Best Doctors Prepaid Medicine Medical Elite
Type of plan
Medical Elite
Cobertura máxima por asegurado
US$10,000,000 per policy year
Edad límite para solicitar cobertura
Unlimited
Período de espera
30 days
Cobertura fuera de Estados Unidos
100% worldwide without restrictions of doctors and hospitals
Cobertura dentro de Estados Unidos
100% without restrictions of doctors and hospitals
Beneficios hospitalarios
Habitación hospitalaria privada estándar
100%
Beneficio especial para suite
N/A
Unidad de cuidados intensivos
100%
Acompañante adulto durante una hospitalización
Related to a hospitalization of an insured under age 18 or older than 75
• US$10,000
This coverage is inside and outside Ecuador and is not limited to the number of entries in the year
• US$10,000
This coverage is inside and outside Ecuador and is not limited to the number of entries in the year
Medicamentos prescritos durante una hospitalización
US$200 no deductible applies, after this amount the coverage will be 100% with deductible
Tratamientos psiquiátricos
Included in the specialized treatments benefit up to US$5,000
Beneficios ambulatorios
Sala de emergencia
100%
Visitas de médicos y especialistas
100%
Visitas de médicos y especialistas en el hogar
N/A
Medicamentos prescritos
100% including ancestral, alternative and generic medicine
Terapias complementarias
Speech therapist
• Included in the physical therapy and rehabilitation benefit at 100%
Home respiratory therapy
• Included in the physical therapy and rehabilitation benefit at 100%
Alternative and ancestral medicine consultations
• US$50
• Included in the physical therapy and rehabilitation benefit at 100%
Home respiratory therapy
• Included in the physical therapy and rehabilitation benefit at 100%
Alternative and ancestral medicine consultations
• US$50
Cuidados de enfermero(a) en el hogar
Included in the physical therapy and rehabilitation benefit at 100%
Chequeo médico preventivo
No deductible applies, for dependents born from a covered maternity
• US$300 per visit, up to 5 visits, from 0 to 12 months old
• US$100 up to 1 visit from 12 months to 18 years old
US$500 from 18 years and older
• US$300 per visit, up to 5 visits, from 0 to 12 months old
• US$100 up to 1 visit from 12 months to 18 years old
US$500 from 18 years and older
Aparatos auditivos
N/A
Enfermedad de Alzheimer
100%
Autismo
• 100% if the insured was born under a covered maternity
• US$10,000 for insured not born under a covered maternity who develop the condition while they are insured
• US$10,000 for insured not born under a covered maternity who develop the condition while they are insured
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
US$30,000 per lifetime, after a 90-day waiting period
Prótesis y medios correctivos implantados durante una cirugía
100%
Trasplante de órganos y tejidos
Per organ/tissue
• US$3,000,000 per lifetime, after a 90-day waiting period
• US$3,000,000 per lifetime, after a 90-day waiting period
Beneficios para el donante vivo
US$50,000 per lifetime, included in the organ transplant benefit
Equipo médico durable
100%
Tratamiento de alergias
100%
Terapia física y de rehabilitación
100% including rehabilitative cardiac therapy, respiratory therapy and speech therapy
Tratamientos especializados
Psychiatrist, occupational therapist, sleep apnea and other sleep disorders
• US$5,000
• US$5,000
Condiciones congénitas diagnosticadas antes de los 18 años
100%
Condiciones congénitas diagnosticadas después de los 18 años
100%
VIH-SIDA
Not specified, this benefit according to the law or zero rate will have coverage for 1 evaluation per year up to US$60 to know the health status of the insured, it could also be considered as a pre-existing condition and have coverage up to 20 Ecuadorian basic salaries, i.e. US$9,000
Tratamiento quirúrgico de trastornos sintomáticos de los pies
• 100%
Non-surgical treatment of symptomatic foot disorders
• US$400
Non-surgical treatment of symptomatic foot disorders
• US$400
Psicología
10 visits
Medicamentos prescritos para la salud mental
N/A
Beneficios de maternidad
Maternidad
No deductible applies, after a 60-day waiting period
Options I, II & III
• 100% per pregnancy for normal or cesarean delivery, in the country of residence
• US$15,000 per pregnancy for normal or cesarean delivery, outside the country of residence within the maternity network, when both parents are in the policy
• US$10,000 per pregnancy for normal or cesarean delivery, outside the country of residence within the maternity network, when only the mother is covered
Options I, II & III
• 100% per pregnancy for normal or cesarean delivery, in the country of residence
• US$15,000 per pregnancy for normal or cesarean delivery, outside the country of residence within the maternity network, when both parents are in the policy
• US$10,000 per pregnancy for normal or cesarean delivery, outside the country of residence within the maternity network, when only the mother is covered
Complicaciones de la maternidad y del recién nacido
