Palig Ecuador World Access
Type of plan
World Access
Cobertura máxima por asegurado
US$5,000,000 per policy year
Edad límite para solicitar cobertura
75
Período de espera
• For outpatient care: 30 Days
• For hospital care: 60 Days
• For emergencies: 24 Hours
• For pre-existing conditions: 24 Months
• For disability: 3 Months
• For the start of maternity: 60 Days
• For hospital care: 60 Days
• For emergencies: 24 Hours
• For pre-existing conditions: 24 Months
• For disability: 3 Months
• For the start of maternity: 60 Days
Cobertura fuera de Estados Unidos
100% worldwide without restrictions of doctors and hospitals
Cobertura dentro de Estados Unidos
100% worldwide without restrictions of doctors and hospitals
Beneficios hospitalarios
Habitación hospitalaria privada estándar
100% Up to the limits of the coverage
Beneficio especial para suite
N/A
Unidad de cuidados intensivos
100% Up to the limits of the coverage
Acompañante adulto durante una hospitalización
Related to the hospitalization of an insured person under 18 years old:
• US$300 per night, with deductible applied.
Related to the hospitalization of an insured person over 18 years old:
• US$300 per night, up to 30 nights
• US$300 per night, with deductible applied.
Related to the hospitalization of an insured person over 18 years old:
• US$300 per night, up to 30 nights
Medicamentos prescritos durante una hospitalización
100%
Tratamientos psiquiátricos
US$1,000
(Coverage for psychiatric illnesses of organic origin, including 6 medical consultations per policy year and medication, without applying a deductible)
(Coverage for psychiatric illnesses of organic origin, including 6 medical consultations per policy year and medication, without applying a deductible)
Beneficios ambulatorios
Sala de emergencia
100%
Visitas de médicos y especialistas
100%
Visitas de médicos y especialistas en el hogar
100%
Medicamentos prescritos
US$10,000
Terapias complementarias
N/A
Cuidados de enfermero(a) en el hogar
Included in the home healthcare benefit 100%
Chequeo médico preventivo
Preventive Medical Exams, without deductible applied
• Up to US$300
Nutritional coverage for health risk factors at 100%, without deductible, up to:
• 2 consultations per year
Well-child checkups from a covered maternity (comprehensive care), without deductible
• $600 the first year of life
• $500 the second year of life
• $200 the third year of life
• $200 the fourth year of life
• $200 the fifth year of life
Well-child checkups from a non-covered maternity (comprehensive care), without deductible
• $400 the first year of life
• $200 the second year of life
• $100 the third year of life
• $100 the fourth year of life
• $100 the fifth year of life
• Up to US$300
Nutritional coverage for health risk factors at 100%, without deductible, up to:
• 2 consultations per year
Well-child checkups from a covered maternity (comprehensive care), without deductible
• $600 the first year of life
• $500 the second year of life
• $200 the third year of life
• $200 the fourth year of life
• $200 the fifth year of life
Well-child checkups from a non-covered maternity (comprehensive care), without deductible
• $400 the first year of life
• $200 the second year of life
• $100 the third year of life
• $100 the fourth year of life
• $100 the fifth year of life
Aparatos auditivos
N/A
Enfermedad de Alzheimer
Included in the alternative therapies benefit at 100%
Autismo
Included in the benefit for congenital conditions diagnosed before 18 years old, up to US$1,000,000
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
• 100%
• 100%
Oncología: exámenes de cáncer, tratamiento (quimioterapia y/o radioterapia) y medicamentos
100%
Diálisis
100%
Cirugía profiláctica para reducir el riesgo de cáncer
N/A
Prótesis y medios correctivos implantados durante una cirugía
100%
Trasplante de órganos y tejidos
Per organ/tissue
• US$1,500,000 per lifetime
• US$1,500,000 per lifetime
Beneficios para el donante vivo
US$50,000 per lifetime, included in the organ transplant benefit
Equipo médico durable
100%
Tratamiento de alergias
N/A
Terapia física y de rehabilitación
100% (maximum 60 days per policy year)
Tratamientos especializados
Organic and psychological psychiatric illnesses
• US$1,000 without deductible, up to 6 consultations
Coverage for maintenance of vital signs in body systems in a life-threatening state
• US$500 lifetime, without deductible
Alternative therapies, chiropractor, psychiatrist, or psychologist
• 100% up to 20 sessions
Nutritionist
• US$200 up to 2 consultations per policy year
• US$1,000 without deductible, up to 6 consultations
Coverage for maintenance of vital signs in body systems in a life-threatening state
• US$500 lifetime, without deductible
Alternative therapies, chiropractor, psychiatrist, or psychologist
• 100% up to 20 sessions
Nutritionist
• US$200 up to 2 consultations per policy year
Condiciones congénitas diagnosticadas antes de los 18 años
US$300,000 lifetime
Newborn from a non-covered maternity
• US$5,000 lifetime
Newborn from a non-covered maternity
• US$5,000 lifetime
Condiciones congénitas diagnosticadas después de los 18 años
100%
VIH-SIDA
US$ 500,000 lifetime
Other sexually transmitted diseases
• US$20,000 lifetime
Other sexually transmitted diseases
• US$20,000 lifetime
Tratamiento quirúrgico de trastornos sintomáticos de los pies
100%
Psicología
US$200 up to 2 consultations per policy year
Medicamentos prescritos para la salud mental
US$2,000 for health conditions resulting from actions and/or illnesses caused by drug use, narcotics, intoxication, alcoholism, and injuries due to mental health disorders, dementia states, including those resulting from a suicide attempt.
