Upload
others
View
1
Download
0
Embed Size (px)
Citation preview
2020
International coverage for seniors including preventive benefits with access to the highest quality providers and GBG’s Security Network in the U.S.
Geographic Coverage Areas
Global Wellness provides worldwide coverage with access to a U.S. Preferred Provider Network containing more than 5,000 hospitals and 550,000 providers with an option for coverage out-of-network. Outside of the U.S. members can access any provider of their choice. This extensive geographic coverage area and use of provider networks allow GBG to provide first class worldwide coverage while maintaining affordable rates.
Global Wellness is tailored exclusively for individuals and couples over the age of 60 residing in Latin America and the Caribbean who seek affordable, comprehensive international health insurance with access to an outstanding U.S. medical provider network.
The plan offers a range of deductibles for members and provides coverage for inpatient care, outpatient care, emergencies, plus a pharmacy and preventive benefit and more.
As with all GBG plans, Global Wellness includes the world-class services of GBG Latin America for case management and evacuations, if necessary, anywhere in the world any time of day. GBG services include a vast network of medical facilities that will bill the Company directly, eliminating the need for a member to pay up-front for services.
Global Wellness also includes the GBG Personal Medical Advisor, one of the world’s leading Medical Second Opinion services.
This is only a brief summary of key Plan provisions. Please refer to the Policy for complete details. Benefits are per person per Policy Period and are based upon medical necessity and Usual, Customary and Reasonable (UCR) charges, after Policy Period Deductible. Currency: USD
Global Wellness Schedule of BenefitsMAXIMUM BENEFIT
Policy Period Maximum of $500,000Lifetime Maximum $2,500,000
PROVIDER NETWORK • Worldwide excluding USA: Free choice of Providers.
• USA: The Insurer maintains the GBG Global Security Network. In-network benefits are paid at 100%. Out-of-network benefits are paid at 70%.
HOSPITALIZATION BENEFITS
Private/Semi-private room including; medical treatment, medicines, laboratory and diagnostic tests
100%; up to $2,250 per day, for the first 120 days of the hospitalization; then $750 per day
thereafter
Intensive care including; medical treatment, medicines, laboratory and diagnostic tests
100%up to $3,000 per day, for the first 30 days of the hospitalization; then $1,000 per day
thereafter
Inpatient Surgery/Inpatient surgeon and consultation 100%; up to $50,000 per Policy Period
Accommodation charges for companion of a hospitalized Insured Up to $2,000 or Private Duty Nursing, maximum $200 per day
OUTPATIENT BENEFITS
Outpatient physician/specialist visit100%;
up to $100 per visit; maximum 12 visits per Policy Period
Diagnostic exams including laboratory and imaging tests 100%; up to $500 per exam
Outpatient surgery, medical and nursing fees 100%; up to $50,000 per Policy Period
Physical therapy and rehabilitation services100%;
up to $100 per visit; maximum 30 visits per Policy Period, all therapies combined
Preventive Care/Checkup (10 month Waiting Period applies)100%;
$150 Maximum per Policy Period; Deductible waived
Prescribed medication after covered hospitalization or consultation 100%; up to $1,000 per Policy Period
POLICY PERIOD DEDUCTIBLESPlan Outside the USA Inside the USA
Plan 1 $3,000 $5,000
Plan 2 $10,000 $10,000
Plan 3 $20,000 $20,000
Deductible per Individual
This is only a brief summary of key Plan provisions. Please refer to the Policy for complete details. Benefits are per person per Policy Period and are based upon medical necessity and Usual, Customary and Reasonable (UCR) charges, after Policy Period Deductible. Currency: USD
EMERGENCIES
Ground Ambulance 100%; Deductible waived
Air Ambulance Not covered
Emergency room and medical services 100%
Emergency Dental Care (Limited to accidental injury of sound natural teeth). Services must be completed within 120 days of Accident
100%; up to $25,000 Lifetime Maximum
SPECIALIZED TREATMENTS
Transplant Procedures(in the U.S. Institutes of Excellence facilities approved by GBG only)
100%; $175,000 Lifetime Maximum per diagnosis
includes donor expenses and donor procurement expenses up to $15,000
OPTIONAL RIDER: Additional $350,000 added to Lifetime Maximum
OTHER BENEFITS
Oncologic treatment 100%; up to $80,000 per Policy Period
GBG Personal Medical Advisor - Medical Second Opinion Included
Home Health Care/ Home Care100%;
up to $100 per day; maximum 30 days per Policy Period
Hospice Care 100%; up to $750 per day; maximum 120 days
Durable Medical Equipment 100%; up to $2,000 per Policy Period
Hearing Aids 100%; up to $1,000 Lifetime Maximum
War and Terrorism Benefit 100%
Repatriation of Mortal Remains $7,500 maximum per Insured
This is only a brief summary of key Plan provisions. Please refer to the Policy for complete details. Benefits are per person per Policy Period and are based upon medical necessity and Usual, Customary and Reasonable (UCR) charges, after Policy Period Deductible. Currency: USD
• Lifetime Maximum of $2,500,000• Inpatient and Outpatient Coverage • Worldwide Direct-bill Network• Online Claims Filing• Live Customer Service• Preventive Benefits• Transplant Procedure Benefit and Optional Rider• Worldwide Portability
Key Benefits
THE FOLLOWING SERVICES REQUIRE PRE-AUTHORIZATION• Hospitalization• Exams or Outpatient procedures that requires more than local anesthesia• Oncologic Treatment in excess of $10,000• Home Health Benefits/ Home Care • Organ, bone Marrow, stem cell transplants, and other similar procedures• Specialty Treatments and Highly Specialized drugs • Any condition that is expected to accumulate over $10,000 of medical treatment per Policy Period.
NOTE: Failure to pre-authorize a procedure that requires Pre-authorization will result in a 30% penalty.
(Except organ, bone marrow, stem cell transplants, and other transplant similar procedures not Pre-Authorized by the Company will not be covered)
GBG Latin America7600 Corporate Center Drive, Suite 500
Miami, FL 33126 USA
LATA
M_G
WEL
LNES
S_EN
G_0
1FEB
2020