hospital offers several classes for the room type he is entitled for, we will only pay for the cost of a room of a standard class. This corresponds to the lowest cost room class offered in that hospital for that type of room. If a member stays in a room which is more expensive than the standard room, the member may have to pay for the difference in room charges. The member may also have to pay for a share of other medical expenses wherever these increase as a result of the room upgrade. Please check with us prior to admission to avoid unnecessary out of pocket expenses. Standard single room Annual Deductible Hospital charges This benefit pays for hospital charges given between admission and discharge including: 1) Diagnostic procedures 2) Surgical procedures 3) Operating theatre charges 4) Nursing care, drugs and dressings 5) Surgeons’ and anaesthetists’ charges 6) Intensive care unit charges 7) Consultations and physiotherapy while admitted for treatment of an eligible medical condition and when such treatment directly relates to it 8) Radiotherapy and chemotherapy 9) Kidney dialysis 10) Computerized tomography, magnetic resonance imaging, x-rays and other such proven medical imaging techniques 11) Special nursing in hospital Included Annual Deductible Organ transplant This benefit pays for transplantation of kidneys, heart, liver, lung or bone marrow required as a result of an eligible medical condition and provided these organ(s) have come from a relative or a certified and verified source of donation. The policy does not cover the costs of collecting donor organs (including but not limited to, transportation and administration costs) or any expenses incurred by the donor or if the organ(s) is not from a relative or a certified and verified source of donation. Included Annual Deductible Reconstructive Surgery This benefit pays for the initial reconstructive surgery and only when it is medically necessary and carried out to restore function after an accident or following surgery for an eligible medical condition, and provided that the member has been continuously covered under the policy since before the accident or surgery happened. Benefit for reconstructive surgery is subject to 1) compulsory annual deductible & coour pre-insurance; 2) authorization and must be done at a medically appropriate stage after the male spouse/ partner Plan A membership is in-force accident or the female member paid the agreed premium loadingsurgery. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.Included Annual Deductible
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Maternity Benefit. Investigation into Infertility (Plan A only) We will pay infertility This benefit pays for investigation and treatment of the cause of infertility. This No benefit becomes available and eligible claims payable for expenses incurred after the member has been continuously covered under Plan A for at least eighteen (18) months. 20% co-insurance Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to or after the childbirthchildbirth for female member over the age of 18 years. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) 90 days following the childbirth. This benefit does not cover: - the costs of any childbirth whether such childbirth is normal, by caesarean section or by any other assisted means, or - any pre- and post-complication arising from elective or non-non medically necessary caesarean section birth. - treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to or after the childbirth if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the benefit “Pregnancy pregnancy and childbirth” ”. For avoidance of doubt, this benefit for member insured on Plan A. shall not be payable if the: • childbirth is through non medically necessary caesarean birth, and/or • conception of the child is conceived by artificial means or any form of assisted conception. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Included Available only after 365 consecutive days membership 20% co-insurance Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available pays for routine pre-natal care, childbirth and routine post-natal care up to 6 weeks following birth for female member over the age of eighteen (18) 18 years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • each policy year, year (even if there is more than one pregnancy) or each pregnancy in that policy year, • pregnancy, (even if a pregnancy, which is an eligible for benefit, pregnancy falls across the policy anniversary, and ) provided the policy, including policy with this benefit, benefit has been renewed renewed. The limit shown applies in aggregate for the subsequent policy year pre-natal, childbirth and post-natal care. For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth delivery costs up to within the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “‘Pre- & post-natal complications” ’ benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal natural childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘“Pre- & post-natal complications’ benefit. Please note: this ‘Pregnancy and Childbirth’ benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is 1). subject to 1) compulsory annual deductible & co-insurance; 2) the ). male spouse/ spouse/partner Plan A membership is must be in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.. No benefit 20% co-insurance New Born Cover 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 Benefits Table Plan C Only applicable when Annual Deductible/ Co-insuranceoption is chosen 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
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Maternity Benefit. Investigation into Infertility (Plan A only) We will pay infertility This benefit pays for investigation and treatment of the cause of infertility. This No benefit becomes available and eligible claims payable for expenses incurred after the member has been continuously covered under Plan A for at least eighteen (18) months. 20% co-insurance Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to or after the childbirthchildbirth for female member over the age of 18 years. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) 90 days following the childbirth. This benefit does not cover: - the costs of any childbirth whether such childbirth is normal, by caesarean section or by any other assisted means, or - any pre- and post-complication arising from elective or non-non medically necessary caesarean section birth. - treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to or after the childbirth if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the benefit “Pregnancy pregnancy and childbirth” ”. For avoidance of doubt, this benefit for member insured on Plan A. shall not be payable if the: • childbirth is through non medically necessary caesarean birth, and/or • conception of the child is conceived by artificial means or any form of assisted conception. