Bupa Ecuador Global Select

Type of plan
Global Select
Maximum coverage per insured
US$2,000,000 per policy year
Age limit to apply
Unlimited
Waiting period
• 30 days for outpatient treatment
• 90 days for inpatient treatment
Coverage outside USA
Ecuador
• 100% without restrictions of doctors and hospitals

Rest of the world
• Only through the Bupa Global Network
Coverage inside USA
100% within the preferred provider network
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 under age 18 or older than 75
• 100%
Prescribed medications while hospitalized
100%
Psychiatric treatments
Mental Health during hospitalization
• 100% up to 90 visits, per lifetime
Outpatient Benefits
Emergency room
100%
Physician and specialist visits
100%
Physician and specialist home visits
Not specified
Prescribed medications
Option I
• 80% up to US$5,000, a 20% coinsurance applies
• 100% after US$5,000

Options II, III, IV & V
• 100%
Complementary therapy
N/A
Nurse care at home
Home Nursing
• US$300 per day, up to 30 days

Nurse practitioners as outpatient treatment
• 100% up to 15 days
Preventive health checkup
No deductible, after a 10-month waiting period
• US$400 for general health examination

Vaccines such as HPV, influenza, pneumococcal, malaria and travel vaccinations
• 80% up to US$300, no deductible applies
Hearing aids
N/A
Alzheimer’s disease
Mental Health
• 100% up to 15 visits
Autism
Mental Health
• 100% up to 15 visits
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%
Oncology: cancer tests, treatment (chemotherapy and/or radiotherapy) and medication
100%
Dialysis
100%
Surgery to reduce the risk of cancer or prophylactic surgery
Preventive surgery
• 100%
Prostheses and medical appliances implanted during surgery
100%
Organ and tissue transplant
Per organ/tissue
• US$500,000 per lifetime
Benefits for live donors
Included in the organ and tissue transplant benefit up to US$500,000, no limit specified
Durable medical equipment
US$8,000
Allergy treatments
N/A
Physical therapy and rehabilitation
Multidisciplinary rehabilitation
• US$300 per day, up to 30 days
Specialized treatments
Inpatient
• Physical therapy, occupational therapy, kinesiology, speech therapy and nutritionist, 100%

Outpatient
• Physical therapy, osteopathy and chiropractics, 100% up to 20 visits
Congenital conditions diagnosed before age 18
US$200,000 per lifetime
Congenital conditions diagnosed after age 18
US$500,000 per lifetime
HIV-AIDS
US$300,000 per lifetime, after a 3-month waiting period for inpatient procedures and 1-month waiting period for outpatient procedures
Surgical treatment of symptomatic foot disorders
N/A
Bariatric surgery
100% after a 3-month waiting period
Psychology
Mental Health
• 100% up to 15 visits
Mental health prescription medication
N/A
Maternity Benefits
Maternity
N/A
Maternity and newborn complications
N/A
Inclusion of the newborn
N/A
Extraction and storage of umbilical cord blood stem cells
N/A
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
N/A
Pre-natal and post-natal care
N/A
Medical Evacuation Benefits
Emergency transportation by ground ambulance
100%
Emergency transportation by air ambulance
100%
Insured’s and companion’s return ticket after an evacuation by air ambulance
100%

Travel costs for one accompanying person
• 100%

Food and transportation costs for accompanying person
• US$100 per day, up to 10 days
Repatriation of mortal remains
100%
Other Benefits
Injuries during the training or practice of hazardous hobbies and sports (non-professional)
100%
Injuries during the training or practice of professional sports
N/A
Emergency dental coverage
100% as long as the first expense is incurred within 30 days after the accident
Reconstructive surgery after an accident or illness
100%
Refractive eye surgery
N/A
Palliative care for terminal cases
100%
Temporary coverage for accidents while application is being underwritten
Not specified
Free extended coverage for eligible dependents after policyholder’s death
1 year if occurs from a covered event
Free coverage for dependents
N/A
Deductible elimination/reduction for no claims made
N/A
Deductible elimination
N/A
Second medical opinion
Included
Prosthetic limbs
100% up to 2 replacements
Routine and major dental treatment
N/A
Travel reimbursement for treatment in centers of excellence Latam network
N/A
War and terrorism
N/A
Term life insurance
N/A
Declared pre-existing conditions
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
Catastrophic and chronic illnesses that survive the contracting of the service
Rare and orphan or catastrophic diseases treated in Ecuador
• US$1,000,000
Catastrophic and unusual conditions
N/A
Medical emergency
100%
Illness or injury in private aircraft
N/A
Contraceptive treatments
Covered, not specified amount in sales material
Patient concierge services
Not specified
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