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INTERNATIONAL - PPO DOCTOR/HOSPITAL
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Best Doctors has Six individual health plans out of which the following four options are more popular:
Medical Elite: A plan with exceptional service to reach VIP. With Medical Elite™ you can enjoy exceptional VIP benefits and a special level of care anywhere in the world.
Premier Plus: The flexible benefits plan with access to premier. Take the most comprehensive medical coverage anywhere in the world and enjoy the best benefits like coverage for transplants.
Global Care: Benefits and best hospitals in one plan. This plan provides access to the best doctors and hospitals in the world through our network and coverage in hospitalizations, outpatient services, maternity and repatriation.
Ultimate Care: The plan with maximum coverage in disasters. The maximum protection against catastrophic medical event, including transplants, cardiovascular surgery, serious injuries and burns.
| BENEFITS | MEDICAL ELITETM | PREMIER PLUSTM | GLOBAL CARETM | ULTIMATE CARETM | ADVANCED CARE PLUSTM | MEDICAL CARETM |
|---|---|---|---|---|---|---|
| Maximum Annual Benefit | USD$10 million | USD$5 million | USD$2 million | USD$1 million | USD$1.5 million (benefit available before 70 years)USD$1.5 million per life (benefit available after 71 years) | USD$1 million |
| Eligibility | Up to age 74 | Up to age 74 | Up to age 74 | Up to age 70 | Up to age 70 | Up to age 74 |
| Coverage Area | Worldwide | Worldwide | Worldwide | Worldwide | Worldwide | Options: Worldwide coverage or Latin American** coverage |
| Coinsurance | Without coinsurance | Without coinsurance | Without coinsurance | Without coinsurance | Without coinsurance | Without coinsurance |
| Hospital Network | Free Choice | Free Choice | Inside U.S.: through the GLOBALCARETM Network Outside U.S. free choice |
Inside U.S.: through the ULTIMATECARETM Network Outside U.S. free choice |
Inside U.S. through the ADVANCECAREPLUSTM Network Outside U.S. free choice |
100% - Outside U.S. Worldwide coverage Plan 100% in Latin America** through the MEDICALCARETM Network Latin America** Coverage Plan 100% - Inside U.S. Worldwide coverage Plan through MEDICALCARETM Network Outside U.S. free choice |
| Covered Medical Conditions | All covered medical conditions | All covered medical conditions | All covered medical conditions | Limited to 8 critical medical conditions* | All covered medical conditions | All covered medical conditions |
| HOSPITALIZATION | ||||||
| Hospitalization (unlimited days) | 100% | 100% | 100% - Outside USA 100% - GLOBALCARE™ Network - Inside USA |
100% - Outside USA 100% - ULTIMATECARE™ Network - Inside USA Outside U.S. free choice |
Inside U.S. through the ADVANCECAREPLUS™ Network Outside U.S. free choice |
100% - Outside U.S. Worldwide coverage Plan 100% in Latin America** through the MEDICALCARETM Network Latin America** Coverage Plan 100% - Inside U.S. Worldwide coverage Plan through MEDICALCARETM Network |
| Room | Private and Semi-Private 100% | Private and Semi-Private 100% | 100% - Outside USA 100% - GLOBALCARETM Network - Inside USA |
Private and Semi-Private 100% - Outside USA Private and Semi-Private 100% - ULTIMATECARETM Network - Inside USA |
Standard 100% inside U.S. through the ADVANCE-CAREPLUSTM Network Outside U.S. free choice |
100% - Outside U.S. Worldwide coverage Plan 100% in Latin America** through the MEDICALCARETM Network Latin America** Coverage Plan 100% - Inside U.S. Worldwide coverage Plan through MEDICALCARETM Network |
| Intensive Care | 100% | 100% | 100% - Outside USA 100% - GLOBALCARETM Network - Inside USA |
100% - Outside USA 100% - ULTIMATECARETM Network - Inside USA |
100% inside U.S. through the ADVANCECAREPLUSTM Network Outside U.S. free choice |
100% - Outside U.S. Worldwide coverage Plan 100% in Latin America** through the MEDICALCARETM Network Latin America** Coverage Plan 100% - Inside U.S. Worldwide coverage Plan through MEDICALCARETM Network |
| Accommodation for Accompanying Minor | $500 per night, up to 20 nights | $300 per night, up to 10 nights | $100 per night, up to 10 nights | Not Applicable | Not Applicable | Not Applicable |
| Reconstructive surgery in case of Illness or accident | 100% | 100% | 100% | Limited to conditions specified in tde plan | 100% | 100% |