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Included Available only after 365 consecutive days membership 20% co-insurance Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available pays for routine pre-natal care, childbirth and routine post-natal care up to 6 weeks following birth for female member over the age of eighteen (18) 18 years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • each policy year, year (even if there is more than one pregnancy) or each pregnancy in that policy year, • pregnancy, (even if a pregnancy, which is an eligible for benefit, pregnancy falls across the policy anniversary, and ) provided the policy, including policy with this benefit, benefit has been renewed renewed. The limit shown applies in aggregate for the subsequent policy year pre-natal, childbirth and post-natal care. For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth delivery costs up to within the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “‘Pre- & post-natal complications” ’ benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal natural childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘“Pre- & post-natal complications’ benefit. Please note: this ‘Pregnancy and Childbirth’ benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is 1). subject to 1) compulsory annual deductible & co-insurance; 2) the ). male spouse/ spouse/partner Plan A membership is must be in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.. No benefit 20% co-insurance New Born Cover 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 Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen New Born Cover 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
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Maternity Benefit. Investigation into Infertility (Plan A only) We will pay infertility This benefit pays for investigation and treatment of the cause of infertility. This No benefit becomes available and eligible claims payable for expenses incurred after the member has been continuously covered under Plan A for at least eighteen (18) months. 20% co-insurance Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to or after the childbirthchildbirth for female member over the age of 18 years. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) 90 days following the childbirth. This benefit does not cover: - the costs of any childbirth whether such childbirth is normal, by caesarean section or by any other assisted means, or - any pre- and post-complication arising from elective or non-non medically necessary caesarean section birth. - treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to or after the childbirth if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the benefit “Pregnancy pregnancy and childbirth” ”. For avoidance of doubt, this benefit for member insured on Plan A. shall not be payable if the: • childbirth is through non medically necessary caesarean birth, and/or • conception of the child is conceived by artificial means or any form of assisted conception. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Included Available only after 365 consecutive days membership 20% co-insurance Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available pays for routine pre-natal care, childbirth and routine post-natal care up to 6 weeks following birth for female member over the age of eighteen (18) 18 years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • each policy year, year (even if there is more than one pregnancy) or each pregnancy in that policy year, • pregnancy, (even if a pregnancy, which is an eligible for benefit, pregnancy falls across the policy anniversary, and ) provided the policy, including policy with this benefit, benefit has been renewed renewed. The limit shown applies in aggregate for the subsequent policy year pre-natal, childbirth and post-natal care. For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth delivery costs up to within the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “‘Pre- & post-natal complications” ’ benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal natural childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘“Pre- & post-natal complications’ benefit. Please note: this ‘Pregnancy and Childbirth’ benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is 1). subject to 1) compulsory annual deductible & co-insurance; 2) the ). male spouse/ spouse/partner Plan A membership is must be in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.. No benefit 20% co-insurance New Born Cover 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 Benefits Table Plan C Only applicable when Annual Deductible/ Co-insuranceoption is chosen New Born Cover 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
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Maternity Benefit. Investigation into Infertility (Plan A only) We will pay for investigation and treatment of the cause of infertility. This benefit becomes available and eligible claims payable for expenses incurred after the member has been continuously covered under Plan A for at least eighteen (18) months. Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to the delivery or after the childbirthdelivery of child. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical interventionThreatened miscarriage, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) days following the childbirthdelivery of child. This benefit does not cover: the costs of delivery of any childbirth child whether such childbirth delivery is normal, by caesarean section or by any other assisted means, or any pre- and post-complication arising from elective or non-medically necessary caesarean section birth. treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to the delivery or after the childbirth delivery if the pregnancy was a result of any form of assisted means or assisted conception/conception/ assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the “Pregnancy and childbirthDelivery” benefit for member insured on Plan A. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available for female member over the age of eighteen (18) years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • policy year, even if there is more than one pregnancy in that policy year, • pregnancy, even if a pregnancy, which is eligible for benefit, falls across the policy anniversary, and provided the policy, including this benefit, has been renewed for the subsequent policy year For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth costs up to the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “Pre- & post-natal complications” benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘Pre- & post-natal complications’ benefit. Please note: this benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is subject to 1) compulsory annual deductible & co-insurance; 2) the male spouse/ partner Plan A membership is in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.
