5/5

preference

Eligibility

  • The owner and spouse or legal partner may enter until the last day of the month in which they turn 71.
  • Dependents may stay until the last day of the month in which they turn 18 years of age or until the last day they turn 30 years of age as long as they are financially dependent on the owner, single, full-time students. Children who study abroad may remain insured until their 24th birthday.

Deductible

  • Applies per insured, per policy year, up to a maximum of 2 deductibles per family.
  • Only one deductible applies per family, per policy year, in the event of a joint accident in the country of residence.
  • Expenses incurred during the last 90 days of the policy year that do not exceed the deductible will be applied to the next
    policy year period.
  • Deductible Elimination:
    • 100% for hospital coverage inside and outside the country of residence, including Colombia (Except in the US)
      For deductible options 1, 2, 4 and 5.
    • 50% deductible in Colombia for options 3, 6 and 7.
    • 100% coverage for ambulatory surgeries and emergencies in the country of residence, without deductible or copayment.
      For deductible options 1, 2, 3, 4 and 5.
    • 50% deductible in select network in the US in options 1, 2, 3, 4, 5 and 6

Pre-Existing Conditions Coverage

・Maximum limit per policy year of USD 5,000 for all declared pre-existing conditions / condition caused by and/or related to it, including the consequences of treatment, after applying the deductible. 24-month grace period.

Waiting period

  • Coverage at 100% for accidents and infectious diseases, including COVID-19 and its variants from the effective date, and a 60-day waiting period for any other covered condition

Travel Assistance Service

You have 100% coverage for medical emergencies or accidents that occur outside your country of residence:

  • Insured with deductibles up to USD 5,000 will have a co-payment of USD 100 and the balance of the invoice will be paid to the
    100% per BMI up to the policy limit.
  • Insureds with deductibles of USD 10,000 or USD 20,000 will have a copayment of USD 100 for the first USD 5,000 in medical expenses. Expenses greater than USD 5,000 will be paid based on the benefits of the policy. (Deductible applies)

BMI Access (Included at no additional cost)

  • The BMI Access Service Center provides 24x7 assistance and exclusive benefits to all BMI health insureds.
  • The insured should only contact BMI Access to be assigned a Medical Coordinator, who will be their
    guide to coordinate any service or benefit available in your health policy outside the country of residence

Hospitalization Benefit

HOSPITALIZATION BENEFITSCOVERAGE
Medical and surgical charges100%
Physician fees100%
In-network room and board100%
In-Network Intensive Care Unit100%
Chemotherapy, radiotherapy and dialysis100%
Laboratory, X-rays, MRIs, CT scans and ultrasounds100%
Physiotherapy100%
Medications during hospitalization100%
Daily income for hospitalization (maximum 30 days a year. Applies from the 3rd day)*$100/day

Outpatient Benefits

OUTPATIENT BENEFITSCOVERAGE
Copayment for consultations in the US without applying a deductible$25
Emergency room100%
outpatient services100%
Ambulatory surgery100%
Physician fees100%
Chemotherapy, radiotherapy and dialysis100%
Laboratory, X-rays, MRIs, CT scans and ultrasounds100%
Physiotherapy100%
Medications inside or outside the country of residence after hospitalization or outpatient surgery (90 days)80%
Medications in the country of residence (within the named network)
90% up to USD 10,000
Drugs outside the country of residence or outside the named local network
80% up to USD 10,000
Routine medical check-ups within the country of residence 100% (Holder and spouse, after 2 years)
(out of network)$300
Psychiatric and psychological consultations in the country of residence (Maximum 12 annual consultations)Included

Maternity Benefit

MATERNITY BENEFITSCOVERAGE
AVAILABLE FOR DEDUCTIBLES 1-2-4 AND 5. (AVAILABLE FOR DEPENDENT DAUGHTERS)
 
Maternity inside and outside the country of residence (without deductible)$8,000
Maternity complications$750,000
Tubal ligation during caesarean section, with covered maternity$1,000
Conditions diagnosed in the first 90 days of the newborn (for life)$500,000
Congenital conditions (diagnosed after 90 days of birth)100%
In-network cord blood stem cell preservation (no deductible, per newborn)100%
Preservation of umbilical cord blood stem cells outside the country of residence or outside the local network
Up to $1,500
Maternity waiting period10 months
Neonatal care, disorders diagnosed during the first 90 days, will be limited by
90% up to USD 10,000
child (with covered maternity) Life$500,000

Other Benefits, after applying the deductible

OTHER BENEFITS, AFTER THE DEDUCTIBLE IS APPLIEDCOVERAGE
Vaccines named in the country of residence (applies to any age) SCV100%
Emergency dental treatment due to accident (no deductible)100%
dangerous sports100%
Local ambulance100%
Air Ambulance (No deductible)100%
Organ transplant and medical expenses of the living donor family member (annual)$500,000
AIDS treatment (lifetime)$250,000
In-home nursing (maximum 90 days)100%
Vasectomy (Lifetime)USD 500
Bariatric surgery after 2 years medically necessary$10,000
Term life insurance – owner$15,000
Accidental death and dismemberment insurance – holder$15,000
Total and permanent disability insurance – holder$15,000
Waiver of premiums for death, total and permanent disability of the holder3 years
Coverage of COVID-19 and its variants100%

 

DEDUCTIBLESOPTION 1OPTION 2OPTION 3OPTION 4OPTION 5OPTION 6OPTION 7OPTION 8
per policy year$1,000$2,500$5,000$1,000$2,500$5,000$10,000$20,000

* SCV – According to the Vaccine Catalog
* Daily income for hospitalization (Does not apply to maternity or newborn).
* Waiting period for any non-accidental disability or infectious disease, 60 days
– All coverage applies once the deductible has been met.

International Support Network

Worldwide and US coverage on select network, additional $1,000,000 for the following conditions:

  • Cardiovascular disease.
  • Chronic renal failure.
  • Cancer. Additional USD 500,000 coverage
  • Organ transplant.

Coordination of Benefits

  • The product allows access to the coordination of benefits between the contracted coverage and another current plan, through BMI or another insurance alternative on the market, without exceeding the 100% of the expenses incurred.

Hospital and Clinic Network

  • To provide the best care, we have an excellent network of Hospitals and Clinics throughout the Dominican Republic, where we offer hospitalization and surgery services. The BMI network can be consulted on our website: www.bmicos.com/dominicana

Medical Network in Colombia

  • We have agreements in the most prestigious Hospitals in Latin America, located in Colombia, where you can attend with your local plan applying the deductible.

Outpatient coverage

  • Our Support Plan allows you to enjoy the highest coverage on the market with free choice of doctors, as long as they have the proper accreditation to practice the profession of medicine in recognized specialties.

BMI-Logos_Rep Dominicana

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