Podcast
Questions and Answers
What type of treatment is included in the policy to change the refraction of one or both eyes?
What type of treatment is included in the policy to change the refraction of one or both eyes?
Which of the following services may incur charges in excess of Usual, Customary and Reasonable (UCR) charges?
Which of the following services may incur charges in excess of Usual, Customary and Reasonable (UCR) charges?
In which country is there 'No Coverage Out-of-Network' according to the policy?
In which country is there 'No Coverage Out-of-Network' according to the policy?
What is the age requirement for minimum entry into the policy?
What is the age requirement for minimum entry into the policy?
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Which of the following countries has 'no provider limitations' except for Brazil?
Which of the following countries has 'no provider limitations' except for Brazil?
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What is required for coverage consideration when applying for the policy?
What is required for coverage consideration when applying for the policy?
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What is the waiting period mentioned in the policy?
What is the waiting period mentioned in the policy?
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What type of conditions are subject to a 12-month waiting period for coverage?
What type of conditions are subject to a 12-month waiting period for coverage?
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What is the age limit for maximum entry into the policy?
What is the age limit for maximum entry into the policy?
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In which country must designated providers be utilized according to the policy guidelines?
In which country must designated providers be utilized according to the policy guidelines?
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Study Notes
Out-of-Network Coverage
- 70% coverage based on Usual, Customary, and Reasonable (UCR) charges
- 100% coverage for services received outside the country of residence
Annual Deductibles
- Various plans with differing deductibles for individuals and families
- Family maximum deductible set at 2 times the individual deductible
Hospitalization and Inpatient Services
- Private or semi-private room covered at 100%
- Intensive Care Unit expenses covered at 100%
- Comprehensive coverage for medical treatment, medications, and diagnostic tests
- Inpatient consultations, medical, and nursing fees are fully covered
- Rehabilitation services covered if confined immediately after hospitalization
- Private duty nursing covered with an annual maximum of $6,000
- Accommodation for a companion of a hospitalized child covered up to $100 per day for a maximum of 10 days
Emergency Ambulance Services
- Ground ambulance costs fully covered
- Air ambulance service requires pre-authorization with a per event maximum of $50,000
- Repatriation of mortal remains covered up to $10,000 per insured
Outpatient Services
- Emergency room and emergency medical services fully covered
- Outpatient physician visits covered up to 24 visits per policy year
- Comprehensive coverage for various diagnostic imaging and laboratory tests at 100%
- Cancer treatment (chemotherapy/radiotherapy) fully covered
- Outpatient surgery and related services covered
- Outpatient dialysis fully funded
- Physical therapy and rehabilitation services offered, along with several complementary therapies
- Home health care services available with pre-authorization, maximum of 60 visits per policy year
Pre-existing Conditions
- Failure to disclose pre-existing conditions may result in claim denial, policy termination, or rescission of coverage
- Underwriters may waive preexisting limitations for specific conditions upon declaration
Maternity Coverage
- Available for Plans 2 and 3, including prenatal, postnatal care, and complications of pregnancy
- Excludes fertility/infertility services and related treatments, including pregnancy care
Pre-authorization Requirements
- Some medical services require pre-authorization, which must be obtained in writing
- Penalties of 40% may apply for failure to obtain pre-authorization for the entire episode of care
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Description
Test your knowledge about health insurance deductibles and coverage with this quiz. Learn about different plan options and understand the out-of-pocket expenses associated with healthcare services.
