Salud S.A. Experience World
Type of plan
Experience World
Cobertura máxima por asegurado
US$1,000,000 per policy year / US$3,000,000 per policy year
Edad límite para solicitar cobertura
Unlimited
Período de espera
• 30 days for outpatient treatment
• 90 days for inpatient and disability treatment
• 90 days for inpatient and disability treatment
Cobertura fuera de Estados Unidos
100% worldwide without restrictions of doctors and hospitals
Cobertura dentro de Estados Unidos
• 100% through the preferred provider network
• Outside the preferred provider network coverage will be at 80%
• Emergency medical treatment will be covered 100% up to the policy limits
• Outside the preferred provider network coverage will be at 80%
• Emergency medical treatment will be covered 100% up to the policy limits
Beneficios hospitalarios
Habitación hospitalaria privada estándar
100% up to the coverage limit
Beneficio especial para suite
N/A
Unidad de cuidados intensivos
100% up to the coverage limit
Acompañante adulto durante una hospitalización
At the Clínica Universidad de Navarra
• 100% during radiotherapy or chemotherapy treatments in day hospital regime
• 100% during radiotherapy or chemotherapy treatments in day hospital regime
Medicamentos prescritos durante una hospitalización
100%
Tratamientos psiquiátricos
Included in the specialized treatments benefit, up to 80% of US$200
Beneficios ambulatorios
Sala de emergencia
100%
Visitas de médicos y especialistas
80% up to US$80 per visit
Visitas de médicos y especialistas en el hogar
Medical consultations
• Unlimited visits, co-payment applies according to the sector where the visit takes place
Specialty medical consultations
• 4 visits
• Unlimited visits, co-payment applies according to the sector where the visit takes place
Specialty medical consultations
• 4 visits
Medicamentos prescritos
100%
Terapias complementarias
Physical rehabilitation therapy, speech therapy and respiratory therapy
• Up to 30 days worldwide
• Up to 40 sessions in Ecuador
Homeopathy, acupuncture and chiropractic therapy
• Up to 12 consultations
• Up to 30 days worldwide
• Up to 40 sessions in Ecuador
Homeopathy, acupuncture and chiropractic therapy
• Up to 12 consultations
Cuidados de enfermero(a) en el hogar
N/A
Chequeo médico preventivo
80% up to US$200
Aparatos auditivos
N/A
Enfermedad de Alzheimer
N/A
Autismo
N/A
Cirugía ambulatoria
100%
Terapia de reemplazo hormonal para aliviar los síntomas de la menopausia
N/A
Beneficios generales
Honorarios del cirujano y del anestesiólogo
100%
Servicios de estudios diagnósticos
Laboratory tests, pathology, X-rays, MRI/CT/PET scans
Inpatient
• 100%
outpatient
• 80%
Inpatient
• 100%
outpatient
• 80%
Oncología: exámenes de cáncer, tratamiento (quimioterapia y/o radioterapia) y medicamentos
100% up to 180 sessions
Diálisis
100% up to 45 days
Cirugía profiláctica para reducir el riesgo de cáncer
N/A
Prótesis y medios correctivos implantados durante una cirugía
Included in the durable medical equipment benefit of 100%
At the University of Navarra Clinic
• US$15,000 for internal trauma prostheses, intraocular lenses, breast prostheses as a result of breast tumor, abdominal meshes, cochlear implants, spinal neurostimulators and deep brain neurostimulators for Parkinson's disease, heart valves, pacemakers, defibrillators, by-pass prostheses, defibrillators and deep brain neurostimulator for Parkinson's disease, heart valves, pacemakers, defibrillators, vascular by-pass prostheses, vascular stents, portocaval shunts, biliary prostheses, portha-cat, venous reservoirs, catheters, nephrotomies, coils and CSF shunt valve
At the University of Navarra Clinic
• US$15,000 for internal trauma prostheses, intraocular lenses, breast prostheses as a result of breast tumor, abdominal meshes, cochlear implants, spinal neurostimulators and deep brain neurostimulators for Parkinson's disease, heart valves, pacemakers, defibrillators, by-pass prostheses, defibrillators and deep brain neurostimulator for Parkinson's disease, heart valves, pacemakers, defibrillators, vascular by-pass prostheses, vascular stents, portocaval shunts, biliary prostheses, portha-cat, venous reservoirs, catheters, nephrotomies, coils and CSF shunt valve
Trasplante de órganos y tejidos
80% Outpatient / 100% Inpatient
• US$250,000 per lifetime
• US$250,000 per lifetime
Beneficios para el donante vivo
80% Outpatient / 100% Inpatient
• US$20,000 per lifetime
• US$20,000 per lifetime
Equipo médico durable
For valve prostheses, pacemakers, implantable cardiodesfibrillators, stents, endoprostheses, catheters, knee, shoulder, hip prostheses stents, stents, endoprostheses, catheters, knee, shoulder, hip and osteosynthesis prostheses
• 100%
• 100%
Tratamiento de alergias
N/A
Terapia física y de rehabilitación
Included in the complementary therapy benefit of 100% for up to 30 days worldwide and 40 sessions in Ecuador
Tratamientos especializados
Psychiatrist and psychologist
• 80% up to US$200
Nutritionist
• 80% up to US$200
• 80% up to US$200
Nutritionist
• 80% up to US$200
Condiciones congénitas diagnosticadas antes de los 18 años
Outpatient
• 80%
• 80%
Condiciones congénitas diagnosticadas después de los 18 años
Outpatient
• 80%
• 80%
VIH-SIDA
Not specified
Tratamiento quirúrgico de trastornos sintomáticos de los pies
N/A
Psicología
Included in the specialized treatments benefit, 80% up to US$200
Medicamentos prescritos para la salud mental
Not specified
Beneficios de maternidad
Maternidad
Worldwide
After a 60-day waiting period
• US$4,000 includes maternity and newborn complications and prenatal and postnatal care
After a 10-month waiting period
• US$20,000 includes maternity and newborn complications, and prenatal and postnatal care