Beneficios de maternidad
Maternidad
No deductible, after a 60-day waiting period
Options I and II
Policyholder and spouse
• US$7,000
Dependent daughters under 24 years old included in the policy
• US$7,000
Options I and II
Policyholder and spouse
• US$7,000
Dependent daughters under 24 years old included in the policy
• US$7,000
Complicaciones de la maternidad y del recién nacido
No deductible, after a 60-day waiting period
Options I and II
• US$1,000,000 lifetime
Options I and II
• US$1,000,000 lifetime
Inclusión del recién nacido
Options I and II
• No risk assessment if the newborn is from a covered maternity, provided the newborn is added to the policy within 90 days after birth.
• No risk assessment if the newborn is from a covered maternity, provided the newborn is added to the policy within 90 days after birth.
Extracción y almacenamiento de células madres
N/A
Tratamiento de fertilidad
N/A
Unidad de Cuidados Intensivos Neonatales (UCIN)
Options I and II
• Included in the maternity and newborn complications benefit, up to US$1,000,000
• Included in the maternity and newborn complications benefit, up to US$1,000,000
Atención prenatal y postnatal
Prenatal without deductible
• US$600, applies only for non-covered maternities
Perinatal without deductible, non-covered maternity
• US$300 per newborn, within the first 28 days
Postnatal without deductible, well-child checkup for non-covered maternity
• US$400 the first year
• US$200 the second year
• US$100 the third year
• US$100 the fourth year
• US$100 the fifth year
Postnatal without deductible, well-child checkup, for covered maternity
• US$600 the first year
• US$500 the second year
• US$200 the third year
• US$200 the fourth year
• US$200 the fifth year
• US$600, applies only for non-covered maternities
Perinatal without deductible, non-covered maternity
• US$300 per newborn, within the first 28 days
Postnatal without deductible, well-child checkup for non-covered maternity
• US$400 the first year
• US$200 the second year
• US$100 the third year
• US$100 the fourth year
• US$100 the fifth year
Postnatal without deductible, well-child checkup, for covered maternity
• US$600 the first year
• US$500 the second year
• US$200 the third year
• US$200 the fourth year
• US$200 the fifth year
Beneficios de evacuación médica
Transportación de emergencia por ambulancia terrestre
US$100,000 no deductible applies, includes emergency transportation by air and water ambulance.
Transportación de emergencia por ambulancia aérea
100% no deductible applies
Pasaje aéreo de regreso del asegurado y del acompañante después de una evacuación por ambulancia aérea
N/A
Repatriación de restos mortales
100%
Otros beneficios
Lesiones durante el entrenamiento o la práctica de actividades de alto riesgo y deportes (no profesionales)
US$250,000
Lesiones durante el entrenamiento o la práctica de deportes profesionales
N/A
Cobertura dental de emergencia
100% for treatment during the first 120 days following the covered accident.
Cirugía correctiva o reconstructiva en caso de enfermedad o accidente
100% if medically necessary and as a result of a medical condition covered by the policy
Cirugía refractiva
Coverage for keratoconus from visual refraction origin
• US$5,000 per lifetime
• US$5,000 per lifetime
Cuidados paliativos en casos terminales
100%
Cobertura provisional para accidentes mientras se procesa la solicitud
N/A
Cobertura gratuita extendida a dependientes elegibles después de la muerte del contratante
2 years for insured members of the family
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
Serious accident, all options
• Removal of the deductible in case of a severe accident requiring hospitalization
Accident, options I, II, and III
• Removal of the deductible for the first medical treatment, hospital, or emergency center, within or outside the country of residence
In Emergency Room for Critical Conditions, options I, II, and III:
• Removal of the deductible as long as the care is within the country of residence
Segunda opinión médica
Included
Prótesis externas
100%
Tratamiento dental mayor o de rutina
N/A
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 20 basic Ecuadorian salaries for all pre-existing conditions in one policy year, after a 24-month waiting period
Disability
• Up to 20 basic Ecuadorian salaries for all disability conditions, after a 3-month waiting period
Disability
• Up to 20 basic Ecuadorian salaries for all disability conditions, after a 3-month waiting period
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
US$100
Servicios de consultoría para pacientes
N/A
Asistencia de viaje
N/A
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