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Maternity Benefit. Investigation into Infertility (Plan A only) We will pay infertility This benefit pays for investigation and treatment of the cause of infertility. This benefit becomes available and eligible claims payable for expenses incurred up to S$2,500 in a member’s lifetime Available only after the member has been continuously covered under Plan A for at least eighteen (18) months. 18 consecutive months membership 20% co-insurance Pre and post-natal complications Benefit only becomes available and eligible claims payable for expenses incurred after the female member over the age of eighteen (18) years has been continuously covered under their chosen plan for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit pays for treatment of an eligible medical condition which is due to and occurs to the female member during the pregnancy prior to or after the childbirthchildbirth for female member over the age of 18 years. The list of eligible pre- and post- natal complications include the following: • Antiphospholipid syndrome, • Cervical incompetence, • Ectopic pregnancy, • Gestational diabetes, • Hydatidiform mole – molar pregnancy, • Hyperemesis gravidarum, • Obstetric cholestasis, • Pre-eclampsia / Eclampsia, • Rhesus (RH) factor, • Miscarriage requiring immediate surgical intervention, • Post partum haemorrhage, • Retained placental membrane Under post-natal complications, we will only pay for treatment received within ninety (90) 90 days following the childbirth. This benefit does not cover: - the costs of any childbirth whether such childbirth is normal, by caesarean section or by any other assisted means, or - any pre- and post-complication arising from elective or non-non medically necessary caesarean section birth. - treatment of any medical condition which is due to and occurs during the pregnancy prior to prior to or after the childbirth if the pregnancy was a result of any form of assisted means or assisted conception/assisted pregnancy. Whilst we recognize that caesarean section may sometimes be a medical necessity, caesarean section can only be covered under the benefit “Pregnancy pregnancy and childbirth” ”. For avoidance of doubt, this benefit for member insured on Plan A. shall not be payable if the: • childbirth is through non medically necessary caesarean birth, and/or • conception of the child is conceived by artificial means or any form of assisted conception. Please note: If we are not able to determine that a caesarean section is medically necessary we will consider it as not medically necessary. Included Available only after 365 consecutive days membership 20% co-insurance Pregnancy and childbirth (Plan A only) Benefit is available and eligible claims are payable for expenses incurred after the member has been continuously covered under Plan A for three hundred sixty-five (365) consecutive days and has effected the annual renewal of that plan for the coming policy year. This benefit is only available pays for routine pre-natal care, childbirth and routine post-natal care up to 6 weeks following birth for female member over the age of eighteen (18) 18 years, and covers the following in aggregate, up to the limit shown for your plan: • routine pre-natal care • childbirth • routine post-natal care up to forty-two (42) days following birth We will also pay for normal, routine pregnancy and childbirth even when such pregnancy was established through assisted conception/assisted pregnancy. This benefit does not cover any expenses related to assisted conception/ assisted pregnancy including any complications. The limit shown is the maximum we will pay under this benefit for each: • each policy year, year (even if there is more than one pregnancy) or each pregnancy in that policy year, • pregnancy, (even if a pregnancy, which is an eligible for benefit, pregnancy falls across the policy anniversary, and ) provided the policy, including policy with this benefit, benefit has been renewed renewed. The limit shown applies in aggregate for the subsequent policy year pre-natal, childbirth and post-natal care. For birth through vaginal childbirth and medically necessary caesarean section, we will pay for the childbirth delivery costs up to within the limit shown for this benefit in the benefits table. Any complications of pregnancy will be paid from “‘Pre- & post-natal complications” ’ benefit. For birth through non medically necessary caesarean section, we will pay for the childbirth costs up to the costs of a normal natural childbirth. If we are not able to determine that a caesarean section is medically necessary, we will consider it is not medically necessary. The complications arising from such childbirth will be paid from ‘“Pre- & post-natal complications’ benefit. Please note: this ‘Pregnancy and Childbirth’ benefit is only payable when 365 consecutive days membership is achieved and since policy commencement date the member is 1). subject to 1) compulsory annual deductible & co-insurance; 2) the ). male spouse/ spouse/partner Plan A membership is must be in-force or the female member paid the agreed premium loading. The member is not entitled to the ‘Pregnancy and Childbirth’ benefit when any of these conditions have not been met.. up to S$22,000 Available only after 365 consecutive days membership 20% co-insurance Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen New Born Cover 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 Other Benefits 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: (i) 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 (ii) agreed in writing by us beforehand that it is medically necessary and appropriate, and (iii) it is prescribed by the treating medical practitioner for the continued treatment for the eligible medical condition which the member was hospitalised for, and (iv) 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 hos- pitals. 