| Surgery (including Outpatient Surgery) | 100% | 100% | 100% | 100% | 100% | 100% |
| Emergency Room | 100% | 100% | 100% | 100% | 100% | 100% |
| Additional Services: Nurses, Medicines, Bandages | 100% | 100% | 100% | 100% | 100% | 100% |
| Anestdesia | 100% | 100% | 100% | 100% | 100% | 100% |
| Mayor Diagnostic Tests | 100% | 100% | 100% | 100% for covered conditions | 100% | 100% |
| OTHER BENEFITS | ||||||
| Surgical Trreatment for symptomatic disorders of the feet | 100% | 100% | 100% | Not Applicable | 100% | 100% |
| Cancer risk reduction surgery (Prophylactic surgery) | $25,000 per Insured per Lifetime | $20,000 per Insured per Lifetime | $15,000 per Insured per lifetime | Not Applicable | Not Applicable | Not Applicable |
| Bariatric Surgery, Gastric by-pass, and any surgical procedure intended for weight loss, its complications, treatments | $15,000 per Insured per Lifetime | $10,000 per Insured per Lifetime | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| Cancer Treatment (chemotherapy/radiation therapy) | 100% | 100% | 100% | USD$200,000 | 100% | 100% |
| Dialysis | 100% | 100% | 100% | USD$100,000 | 100% | 100% |
| Emergency Dental Coverage | Only covered within the first 180 days of the accident | Only covered within the first 180 days of the accident | Only covered within the first 180 days of the accident | Only covered within the first 180 days of the accident | Only covered within the first 180 days of the accident | Only covered within the first 180 days of the accident |
| Physicians and Specialists Visits (usual and customary) | 100% | 100% | 100% | 100% | 100% | 100% |
| Surgeon and Anesthetist Fees | 100% | 100% | 100% GLOBALCARETM Network | 100% ULTIMATECARETM Network | 100% ADVANCEDCAREPLUSTM Network | 100% MEDICALCARETM Network |
| Prescribed Medications | 100% | 100% | USD$7,000 outside hospitalization | 100% | 100% if has ISAPRE coverage; 35% otherwise | USD$2,500 as an outpatient |
| Outpatient Physical Therapy, Rehabilitation and Home Health Care (private nurse) | 100% | 100% | USD$10,000 per Insured per Policy Year | Not Applicable | 100% | USD$3,000 |
| Illness or injury in Private Aircraft | 100% | 100% | 100% | Not Applicable | 100% | 100% |
| Free coverage for dependants in case of death of Main Insured | 2 years | 2 years | Not Applicable | Not Applicable | 2 years | Not Applicable |
| Surgical Implants or Prosthesis (excluded dental) | 100% | 100% | 100% | Not Applicable | 100% | 100% |
| OTHER BENEFITS | ||||||
| Durable Medical Equipment, Special devices (External Prosthesis, Orthotic devices) | 100% | 100% | USD$10,000 per Insured per Policy year | Not Applicable | 100% | USD$3,000 |
| Maternity | Normal delivery 100% within Best Doctors Maternity Network, no Deductible applies. In other Hospitals USD$7,000, no Deductible applies. Available for options I, II and III. For Elective or Selected Cesarean delivery USD$8,500 in any hospital | USD$5,000 (options I, II and III) per event, no Deductible applies | USD$3,000 (options I and II), no Deductible applies | Not Applicable | Not Applicable | USD$2,000 (option I), no Deductible applies |
| Stem Cells | USD$2,000 per covered pregnancy for extraction and one year preservation of stem cells. Only options I, II & III | Included in maternity benefit | Included in maternity benefit | Not Applicable | Not Applicable | Not Applicable |
| Maternity Complications and Birth Complications | USD$2,000 per covered pregnancy for extraction and one year preservation of stem cells. Only options I, II & III | Included in maternity benefit | Included in maternity benefit | Not Applicable | Not Applicable | Not Applicable |
| Inclusion of Newborn | Automatically included without underwriting if born from a covered maternity and if not born of a pregnancy that is a result of any type of fertility treatment | Automatically included without underwriting if born from a covered maternity and if not born of a pregnancy that is a result of any type of fertility treatment | Automatically included without underwriting if born from a covered maternity and if not born of a pregnancy that is a result of any type of fertility treatment | Subject to underwriting | Automatically included without underwriting with Maternity Complications and Birth Complications Rider and if not born of a pregnancy that is a result of any type of fertility treatment | Automatically included without underwriting if born from a covered maternity and if not born of a pregnancy that is a result of any type of fertility treatment |
