Flexi Plan III Latin America

Eligibility

• The maximum age for enrollment is 70 years. No age limit for renewal.
• Dependent children up to their 18th birthday or if they are single and residing with the policyholder up to their 30th birthday. Dependents studying full-time outside their country of residence until their 24th birthday.
• Medical Exam is required for all proposed insureds age 65 and over.

Deductible Options

I	II	III	IV	V	VI	VII
US$250	US$500	US$1,000	US$2,500	US$5,000	US$10,000	US$20,000

• Applies per insured, per policy year, up to a maximum of 2 deductibles per family.
• In case of an accident in country of residence in which one or more family members suffer injury only one deductible per policy year will apply.
• Expenses incurred during the last 90 days of the policy year not exceeding the deductible will be applied to the next policy year period.

Travel Assistance-Medical Emergency Transportation

Does not apply.

General Information

Maximum coverage per insured (Per policy year)	US$500,000
Waiting period	60 days / Immediate coverage for accidents and infectious diseases
Geographic coverage	Latin America and the Caribbean
Hospital network	Freedom of choice
Renewals	Guaranteed. No age limit
Temporary emergency coverage due to accident while application is being underwritten	US$50,000
Emergency medical treatment outside area of coverage	US$25,000
Waiver of premium upon death or permanent & total disability of policyholder under 60 years old	2 years

Hospitalization Benefits

Description	Coverage
Medical and surgical charges	100%
Physician fees	100%
Hospital room (Per day. Maximum 240 days)	US$400
Intensive care unit (Per day. Maximum 240 days)	US$800
Chemotherapy, radiotherapy and dialysis	100%
Laboratory tests and diagnostic services	100%
Physical therapy, occupational therapy and language therapy due to illness or covered accident	100%
Prescription Drugs	100%
Treatment for injuries as a result of participation in non-professional sports	100%
Congenital conditions	100%
Hospital indemnity (Per day. Maximum 10 days)	US$100

Outpatient Beneﬁts

Description	Coverage
Ambulatory surgery	100%
Routine medical check-up (Deductible does not apply. Policyholder and spouse. 12 months waiting period)	US$250

Maternity benefits

Does not apply.

Other Beneﬁts

Description	Coverage
Complications of pregnancy (Ectopic pregnancy, spontaneous/not elective abortion, death of the embryo or fetus, hydatidiform)	100%
Dental treatment due to accident (Deductible does not apply)	100%
Home nursing (Maximum 30 days)	100%
Cancer risk reduction surgery (Prophylactic surgery)	100%
Reconstructive surgery due to illness	100%
Organ transplant (Lifetime)	US$500,000
Medical benefit for organ resection from a donor	US$25,000
Permanent & total disability of policyholder under 60 years old	US$50,000
Local ambulance (Deductible does not apply)	US$1,000

Supplements

Description	Coverage
Maximum coverage per insured (Per policy year)	US$1,500,000
Hospital room and intensive care unit (Maximum 240 days)	100%
Outpatient Service	80% or 100%
Includes: Outpatient chemotherapy, radiotherapy and dialysis	100%
Medications after hospitalization / outpatient surgery (90 days)	according to % selected
Laboratory tests and diagnostic services	according to % selected
Physical therapy, occupational therapy and language therapy due to illness or covered accident	according to % selected
Treatment for injuries as a result of participation in non-professional sports	according to % selected
Congenital conditions	according to % selected