Salud S.A. Experience World
Type of plan
Experience World
Cobertura máxima por segurado
US$1,000,000 per policy year / US$3,000,000 per policy year
Idade limite para solicitar cobertura
Unlimited
Período de carência
• 30 days for outpatient treatment
• 90 days for inpatient and disability treatment
• 90 days for inpatient and disability treatment
Cobertura fora dos Estados Unidos
100% worldwide without restrictions of doctors and hospitals
Cobertura dentro dos Estados Unidos
• 100% through the preferred provider network
• Outside the preferred provider network coverage will be at 80%
• Emergency medical treatment will be covered 100% up to the policy limits
• Outside the preferred provider network coverage will be at 80%
• Emergency medical treatment will be covered 100% up to the policy limits
Coberturas Hospitalares
Quarto de hospital padrão particular
100% up to the coverage limit
Benefício especial para uma suíte
N/A
Unidade de cuidados intensivos
100% up to the coverage limit
Acompanhante durante uma hospitalização
At the Clínica Universidad de Navarra
• 100% during radiotherapy or chemotherapy treatments in day hospital regime
• 100% during radiotherapy or chemotherapy treatments in day hospital regime
Medicamentos prescritos durante uma internação
100%
Tratamento hospitalar para saúde mental
Included in the specialized treatments benefit, up to 80% of US$200
Coberturas Ambulatoriais
Sala de emergência
100%
Consultas médicas e de especialistas
80% up to US$80 per visit
Consultas médicas e de especialistas em residência
Medical consultations
• Unlimited visits, co-payment applies according to the sector where the visit takes place
Specialty medical consultations
• 4 visits
• Unlimited visits, co-payment applies according to the sector where the visit takes place
Specialty medical consultations
• 4 visits
Medicamentos prescritos
100%
Terapias complementares
Physical rehabilitation therapy, speech therapy and respiratory therapy
• Up to 30 days worldwide
• Up to 40 sessions in Ecuador
Homeopathy, acupuncture and chiropractic therapy
• Up to 12 consultations
• Up to 30 days worldwide
• Up to 40 sessions in Ecuador
Homeopathy, acupuncture and chiropractic therapy
• Up to 12 consultations
Cuidados de enfermagem no domicílio / home care
N/A
Exame médico preventivo (check-up)
80% up to US$200
Aparelhos auditivos
N/A
Doença de Alzheimer
N/A
Autismo
N/A
Cirurgia ambulatorial
100%
Terapia de reposição hormonal para aliviar os sintomas da menopausa
N/A
Benefícios Gerais
Honorários do cirurgião e do anestesista
100%
Serviços de estudos diagnósticos
Laboratory tests, pathology, X-rays, MRI/CT/PET scans
Inpatient
• 100%
outpatient
• 80%
Inpatient
• 100%
outpatient
• 80%
Oncologia: exames de câncer, tratamento (quimioterapia e/ou radioterapia) e medicamentos
100% up to 180 sessions
Diálise
100% up to 45 days
Cirurgia para reduzir o risco de câncer ou cirurgia profilática
N/A
Prótese e meios corretivos implantados durante uma cirurgia
Included in the durable medical equipment benefit of 100%
At the University of Navarra Clinic
• US$15,000 for internal trauma prostheses, intraocular lenses, breast prostheses as a result of breast tumor, abdominal meshes, cochlear implants, spinal neurostimulators and deep brain neurostimulators for Parkinson's disease, heart valves, pacemakers, defibrillators, by-pass prostheses, defibrillators and deep brain neurostimulator for Parkinson's disease, heart valves, pacemakers, defibrillators, vascular by-pass prostheses, vascular stents, portocaval shunts, biliary prostheses, portha-cat, venous reservoirs, catheters, nephrotomies, coils and CSF shunt valve
At the University of Navarra Clinic
• US$15,000 for internal trauma prostheses, intraocular lenses, breast prostheses as a result of breast tumor, abdominal meshes, cochlear implants, spinal neurostimulators and deep brain neurostimulators for Parkinson's disease, heart valves, pacemakers, defibrillators, by-pass prostheses, defibrillators and deep brain neurostimulator for Parkinson's disease, heart valves, pacemakers, defibrillators, vascular by-pass prostheses, vascular stents, portocaval shunts, biliary prostheses, portha-cat, venous reservoirs, catheters, nephrotomies, coils and CSF shunt valve
Transplante de órgãos e tecido
80% Outpatient / 100% Inpatient
• US$250,000 per lifetime
• US$250,000 per lifetime
Cobertura para o doador vivo
80% Outpatient / 100% Inpatient
• US$20,000 per lifetime
• US$20,000 per lifetime
Equipamento médico-hospitalar
For valve prostheses, pacemakers, implantable cardiodesfibrillators, stents, endoprostheses, catheters, knee, shoulder, hip prostheses stents, stents, endoprostheses, catheters, knee, shoulder, hip and osteosynthesis prostheses
• 100%
• 100%
Tratamento de alergia
N/A
Fisioterapia e reabilitação
Included in the complementary therapy benefit of 100% for up to 30 days worldwide and 40 sessions in Ecuador
Tratamentos especializados
Psychiatrist and psychologist
• 80% up to US$200
Nutritionist
• 80% up to US$200
• 80% up to US$200
Nutritionist
• 80% up to US$200
Condições congênitas diagnosticadas antes dos 18 anos
Outpatient
• 80%
• 80%
Condições congênitas diagnosticadas na idade de 18 ou após
Outpatient
• 80%
• 80%
HIV-AIDS
Not specified
Tratamento cirúrgico de distúrbios sintomáticos do pé
N/A
Psicoterapia
Included in the specialized treatments benefit, 80% up to US$200
Medicamentos prescritos para saúde mental
Not specified
Benefícios de Maternidade
Maternidade
Worldwide
After a 60-day waiting period
• US$4,000 includes maternity and newborn complications and prenatal and postnatal care
After a 10-month waiting period
