Palig Ecuador World Access
Type of plan
World Access
Maximum coverage per insured
US$5,000,000 per policy year
Age limit to apply
75
Waiting period
• 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
Coverage outside USA
100% worldwide without restrictions of doctors and hospitals
Coverage inside USA
100% worldwide without restrictions of doctors and hospitals
Inpatient Benefits
Standard private hospital room
100% Up to the limits of the coverage
Special benefit for suite
N/A
Intensive care unit
100% Up to the limits of the coverage
Adult companion accommodation during a hospitalization
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
Prescribed medications while hospitalized
100%
Psychiatric treatments
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)
Outpatient Benefits
Emergency room
100%
Physician and specialist visits
100%
Physician and specialist home visits
100%
Prescribed medications
US$10,000
Complementary therapy
N/A
Nurse care at home
Included in the home healthcare benefit 100%
Preventive health checkup
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
Hearing aids
N/A
Alzheimer’s disease
Included in the alternative therapies benefit at 100%
Autism
Included in the benefit for congenital conditions diagnosed before 18 years old, up to US$1,000,000
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
N/A
Prostheses and medical appliances implanted during surgery
100%
Organ and tissue transplant
Per organ/tissue
• US$1,500,000 per lifetime
• US$1,500,000 per lifetime
Benefits for live donors
US$50,000 per lifetime, included in the organ transplant benefit
Durable medical equipment
100%
Allergy treatments
N/A
Physical therapy and rehabilitation
100% (maximum 60 days per policy year)
Specialized treatments
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
Congenital conditions diagnosed before age 18
US$300,000 lifetime
Newborn from a non-covered maternity
• US$5,000 lifetime
Newborn from a non-covered maternity
• US$5,000 lifetime
Congenital conditions diagnosed after age 18
100%
HIV-AIDS
US$ 500,000 lifetime
Other sexually transmitted diseases
• US$20,000 lifetime
Other sexually transmitted diseases
• US$20,000 lifetime
Surgical treatment of symptomatic foot disorders
100%
Psychology
US$200 up to 2 consultations per policy year
Mental health prescription medication
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.
Maternity Benefits
Maternity
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
Maternity and birth complications
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
Inclusion of the newborn
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.
Extraction and storage of umbilical cord blood stem cells
N/A
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
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
Pre-natal and post-natal care
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
Medical Evacuation Benefits
Emergency transportation by ground ambulance
US$100,000 no deductible applies, includes emergency transportation by air and water ambulance.
Emergency transportation by air ambulance
100% no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulance
N/A
Repatriation of mortal remains
100%
Other Benefits
Injuries during the training or practice of hazardous hobbies and sports (non-professional)
US$250,000
Injuries during the training or practice of professional sports
N/A
Emergency dental coverage
100% for treatment during the first 120 days following the covered accident.
Reconstructive surgery after an accident or illness
100% if medically necessary and as a result of a medical condition covered by the policy
Refractive eye surgery
Coverage for keratoconus from visual refraction origin
• US$5,000 per lifetime
• US$5,000 per lifetime
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
2 years for insured members of the family
Free coverage for dependents
N/A
Elimination/reduction of deductible for no claims made or not having met the deductible
N/A
Deductible elimination
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
Second medical opinion
Included
Prosthetic limbs
100%
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 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
Catastrophic and chronic illnesses that survive the contracting of the service
N/A
Catastrophic and unusual conditions
N/A
Medical emergency
100%
Illness or injury in private aircraft
N/A
Contraceptive treatments
US$100
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