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Group Plans / International Health Insurance
 

Groups larger than three persons. we can developed customized coverage and offer premium discounts. Group plans general have the same or better coverage than individual plans. Plan premiums are calculated depending upon where group members live and their ages but do not depend on occupation or nationality. The plans are not specific to one country so if a member of the group relocates to a new country, the coverage can be taken with them. Furthermore, if the member should leave the group he can normally take out an individual plan with the same insurer and all pre-existing conditions will still be covered.

Plans can be customized to have levels of cover depending on group member seniority and can include maternity, dental, chronic conditions, travel, personal accident, etc. We can also include a deductible (excess) to minimize the policy administration and keep premiums low.

If you are interested in arranging a group, please contact us so that we can better understand your needs.

The following details the typical benefits covered by an International Medical plan:
 
Inpatient or Hospitalization Coverage

This coverage normally gives you a free choice to visit any hospital or use any surgeon you choose. Coverage is typically for:

  • Room and Board (Private Room)
  • Surgery, Anaesthesia and Nursing
  • Operation and Recovery room equipment
  • Medicine whilst Hospitalized
  • Diagnostic tests, Lab tests, X rays, (MRI) etc.
  • Chemotherapy and Radiotherapy
  • Room and Board for parent or guardian accompanying a child
  • Care at home following hospital discharge
  • Outpatient Surgery
  • Acute Dental treatment following an accident
  • Transportation by Ambulance
Outpatient or Clinical Coverage

This coverage normally gives you free choice to visit any doctor, specialist or clinic you choose. Coverage is typically for:

  • Medical Practioner's fees, including Specialist's fees
  • Prescribed Medicine and Medical Equipment
  • Diagnostic tests and procedures, Lab tests, X rays, Magnetic Resonance Imaging (MRI)
  • Physiotherapy, Chiropractor, Homeopathic and Acupuncture treatment
  • Outpatient Surgery
  • Psychiatric treatment
  • Home Nursing
 
 
Plan may also include the following coverage:
Maternity  
Emergency Evacuation
Covers the cost of transportation to the nearest medical centre where adequate medical facilities are available to treat the condition. This can include emergency airlift, the cost of an accompanying person is normally included as well as the return journey.
Dental
Some plans offer additional dental coverage. Coverage is normally of two types:
Routine Dental: polishing, scaling and normal compound fillings, etc.
Major Dental: Removal of impacted, buried or un-erupted teeth, removal of roots, new or repair of bridge work, new or repair of crowns, root canal treatment, dentures, etc.

Many plans offer additional coverage for Maternity. Maternity normally has a waiting period before coverage is effective and this typically means conceptions can only occur 3 to 12 months after the medical plan starts. Maternity coverage normally includes:

  • Normal Delivery
  • Pre and Post Natal consultations
  • Diagnostic tests and medication
  • New born coverage (some plans also cover congenital conditions)
  • Complications of delivery are normally also covered to higher limits.
 
 
 
When selecting a plan it is important to consider the following additional points:
 
Chronic Condition Coverage
Chronic conditions are generally defined as medical conditions which you do not recover from but only manage and maintain, for example diabetes and asthma. Currently about half of the international medical insurance plans in the market offer coverage for chronic conditions. It is important to understand that the on going treatment and management of chronic conditions can be very expensive, as such plans offering this coverage are generally more expensive.
 
 
Geographic Coverage

There are basically two types of coverage. Worldwide including North America and Worldwide excluding North America. If you choose Worldwide excluding North America then you can choose to visit any hospital, doctor or clinic anywhere in the World excluding North America. Conversely if you choose to include coverage of North America then you can go for treatment anywhere.

Premiums to include coverage in North America are normally much higher. Most plans taken out are Worldwide excluding North America unless you are a US citizen. Plans that do not cover North America for elective treatment will normally still cover you for emergency or unscheduled treatment if you happen to be there while on business or vacation for a short period.

 
Deductible or Excess
Using a deductible or excess is an effective way to keep premiums low and reduce administration. There are three basic types of deductible
 
Per Condition   Annual   Percentage Coverage
This is the most common form of deductible. The deductible is applied once for treatment of a condition. i.e a USD40 deductible will be applied to a course of treatment for the flu. If the total bill is USD100 then USD60 is reimbursed. If the total bill from 3 visits is USD300, then USD260 is reimbursed.
 
All eligible medical expenses are added together throughout the policy year and after the deductible is reached all further expenses are paid in full. i.e. if the deducible is USD400 then after 4 vsisits to the doctor for separate conditions of USD100 each, all further expenses are paid in full.
 
Medical expenses are reimbursed by calculating a percentage of the total expenses. i.e. if the deductable is 20%, then if the claim amount is USD100 then USD80 will be reimbursed.
 
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