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) all 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; or b) treatment of congenital conditions (whether existing before or after the commencement of cover). 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 Benefits Table Plan A Only applicable when Annual Deductible/ Co-insuranceoption is chosen Other Benefits 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 Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen Please note: Benefit values are per member each year unless otherwise specified and are reduced each time the member claims only by the net amount (less any annual deductible or co-insurance) we have actually paid. Please refer to the policy wordings on full terms applying to these benefits. Overall Annual Limit Yearly maximum limit This is the maximum we will pay for each member each policy year. All benefits paid during the policy period will count against the yearly maximum. S$3,500,000 Area of cover Area of cover This is the geographical area where you can choose to receive treatment. You can select your area of cover at time of application. Your chosen area of cover has an impact on your premium. Options: 1. Worldwide, or 2. Worldwide excluding USA, or 3. Asia Outside area of cover This benefit pays for emergency treatment, or treatment of a medical condition which arises suddenly whilst outside the selected area of cover. Emergency treatment only up to S$250,000 Annual Deductible In-patient and Daycare Treatment Daily accommodation charges While admitted as an in-patient or day-patient, we will pay for the costs of your accommodation in the type of room shown in your benefits table. Wherever a member receives treatment, if the hospital offers several classes for the room type he is entitled for, we will only pay for the cost of a room of a standard class. This corresponds to the lowest cost room class offered in that hospital for that type of room. If a member stays in a room which is more expensive than the standard room, the member may have to pay for the difference in room charges. The member may also have to pay for a share of other medical expenses wherever these increase as a result of the room upgrade. Please check with us prior to admission to avoid unnecessary out of pocket expenses. Standard single room Annual Deductible Hospital charges This benefit pays for hospital charges given between admission and discharge including: 1) Diagnostic procedures 2) Surgical procedures 3) Operating theatre charges 4) Nursing care, drugs and dressings 5) Surgeons’ and anaesthetists’ charges 6) Intensive care unit charges 7) Consultations and physiotherapy while admitted for treatment of an eligible medical condition and when such treatment directly relates to it 8) Radiotherapy and chemotherapy 9) Kidney dialysis 10) Computerized tomography, magnetic resonance imaging, x-rays and other such proven medical imaging techniques 11) Special nursing in hospital Included Annual Deductible Organ transplant This benefit pays for transplantation of kidneys, heart, liver, lung or bone marrow required as a result of an eligible medical condition and provided these organ(s) have come from a relative or a certified and verified source of donation. The policy does not cover the costs of collecting donor organs (including but not limited to, transportation and administration costs) or any expenses incurred by the donor or if the organ(s) is not from a relative or a certified and verified source of donation. Included Annual Deductible Living organ donor This benefit pays up to the annual limits shown in the benefit schedule for reasonable and customary charges incurred for a live member to donate an organ or tissue specified in the Organ Transplant benefit (limited to kidney, heart, liver, lung or bone marrow) of this policy, provided : 1) the operation and transplant is for the member’s family member (parent, sibling, child, spouse or partner) ; 2) the transplant is in line with appropriate regulatory guidelines; 3) the recipient of the organ was first diagnosed by a doctor or have symptoms which first appeared after a waiting period of twenty-four (24) months from the the policy commencement date or the date after this Living Organ Donor (member) Transplant benefit first became effective under this policy or the last reinstatement date (if any) whichever is the latest; and Shall include eligible expenses relating to pre-hospital specialist consultation, related examination and laboratory tests and post-hospitalization treatment. Both pre- and post-hospitalisation benefit are limited to ninety (90) days prior or after treatment respectively. This benefit requires pre-authorization from us. This benefit does not pay for the cost of collecting donor organs or tissue, administration costs, its complications, and illegal organ transplants. up to S$60,000 Available only after 24 consecutive months membership Annual Deductible Benefits Table Plan B Only applicable when Annual Deductible/ Co-insuranceoption is chosen In-patient and Daycare Treatment Reconstructive Surgery This benefit pays for the initial reconstructive surgery and only when it is medically necessary and carried out to restore function after an accident or following surgery for an eligible medical condition, and provided that the member has been continuously covered under the policy since before the accident or surgery happened. Benefit for reconstructive surgery is subject to our pre-authorization and must be done at a medi- cally appropriate stage after the accident or surgery. Included Annual Deductible
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