GBG Global Choice Plus
Type of plan
Global Choice Plus
Maximum coverage per insured
US$2,000,000 per policy year
Age limit to apply
75
Waiting period
Not specified
Coverage outside USA
100% worldwide without restrictions of doctors and hospitals
Coverage inside USA
• 100% through the preferred network of providers, applies a 10% coinsurance for all services up to US$2,000
• Outside the preferred provider network coverage will be at 70%
• Outside the preferred provider network coverage will be at 70%
Inpatient Benefits
Standard private hospital room
100% up to the coverage limit
Special benefit for suite
N/A
Intensive care unit
100% up to the coverage limit
Adult companion accommodation during a hospitalization
Related to a hospitalization of an insured
• US$100 per night, up to 10 nights
• US$100 per night, up to 10 nights
Prescribed medications while hospitalized
100%
Psychiatric treatments
100%
Outpatient Benefits
Emergency room
100%
Physician and specialist visits
100%
Physician and specialist home visits
N/A
Prescribed medications
Following a hospitalization or outpatient surgery
• 100% up to 6 months
Following a physician or specialist visit
• US$4,000
• 100% up to 6 months
Following a physician or specialist visit
• US$4,000
Complementary therapy
N/A
Nurse care at home
US$4,000
Preventive health checkup
No deductible applies, after a 10-month waiting period
All options
• 100% from 0 to 6 months old, up to 3 visits, including vaccines and medical exams
No deductible applies
All options
• US$100 from 6 months and older
All options
• 100% from 0 to 6 months old, up to 3 visits, including vaccines and medical exams
No deductible applies
All options
• US$100 from 6 months and older
Hearing aids
N/A
Alzheimer’s disease
Included in the 100% psychiatric treatment benefit, mental health treatment during hospitalization in a hospital or approved facility
Autism
Included in the 100% psychiatric treatment benefit, mental health treatment during hospitalization in a hospital or approved facility
Outpatient surgery
100%
Hormone replacement therapy to relieve the symptoms of menopause
N/A
General Benefits
Surgeon and anesthesiologist fees
100%
Diagnostic study services
Laboratory tests, pathology, X-rays, MRI/CT/PET scans
• 100%
• 100%
Oncology: cancer tests, treatment (chemotherapy and/or radiotherapy) and medication
100%
Dialysis
100%
Prophylactic surgery to reduce the risk of cancer
US$10,000 per lifetime, after a 12-month waiting period for gynecological cancer only (mastectomy and/or oophorectomy), BRCA testing and breast reconstruction
Prostheses and medical appliances implanted during surgery
100% for prosthetics, implants, orthopedic devices and appliances, and highly specialized drugs
Organ and tissue transplant
Per organ/tissue
• US$250,000 per lifetime
• Increase of up to US$750,000 lifetime (optional rider) including US$40,000 for living donor benefits
• US$250,000 per lifetime
• Increase of up to US$750,000 lifetime (optional rider) including US$40,000 for living donor benefits
Benefits for live donors
Included in organ and tissue transplant benefit up to US$40,000
Durable medical equipment
US$6,000
Allergy treatments
N/A
Physical therapy and rehabilitation
Inpatient
• US$6,000
Outpatient
• 100% up to 40 visits, all therapies combined
• US$6,000
Outpatient
• 100% up to 40 visits, all therapies combined
Specialized treatments
N/A
Congenital conditions diagnosed before age 18
US$250,000 per lifetime
Congenital conditions diagnosed after age 18
US$750,000
HIV-AIDS
US$15,000 per lifetime, after a 24-month waiting period
Surgical treatment of symptomatic foot disorders
N/A
Psychology
N/A
Mental health prescription medication
Included in the 100% psychiatric treatment benefit, mental health treatment during hospitalization in a hospital or approved facility
Maternity Benefits
Maternity
No deductible applies, after a 10-month waiting period
Options I, II, III & IV, including circumcision
• US$3,500 per pregnancy for normal or cesarean delivery, if only the mother is covered
• US$4,500 per pregnancy for normal or cesarean delivery, if both parents are covered
Options I, II, III & IV, including circumcision
• US$3,500 per pregnancy for normal or cesarean delivery, if only the mother is covered
• US$4,500 per pregnancy for normal or cesarean delivery, if both parents are covered
