VUMILATINA Absolute VIP
Type of plan
Absolute VIP
Maximum coverage per insured
Unlimited
Age limit to apply
Unlimited
Waiting period
30 days
Coverage outside USA
100% worldwide without restrictions of doctors and hospitals
Coverage inside USA
100% without restrictions of doctors and hospitals
Inpatient Benefits
Standard private hospital room
100%
Special benefit for suite
N/A
Intensive care unit
100%
Adult companion accommodation during a hospitalization
Related to a hospitalization of an insured under age 16 or older than 75
• US$500 per night, max. of 25 nights
• In Ecuador coverage from the 26th night will be US$50 per night
• US$500 per night, max. of 25 nights
• In Ecuador coverage from the 26th night will be US$50 per night
Prescribed medications while hospitalized
100%
Psychiatric treatments
N/A
Outpatient Benefits
Emergency room
100%
Physician and specialist visits
100%
Physician and specialist home visits
N/A
Prescribed medications
100%
Complementary therapy
Ancestral and alternative medicine
• US$6,000
• US$6,000
Nurse care at home
100%
Preventive health checkup
Zero rate coverage
• US$300
• US$300
Hearing aids
US$3,000 per lifetime
Alzheimer’s disease
100%
Autism
• 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
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
US$30,000 per lifetime, after a 90-day waiting period
Prostheses and medical appliances implanted during surgery
100%
Organ and tissue transplant
Per organ/tissue
• US$3,000,000 per lifetime
• US$3,000,000 per lifetime
Benefits for live donors
US$80,000 per lifetime, included in the organ transplant benefit
Durable medical equipment
100%
Allergy treatments
100%
Physical therapy and rehabilitation
100% including cardiac rehabilitation therapy, respiratory therapy, and speech therapy
Specialized treatments
Psychiatrist and occupational therapy
• US$4,000
Sleep apnea and other sleep disorders
• US$4,000
• US$4,000
Sleep apnea and other sleep disorders
• US$4,000
Congenital conditions diagnosed before age 18
US$2,000,000 per lifetime
Congenital conditions diagnosed after age 18
100%
HIV-AIDS
US$1,000,000 per lifetime, only in case of pre-existence a 24-month waiting period will apply
Surgical treatment of symptomatic foot disorders
100%
Psychology
US$6,000
Mental health prescription medication
US$200 for health conditions resulting from actions and/or illnesses due to drug use, narcotics, drunkenness, alcoholism and injuries due to mental health disorders, states of dementia including those resulting from suicide attempt
Maternity Benefits
Maternity
No deductible applies, after a 60-day waiting period
Option I
Inside the Special Maternity Network
• 100% per pregnancy for normal delivery
• US$10,000 per pregnancy for cesarean delivery
Outside the Special Maternity Network
• US$8,000 per pregnancy for normal delivery
• US$10,000 per pregnancy for cesarean delivery
Option I
Inside the Special Maternity Network
• 100% per pregnancy for normal delivery
• US$10,000 per pregnancy for cesarean delivery
Outside the Special Maternity Network
• US$8,000 per pregnancy for normal delivery
• US$10,000 per pregnancy for cesarean delivery
Maternity and birth complications
No deductible applies, after a 60-day waiting period
Option I
• US$1,000,000 per covered pregnancy, up to 6 months after birth, per lifetime
Option I
• US$1,000,000 per covered pregnancy, up to 6 months after birth, per lifetime
Inclusion of the newborn
Option I
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
Intra-uterine Inclusion, within the Ecuadorian territory
After a 60-day waiting period
• US$8,000 no deductible, closed network
• 100% open network
Notification period from 20 to 32 weeks of gestation
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
Intra-uterine Inclusion, within the Ecuadorian territory
After a 60-day waiting period
• US$8,000 no deductible, closed network
• 100% open network
Notification period from 20 to 32 weeks of gestation
Extraction and storage of umbilical cord blood stem cells
No deductible applies, after a 60-day waiting period
Option I
• US$2,000 per covered pregnancy for extraction and storage for 1 year
Option I
• US$2,000 per covered pregnancy for extraction and storage for 1 year
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
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
Pre-natal and post-natal care
Does not apply to dependent daughters
Pre-natal care
• US$40 per visit, only applies for non-covered maternities
Post-natal care
• US$50
Pre-natal care
• US$40 per visit, only applies for non-covered maternities
Post-natal care
• US$50
Medical Evacuation Benefits
Emergency transportation by ground ambulance
100% no deductible applies
Emergency transportation by air ambulance
100% no deductible applies
Emergency transportation by river ambulance
100% no deductible applies
Insured’s and companion’s return ticket after an evacuation by air ambulance
US$2,000 per person
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
100%
Emergency dental coverage
100% for treatment within the first 180 days of 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
Option I
• US$500 per eye, per lifetime, after a 60-day waiting period
• US$500 per eye, per lifetime, after a 60-day waiting period
Palliative care for terminal cases
US$50,000 per lifetime
Temporary coverage for accidents while application is being underwritten
US$30,000
Free extended coverage for eligible dependents after policyholder’s death
• 2 years if occurs from a covered event
• 1 year if occurs from a non-covered event
• 1 year if occurs from a non-covered event
Free coverage for dependents
N/A
Elimination/reduction of deductible for no claims made or not having met the deductible
Options I & IV
• Elimination for 1 policy year after the end of the 3rd year without claims
Options V & VI
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims
• Elimination for 1 policy year after the end of the 3rd year without claims
Options V & VI
• Reduction of up to 50% for 1 policy year after the end of the 3rd year without claims
Deductible elimination
Elimination of deductible for the first medical treatment in an emergency room, hospital or emergency facility within 24 hours after a serious accident
Second medical opinion
Included
Prosthetic limbs
Included in the durable medical equipment benefit at 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 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
Catastrophic and chronic illnesses that survive the contracting of the service
All conditions not related to the use of psychotropic substances, undeclared pre-existing conditions and exclusions of this plan are covered
Catastrophic and unusual conditions
• US$200
• US$200 additional medications prescribed during treatment with growth stimulants
• US$200 additional medications prescribed during treatment with growth stimulants
Medical emergency
100% after a 24-hour waiting period
Illness or injury in private aircraft
N/A
Contraceptive treatments
N/A
Patient concierge services
VIP Patient Concierge Services
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