Major Medical Benefits - Pacific Cross Insurance Company Limited

MEDICAL PLANS: Major Medical Plan

BENEFITS

HOSPITAL & EMERGENCY MEDICAL PLAN

	Major Medical Plan
MAXIMUM BENEFIT FOR ANY ONE DISABILITY AND SEQUELAE	US$250,000 (US$1,000,000 option)
DEDUCTIBLE (per person per year)	US$1,000 (US$2,500 & US$5,000 option)
Covers normal, usual and customary charges for:
INPATIENT BENEFITS
Room and Board	Semi-private up to US$350 per day (Option to increase up to US$1,000 per day) (Private in Indonesia, Malaysia,Philippines & Thailand)
Parent Accommodation An extra bed in the same room for a parent accompanying an insured child under 12 years old	100%
Intensive Care Unit, Coronary Care Unit and Operating Room	100%
Surgeon's Fee Includes pre-surgical assessment and normal post-surgical care for each operation as per Surgical Schedule up to	US$30,000 (US$50,000 option)
Anaesthetist's Fee	30% of eligible Surgeon's Fee
Miscellaneous Inpatient Charges For required diagnostic laboratory tests, x-rays, prescribed medicines; professional fees; blood and plasma; wheel chair rentals; outpatient surgery; surgical appliances and devices; and intra-operative standard prosthetics (as approved by the Company)	100%
Organ Transplant Fees for kidney, heart, liver and bone marrow transplants (up to 50% for donor and the remaining percentages for recipient, at the option of the Insured Person) to a total of This benefit is a lump sum maximum per organ and no other policy benefits are payable in respect of Organ Transplant	US$100,000
HIV/AIDS Coverage will apply when HIV and/or its related illnesses present for the first time after 5 years continuous coverage under the Policy and any renewal thereof, with lifetime limit of	US$100,000
Home Nursing When certified necessary by the attending physician for up to 30 days immediately after hospitalization	100%
Rehabilitation When certified necessary by the attending physician for up to 45 days of inpatient, day case or outpatient treatment starting within 14 days of hospitalization	100%
Oncology Radiotherapy and chemotherapy (by way of infusion and injection) received as inpatient, day case or outpatient treatment	100%
Hospice Care For terminal illnesses with lifetime limit of	US$10,000
Psychiatric and Mental Disorders Hospital charges with lifetime limit of	US$5,000
Follow-up Care For up to 90 days of normal care immediately after hospitalization. Outpatient physician and physiotherapist when certified medically necessary by the attending physician; and, for required diagnostic laboratory tests, x-rays and prescribed medicines	US$2,500
EMERGENCY BENEFITS
Accidental Damage to Teeth Emergency treatment for up to 7 days following accidental loss or damage caused to sound natural teeth	100%
Emergency Room Treatment	100%
Emergency Local Ambulance Service	100%
24-Hour Emergency Assistance Services and Emergency Medical Evacuation Service Additional Travel Expenses (following Evacuation) One economy class airline ticket to return an Insured Person to the Country of Residence	Included
NOTE:
"100%" herein means full reimbursement of the normal, usual and customary charge in accordance with the eligible room type or other localized circumstances or customs.

ADDITIONAL BENEFIT PLANS


Covers normal, usual and customary charges for eligible expenses:
Dental Benefit 80% reimbursement up to an annual limit of	(US$2,000 option)
Personal Accident Benefit Covers loss of life, loss of one or both hands or feet, loss of vision in one or both eyes, or permanent and total disability caused directly and solely by an accident. (Maximum benefit is US$100,000 after age 65 and coverage is terminated after age 75. Child benefit limits are US$10,000 to US$50,000)	(US$100,000 to US$500,000 option)
Travel Benefit Covers the following eligible expenses worldwide when travelling outside your country of residence on trips lasting up to 90 days:	(option)
Emergency Medical Expenses - covers illness or injury including: "Emergency Evacuation" - (up to US$25,000) with a maximum of US$300 per day for hospital room and board which is doubled when the room fee includes medical service costs and tripled when the room fee also includes all professional services; and "Get You Home Benefit " - covers the additional cost of your own travel and accommodation necessarily incurred as a result of a covered disability to get you back home.	US$35,000
Baggage & Travel Documents - covers loss and damage of baggage and personal items including laptop computer; and loss of travel documents up to	US$750
Baggage Delay - covers purchase of essential clothing and toiletries if your checked baggage is delayed on arrival at your destination for over 12 hours up to	US$125
Personal Money - covers theft, burglary and robbery of cash, bank notes and travellers checks up to	US$500
Hospital Cash Income - pays US$50 per day for each day you are hospitalized over 24 hours up to	US$600
Travel Delay - covers transportation expenses incurred as a direct consequence of travel delay resulting from serious weather conditions, industrial action, hijack, mechanical derangement if an Insured Person has to re-route his trip due to cancellation of a prior confirmed booking; or " Cash Allowance " - pays US$25 for each full 12 hours delay up to a maximum of US$100.	US$650
Curtailment of Trip & Cancellation Charges - covers irrecoverable prepaid travel arrangement deposits or any increased cost of travel in the event of death, serious injury or illness of the Insured Person, immediate family members or close business partner or travel companion of the Insured Person, witness summons, jury service,compulsory quarantine; natural disasters at the planned destination or complete destruction of the Insured Person's principal residence.	US$2,500
Optional Rental Car Protection - covers loss and damage occurs to a rental car result directly from fire, theft, collision or vandalism. Deductible: US$250	(US$10,000 option)