After deductible according to the deductible option, after a 60-day waiting period
Options I, II & III
• US$1,000,000 per covered pregnancy, per lifetime
Including obstetric emergencies, up to 6 months after normal delivery or cesarean section and/or late puerperium and pre-term newborn care, neonatal care, specialist care and intensive care
Options I, II & III
• US$1,000,000 per covered pregnancy, per lifetime
Including obstetric emergencies, up to 6 months after normal delivery or cesarean section and/or late puerperium and pre-term newborn care, neonatal care, specialist care and intensive care
Inclusión del recién nacido
Options I, II & III
• Without underwriting if born from a covered maternity within the maternity network and when the newborn is added to the policy within 60 days after birth
Intra-uterine Inclusion
• 100% coverage within the Ecuadorian territory
Notification period from 20 to 32 weeks of gestation
• Without underwriting if born from a covered maternity within the maternity network and when the newborn is added to the policy within 60 days after birth
Intra-uterine Inclusion
• 100% coverage within the Ecuadorian territory
Notification period from 20 to 32 weeks of gestation
Extracción y almacenamiento de células madres
No deductible applies, after a 60-day waiting period
Options I, II & III
• US$2,000 per covered pregnancy for extraction and storage for 1 year
Options I, II & III
• US$2,000 per covered pregnancy for extraction and storage for 1 year
Tratamiento de fertilidad
N/A
Unidad de Cuidados Intensivos Neonatales (UCIN)
Option I
• 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
Included in the maternity benefit
Beneficios de evacuación médica
Transportación de emergencia por ambulancia terrestre
100% no deductible applies
Transportación de emergencia por ambulancia aérea
100% no deductible applies
Transportación de emergencia por ambulancia fluvial
Included in the emergency transportation by ground ambulance benefit
Pasaje aéreo de regreso del asegurado y del acompañante después de una evacuación por ambulancia aérea
US$2,000 per person, for a return economy class ticket
Repatriación de restos mortales
100%
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
100%
Cirugía correctiva o reconstructiva en caso de enfermedad o accidente
100%
Cirugía refractiva
N/A
Cuidados paliativos en casos terminales
100%
Cobertura provisional para accidentes mientras se procesa la solicitud
US$30,000 per lifetime, for medical expenses arising from bodily injury sustained in an accident occurring from the time the completed application and full premium are received until the date coverage begins or 60 days from the date the application is received, whichever comes first
Cobertura gratuita extendida a dependientes elegibles después de la muerte del contratante
1 year for contractual dependents and beneficiaries
Cobertura gratuita para dependientes
N/A
Eliminación/reducción del deducible por no presentar reclamos o no haber alcanzado el deducible
Options I, II, III & IV
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims
Eliminación del deducible
• Elimination of deductible in the first hospitalization in case of a serious accident
• Elimination of deductible up to US$5,000 in case of an accident or emergency that occurs while the insured is traveling outside of his/her country of residence
• Elimination of deductible up to US$5,000 in case of an accident or emergency that occurs while the insured is traveling outside of his/her country of residence
Segunda opinión médica
Included
Prótesis externas
Included in the durable medical equipment benefit at 100%
Tratamiento dental mayor o de rutina
US$50
Reembolso por viaje para tratamientos en la red de centros de excelencia de Latinoamérica
US$2,000 per person, for a return economy class ticket
Guerra y terrorismo
N/A
Seguro de vida a término
N/A
Condiciones preexistentes declaradas
Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 24-month waiting period
Disability
• Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 3-month waiting period
Disability
• Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 3-month waiting period
Enfermedades catastróficas y crónicas sobrevinientes a la contratación
100% after a 30-day waiting period for outpatient services and 90 days for inpatient services
Coverage within Ecuadorian territory for conditions named and determined by the national health authority
Coverage within Ecuadorian territory for conditions named and determined by the national health authority
Condiciones catastróficas y raras
US$1,000 additional to the amount of drugs prescribed for treatment with growth stimulants
Emergencia médica
US$1,000 with no deductible, after this amount the coverage will be 100% with deductible, after a 24 hour waiting period
Enfermedad o lesión en aeronave privada
100%
Tratamientos anticonceptivos
US$300
Servicios de consultoría para pacientes
Best Doctors Concierge
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