| Congenital and Hereditary Disorders (<18 years old) | USD$2 millions lifetime per Insured | USD$1 million lifetime per Insured | USD$500,000 lifetime per Insured | 2 years waiting period 10% of Maximum Benefits of covered expenses | USD$250,000 lifetime per | USD$100,000 lifetime per Insured |
| Congenital and Hereditary Disorders (≥18 years old) | 100% | 100% | 100% | 2 years waiting period 10% of Maximum Benefits of covered expenses | 100% | 100% per Insured per lifetime, subject to the Maximum Benefit of the Policy |
| Organ and Tissue Transplants | USD$2 million per organ/tissue per Insured per lifetime and USD$50,000 for Living Donor | USD$1 million per organ/tissue per Insured per lifetime and USD$40,000 for Living Donor | Rider (USD$500,000 lifetime) USD$400 annual cost | Heart USD$300,000 lifetime Heart/Lung USD$300,000 lifetime Lung USD$250,000 lifetime Pancreas USD$250,000 lifetime Pancreas/Kidney USD$300,000 lifetime Kidney USD$200,000 lifetime Liver USD$200,000 lifetime Bone Marrow USD$250,000 | USD$1 million per organ/tissue per Insured per lifetime and USD$20,000 for Living Donor | USD$300,000 per organ/tissue per Insured per lifetime and USD$20,000 for Living Donor |
| OTHER BENEFITS | ||||||
| Specialized Treatments | Psychiatry, autism, occupational therapies, sleep apnea and any other sleep disorders $3,000 per Insured per Policy Year | Psychiatrist, autism and occupational therapies $2,500 per Insured per Policy Year | Treatment related to psychiatrist, autism, occupational therapies USD$2,000 per Insured, per Policy Year | Not Applicable | Not Applicable | Not Applicable |
| Routine Health Checkup | One Medical checkup a year USD$300 (≥18 years old) per Policy Member | Newborns | Newborns | Not Applicable | Not Applicable | Newborns |
| Child Well Care | 5 visits per year up to USD$300 per visit (before 12 months of age) Up to USD$100 per visit (from 12 months and until 18 years of age) | Not Applicable | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| Palliative / Hospice Care | 100% per Insured per Lifetime Max 30 days | $15,000 per Insured per Lifetime Max 30 days | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| HIV/AIDS | USD$1,000,000 lifetime Waiting period of 24 months applies | USD$500,000 lifetime Waiting period of 24 months applies | Excluded | Excluded | USD$250,000 lifetime | N/A |
| Sports | Professional Included | Professional Included | Only non-professional | Not applicable | Not applicable | Only non-professional |
| Air Ambulance (pre-approved) | 100% to the closest hospital of qualified treatment. No deductible applies | USD$100,000 per Insured per Policy Year to the closest hospital of qualified treatment. No deductible applies | USD$50,000 per Insured per Policy Year to the closest hospital of qualified treatment. No deductible applies | USD$25,000 per Insured per Policy Year to the closest hospital of qualified treatment | USD$50,000 per Insured per Policy Year to the closest hospital of qualified treatment | USD$30,000 per Insured per Policy Year to the closest hospital of qualified treatment |
| Ground Ambulance | 100% No Deductible applies | 100%No Deductible applies | 100% No Deductible applies | 100% No Deductible applies | 100% No Deductible applies | 100% No Deductible applies |
| Repatriation of Mortal Remains | 100% | USD$25,000 | USD$15,000 | Not applicable | USD$5,000 | USD$5,000 |
| Unique Services | InterConsultation® Best Doctors ConciergeTM Elite NavigatorTM | InterConsultation® Best Doctors ConciergeTM | InterConsultation® Best Doctors ConciergeTM | InterConsultation® Best Doctors ConciergeTM | InterConsultation® Best Doctors ConciergeTM | InterConsultation® Best Doctors ConciergeTM |
| Optional Coverage Available | Critical Select | Critical Select Maternity Complications (Options I, II and III)" | Critical Select Maternity Complications (Options I and II) Organ Transplants | Critical Select | Critical Select Maternity Complications | Critical Select |
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