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Support

 

Eligibility

  • This product may be contracted by those people residing in the Dominican Republic.
  • Inclusion age up to 65 years.
  • Age of permanence up to 99 years.
  • 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 holder, single, full-time students. Children who study abroad may remain insured
    until the day they turn 24 years old.

Worldwide coverage for 4 specific conditions

  • Cancer.
  • Chronic renal failure.
  • Cardiovascular diseases.
  • Organ transplant.

 

  • Triples the sum insured outside the country of residence (in the USA within a select network).
  • Cancer, chronic kidney failure and cardiovascular diseases – Maximum limit USD 1,500,000
  • Organ transplant – Maximum limit USD 750,000

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. Grace of 24 months.

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 in the market, the expenses incurred in another current plan can be applied to the
    deductible

Hospital and Clinic Network

  • To provide the best care we have a premium 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 with the most prestigious hospitals in Latin America, located in Colombia, where you can receive 100% coverage under the same conditions as in the Dominican Republic, after applying the deductible. Most of these hospitals hold the prestigious certification of the Joint Commission International.

Outpatient coverage

  • Our Support Plan has 100% coverage for consultations, special services, ambulatory surgery and medical prescriptions (medications) at 100%. After the deductible has been applied.

Deductible

・Applies per insured, per policy year, up to a maximum of 2 deductibles per family.

・A single 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 following period of the policy year.

・Elimination of Deductible –

– 100% for hospital coverage inside and outside the country of residence (Except in the USA). Applies to deductible options 1, 2, 4 and 5.

– 100% coverage for outpatient surgeries and emergencies in the country of residence, without deductible or copayment. Applies to deductible options 4 and 5.

– 50% deductible in select network in the USA.

Waiting period

・100% coverage for accidents and infectious diseases from the effective date, with a period

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:

・Insureds with deductibles up to USD 5,000 will have a copay 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 copay of USD 100 for the first USD 5,000 in

medical expenses. Expenses greater than US$ 5,000 will be paid based on the benefits of the policy. (Deductible applies)

BMI Access

・The BMI Access Service Center provides 24x7 assistance and exclusive benefits to all BMI health members.

・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.

 

Maximum benefits

MAXIMUM BENEFITSCOVERAGE
Maximum limit per illness, per insured$500,000
illness period365 days
Claims submission period120 days
Waiting period for any non-accidental illness or infectious disease90 days
Waiting period for appendicitis and cholecystitisNo wait
Exemption of premiums due to the death of the holder3 years

Hospital Expenses

HOSPITAL EXPENSESCOVERAGE
Room and board daily, after applying the deductible100%
Intensive care unit, after deductible has been applied100%
Maximum days of hospitalization240 days
Copayment for hospitalization outside the service network (company/owner and/or dependent)80% / 20%
In-network hospitalization copayment100%

Outpatient expenses after applying the deductible

OUTPATIENT EXPENSES, AFTER THE DEDUCTIBLE IS APPLIEDCOVERAGE
Copayment for outpatient services100%
Optional prescriptions (medications)100%

Maternity, after applying the deductible

MATERNITY, AFTER THE DEDUCTIBLE IS APPLIEDCOVERAGE
Maximum limit for maternity benefit100%
Maximum limit for maternity complications$50,000
Newborn care and its complications100%
Waiting Period for Maternity Benefit and Maternity Complications60 days
Congenital, genetic and hereditary diseases (as long as maternity is covered)100%

Organ transplant

ORGAN TRANSPLANTCOVERAGE
Maximum limit for transplants in the Dominican Republic (annual renewable)$250,000
Maximum limit for transplants in the select network in the US and outside the country of residence$750,000

Foreign Travel Assistance (only for emergencies)

ASSISTANCE IN FOREIGN TRAVEL (ONLY FOR EMERGENCY)COVERAGE
Maximum limit per trip, per insured$10,000
Deductible per trip, per insuredUSD 150
Maximum days per trip30 days

 

* This benefit is provided abroad by MULTI ASSISTANCE SERVICES and does not apply to pre-existing conditions

Other Benefits, after applying the deductible

OTHER BENEFITS, AFTER THE DEDUCTIBLE IS APPLIEDCOVERAGE
Alternative medicine100%
AIDS treatment$10,000
Injuries due to mental health disorder, states of insanity, including those resulting from
 
suicide attemptUSD 500
Medical emergency related to a declared pre-existing condition, incurred during the
 
grace periodUSD 500
Local ambulance service (per event)USD 100
robotic surgery$20,000
Fallopian tube ligation, vasectomy$3,000
Emergency dental treatment as a result of an accident
USD 50 (10 Days)
Charges for hospital accommodation of a companion per patient under 16 years of age and over 65 years of age100%
Thinness and obesity as long as there is a definitive medical diagnosis and it is medically necessaryUSD 500
Coverage for disabilities resulting from the use or consumption of alcohol, drugs or narcotics100%
COVID-19 coverage and its variants 

 

DEDUCTIBLESOPTION 1OPTION 2OPTION 3OPTION 4
Deductible per policy year$5,000$10,000$15,000$20,000

BMI-Logos_Rep Dominicana

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