In Ecuador, no deductible on US$200 option
• US$4,500 includes vitamins and maternal vaccinations at 80% up to US$1,000
• 80% Outpatient
• 100% Inpatient
After a 60-day waiting period
• US$4,000 includes maternity and newborn complications and prenatal and postnatal care
After a 10-month waiting period
• US$20,000 includes maternity and newborn complications, and prenatal and postnatal care
In Ecuador, no deductible on US$200 option
• US$4,500 includes vitamins and maternal vaccinations at 80% up to US$1,000
• 80% Outpatient
• 100% Inpatient
Complicaciones de la maternidad y del recién nacido
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• US$50,000 for maternity complications
• US$10,000 until the 28th day of birth
• 80% Outpatient
• 100% Inpatient
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• US$50,000 for maternity complications
• US$10,000 until the 28th day of birth
• 80% Outpatient
• 100% Inpatient
Inclusión del recién nacido
Not specified
Extracción y almacenamiento de células madres
N/A
Tratamiento de fertilidad
N/A
Unidad de Cuidados Intensivos Neonatales (UCIN)
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• Included in the maternity and newborn complications benefit up to US$50,000 for maternity complications and US$10,000 for newborn complications
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• Included in the maternity and newborn complications benefit up to US$50,000 for maternity complications and US$10,000 for newborn complications
Atención prenatal y postnatal
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• 1 visit per month for well-baby checkup, up to 2 years of age
• US$700 for vaccinations up to 2 years of age
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• 1 visit per month for well-baby checkup, up to 2 years of age
• US$700 for vaccinations up to 2 years of age
Beneficios de evacuación médica
Transportación de emergencia por ambulancia terrestre
US$1,000
Transportación de emergencia por ambulancia aérea
National
• US$5,000
International
• US$25,000
• US$5,000
International
• US$25,000
Pasaje aéreo de regreso del asegurado y del acompañante después de una evacuación por ambulancia aérea
N/A
Repatriación de restos mortales
Benefit of funeral product is mentioned but no amounts or type of coverage are mentioned
Otros beneficios
Lesiones durante el entrenamiento o la práctica de actividades de alto riesgo y deportes (no profesionales)
N/A
Lesiones durante el entrenamiento o la práctica de deportes profesionales
N/A
Cobertura dental de emergencia
Options US$200, US$1,000 and US$2,500
• Included, no amount specified
• Included, no amount specified
Cirugía correctiva o reconstructiva en caso de enfermedad o accidente
100% for oncologic reconstructive surgery
• 80% Outpatient
• 100% Inpatient
• 80% Outpatient
• 100% Inpatient
Cirugía refractiva
Not specified
Cuidados paliativos en casos terminales
Up to US$5,000 for 15 days
• 80% Outpatient
• 100% Inpatient
• 80% Outpatient
• 100% Inpatient
Cobertura provisional para accidentes mientras se procesa la solicitud
• US$400 for emergencies and medical emergencies
• US$240 for prenatal checkups for pregnancy developed during the vesting period
• US$240 for prenatal checkups for pregnancy developed during the vesting period
Cobertura gratuita extendida a dependientes elegibles después de la muerte del contratante
N/A
Cobertura gratuita para dependientes
N/A
Eliminación/reducción del deducible por no presentar reclamos o no haber alcanzado el deducible
N/A
Eliminación del deducible
N/A
Segunda opinión médica
Included
Prótesis externas
US$120,000 per lifetime / US$30,000 per event
Tratamiento dental mayor o de rutina
Options US$200, US$1,000 and US$2,500
• Included, no amount specified
• Included, no amount specified
Reembolso por viaje para tratamientos en la red de centros de excelencia de Latinoamérica
N/A
Guerra y terrorismo
N/A
Seguro de vida a término
N/A
Condiciones preexistentes declaradas
Up to US$1,500 after 12 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to US$3,000 after a 24 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 24-month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all disabilities
• 80% Outpatient
• 100% Inpatient
Disability
• Up to 20 Ecuadorian base salaries for all disability conditions, after a waiting period of 3 months
• 80% Outpatient
• 100% Inpatient
Up to US$3,000 after a 24 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 24-month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all disabilities
• 80% Outpatient
• 100% Inpatient
Disability
• Up to 20 Ecuadorian base salaries for all disability conditions, after a waiting period of 3 months
Enfermedades catastróficas y crónicas sobrevinientes a la contratación
N/A
Condiciones catastróficas y raras
N/A
Emergencia médica
100%
Enfermedad o lesión en aeronave privada
N/A
Tratamientos anticonceptivos
N/A
Servicios de consultoría para pacientes
N/A
Asistencia de viaje
• Elimination of the deductible for emergencies or accidents outside the country of residence
• Saludsa Travel: US$100,000 for medical assistance for business or pleasure trips abroad, without deductible
• US$10,000 per event, for emergencies on trips to the United States
• Saludsa Travel: US$100,000 for medical assistance for business or pleasure trips abroad, without deductible
• US$10,000 per event, for emergencies on trips to the United States
Beneficio hospitalario en dinero en efectivo
N/A
Beneficios adicionales opcionales
Evacuación al país de elección, de residencia o domiciliar del asegurado
N/A
Evacuación que no sea de emergencia
N/A
Exoneración del período de espera para condiciones preexistentes
N/A