Maternity and birth complications
No deductible applies, after a 10-month waiting period
Options I, II, III & IV
• US$75,000 vitalicio
After a 10-month waiting period
Options I, II, III & IV
• US$500,000 for all pregnancies combined, per lifetime (with optional rider)
Options I, II, III & IV
• US$75,000 vitalicio
After a 10-month waiting period
Options I, II, III & IV
• US$500,000 for all pregnancies combined, per lifetime (with optional rider)
Inclusion of the newborn
Options I, II, III & IV
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
Extraction and storage of umbilical cord blood stem cells
N/A
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
No deductible applies
Options I, II, III & IV
• Included in the maternity and newborn complications benefit up to US$75,000 with no limit specified, provided that the newborn is added to the policy within these 90 days
Options I, II, III & IV
• Included in the maternity and newborn complications benefit up to US$75,000 with no limit specified, provided that the newborn is added to the policy within these 90 days
Pre-natal and post-natal care
Options I, II, III & IV
• Included in the maternity benefit up to US$3,500 if only the mother is covered and US$4,500 if both parents are covered
• Included in the maternity benefit up to US$3,500 if only the mother is covered and US$4,500 if both parents are covered
Medical Evacuation Benefits
Emergency transportation by ground ambulance
100%
Emergency transportation by air ambulance
US$30,000 per event, no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulance
US$2,000 per person for economy class tickets, within 90 days of the occurrence, included in the emergency transportation by air ambulance
Repatriation of mortal remains
US$10,000
Other Benefits
Injuries during the training or practice of hazardous hobbies and sports (non-professional)
N/A
Injuries during the training or practice of professional sports
N/A
Emergency dental coverage
100% for treatment within the first 120 days of the covered accident
Reconstructive surgery after an accident or illness
• 100% for nose and nasal septum deformity, if medically necessary and as a result of a medical condition covered by the policy
• US$10,000 for breast reconstruction included in cancer risk reduction surgery or prophylactic surgery benefit
• US$10,000 for breast reconstruction included in cancer risk reduction surgery or prophylactic surgery benefit
Refractive eye surgery
N/A
Palliative care for terminal cases
100%
Temporary coverage for accidents while application is being underwritten
N/A
Free extended coverage for eligible dependents after policyholder’s death
N/A
Free coverage for dependents
N/A
Elimination/reduction of deductible for no claims made or not having met the deductible
Options I, II, III & IV
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims and no change in policy deductible, excluding preventive health checkup
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims and no change in policy deductible, excluding preventive health checkup
Deductible elimination
Elimination of deductible on the first hospitalization, for 24 hours or more, in case of serious accident
Second medical opinion
Included
Prosthetic limbs
• US$30,000 per policy year
• US$120,000 per lifetime
• US$120,000 per lifetime
Routine and major dental treatment
N/A
Travel reimbursement for treatment in centers of excellence Latam network
N/A
War and terrorism
• US$125,000 per policy year
• US$500,000 per family
• US$500,000 per family
Term life insurance
N/A
Declared pre-existing conditions
Covered when disclosed in the application, benefit will be previously evaluated and subject to a 12-month waiting period
Catastrophic and chronic illnesses that survive the contracting of the service
N/A
Catastrophic and unusual conditions
N/A
Medical emergency
100% and at emergency centers in the U.S. a US$50 co-payment applies if the deductible has not been met
Illness or injury in private aircraft
N/A
Contraceptive treatments
N/A
Patient concierge services
N/A
Travel assistance
N/A
Hospital cash benefit
N/A
Optional additional benefits
Evacuation to country of choice, country of residence or home country
N/A
Non-emergency evacuation
N/A
Pre-existing conditions waiting period waiver
N/A