• US$20,000 includes maternity and newborn complications, and prenatal and postnatal care
In Ecuador, no deductible on US$200 option
• US$4,500 includes vitamins and maternal vaccinations at 80% up to US$1,000
• 80% Outpatient
• 100% Inpatient
After a 60-day waiting period
• US$4,000 includes maternity and newborn complications and prenatal and postnatal care
After a 10-month waiting period
• US$20,000 includes maternity and newborn complications, and prenatal and postnatal care
In Ecuador, no deductible on US$200 option
• US$4,500 includes vitamins and maternal vaccinations at 80% up to US$1,000
• 80% Outpatient
• 100% Inpatient
Complicações de maternidade e do nascimento
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• US$50,000 for maternity complications
• US$10,000 until the 28th day of birth
• 80% Outpatient
• 100% Inpatient
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• US$50,000 for maternity complications
• US$10,000 until the 28th day of birth
• 80% Outpatient
• 100% Inpatient
Inclusão de recém-nascido
Not specified
Extração e armazenamento de células tronco
N/A
Tratamento de fertilidade
N/A
Unidade de Cuidados Intensivos Neonatais (UCIN)
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• Included in the maternity and newborn complications benefit up to US$50,000 for maternity complications and US$10,000 for newborn complications
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• Included in the maternity and newborn complications benefit up to US$50,000 for maternity complications and US$10,000 for newborn complications
Cuidados pré-natais e pós-natais
Worldwide
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• 1 visit per month for well-baby checkup, up to 2 years of age
• US$700 for vaccinations up to 2 years of age
• Included in the maternity benefit of US$4,000 and US$10,000 according to the applicable waiting period for conception
In Ecuador
• 1 visit per month for well-baby checkup, up to 2 years of age
• US$700 for vaccinations up to 2 years of age
Benefícios de Evacuação Médica
Transporte de emergência por ambulância terrestre
US$1,000
Transporte de emergência por ambulância aérea
National
• US$5,000
International
• US$25,000
• US$5,000
International
• US$25,000
Passagem aérea de volta do segurado e acompanhante após uma evacuação por ambulância aérea
N/A
Repatriação de restos mortais
Benefit of funeral product is mentioned but no amounts or type of coverage are mentioned
Outros Benefícios
Lesões durante o treinamento ou na prática de hobbies e/ou esportes perigosos não profissionais
N/A
Lesões durante o treinamento ou na prática de esportes profissionais
N/A
Cobertura dental de emergência
Options US$200, US$1,000 and US$2,500
• Included, no amount specified
• Included, no amount specified
Cirurgia corretiva ou reconstrutiva em caso de doença ou acidente
100% for oncologic reconstructive surgery
• 80% Outpatient
• 100% Inpatient
• 80% Outpatient
• 100% Inpatient
Cirurgia refrativa ocular
Not specified
Cuidados paliativos em casos terminais
Up to US$5,000 for 15 days
• 80% Outpatient
• 100% Inpatient
• 80% Outpatient
• 100% Inpatient
Cobertura provisória para acidentes enquanto se processa a solicitação do seguro
• US$400 for emergencies and medical emergencies
• US$240 for prenatal checkups for pregnancy developed during the vesting period
• US$240 for prenatal checkups for pregnancy developed during the vesting period
Cobertura gratuita prorrogada para dependentes após a morte do titular da apólice
N/A
Cobertura gratuita para dependentes
N/A
Eliminação / redução da franquia por não apresentar reembolsos
N/A
Eliminação da franquia
N/A
Segunda opinião médica
Included
Prótese de membros
US$120,000 per lifetime / US$30,000 per event
Tratamento odontológico maior ou de rotina
Options US$200, US$1,000 and US$2,500
• Included, no amount specified
• Included, no amount specified
Reembolso de viagens para tratamentos na rede de centros de excelência da América Latina
N/A
Guerra e Terrorismo
N/A
Seguro de vida temporário
N/A
Condições pré-existentes declaradas
Up to US$1,500 after 12 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to US$3,000 after a 24 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 24-month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all disabilities
• 80% Outpatient
• 100% Inpatient
Disability
• Up to 20 Ecuadorian base salaries for all disability conditions, after a waiting period of 3 months
• 80% Outpatient
• 100% Inpatient
Up to US$3,000 after a 24 month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all pre-existing conditions in a policy year, after a 24-month waiting period
• 80% Outpatient
• 100% Inpatient
Up to 20 Ecuadorian base salaries for all disabilities
• 80% Outpatient
• 100% Inpatient
Disability
• Up to 20 Ecuadorian base salaries for all disability conditions, after a waiting period of 3 months
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
N/A
Serviços de concierge para pacientes
N/A
Assistência de viagem
• Elimination of the deductible for emergencies or accidents outside the country of residence
• Saludsa Travel: US$100,000 for medical assistance for business or pleasure trips abroad, without deductible
• US$10,000 per event, for emergencies on trips to the United States
• Saludsa Travel: US$100,000 for medical assistance for business or pleasure trips abroad, without deductible
• US$10,000 per event, for emergencies on trips to the United States
Benefício hospitalário em dinheiro
N/A
Benefícios adicionais opcionais
Evacuação para o país de escolha do segurado, país de residência ou país de origem
N/A
Evacuação não emergencial
N/A
Exoneração do período de espera para condiciones preexistentes
N/A