Rates Without Pre-Conditions:
Age/Rate Per Day Individual Family
0-25 $1.28 $2.56
26-40 $1.54 $3.08
41-60 $1.76 $3.52
61-64 $2.07 $4.14
65-69 $2.36 $4.72
70-74 $3.73 N/A
75-79 $4.56 N/A
80-85 $6.67 N/A
86-150 $10.28 N/A
Rates With Pre-Conditions:
Age/Rate Per Day Individual Family
0-25 $1.87 $3.74
26-40 $2.11 $4.22
41-60 $2.35 $4.70
61-64 $3.02 $6.04
65-69 $3.44 $6.88
70-74 $5.44 N/A
75-79 $6.65 N/A
Deductibles
Deductible Age Type Value
0.00 0-150 Saving 0.0%
250.00 0-85 Saving 10.0%
500.00 0-150 Saving 15.0%
1,000.00 0-85 Saving 20.0%
Coverage Benefits:

COVID 19 COVERAGE

COVID 19 COVERAGE - Hospitalization Covered


Emergency Hospital Services

In-Patient Hospital Accommodation - Semi-Private

Hospital Services and Supplies - Up to sum insured

Out-Patient Hospital Services -

Hospital Stay Allowance -


Emergency Medical Coverage

Services of physician, surgeon, anesthetist - Up to sum insured

Rental/Cost of Medical Appliances -

Laboratory Diagnostics and Tests (X-ray, MRI, etc) - Covered (May require Pre-approval)

Prescription Medications - Up to $1,000 total/30-day supply per prescription

Follow Up Treatment - Up to $3,000

Services of a Private Duty Nurse / Medical Attendant - Up to $10,000

Recreational Sports Injuries Coverage -


Paramedical Services

Chiropractor - up to $500

Osteopath - up to $500

Chiropodist - up to $500

Podiatrist - up to $500

Physiotherapist - up to $500

Acupuncturist -

Acupressurist -

Naturopath -

Holistic -


Ambulance Transportation to the nearest hospital

Ground Local Ambulance -

Air Ambulance / Emergency Air Transportation -

Sea Ambulance -

Mountain Evacuation -


Emergency Dental Services

Emergency Dental Repair -

Dental Pain Relief -


Life Insurance Coverage

Return of Deceased Body / Remains -

Cremation / Burial -

Accidental Death -

Double Dismemberment -

Single Dismemberment -

Flight Accident -


Companion and Dependents Coverage

Transportation of Family or Friend -

Meals and Accommodation -

Attendant for Dependents / Child Care -

Out-of-Pocket Expenses of Travelling Companion -

Return of Dependent Children / Travelling Companion -


Travel Coverage and Repatriation

Side-Trips Benefit -

Trip-Break Benefit -

Travel Coverage -

Emergency Return Home / Repatriation -


Maternity Benefits

Pregnancy related benefits -


Non-Medical Benefits

Return of Vehicle -

Return of Baggage and Personal Effects -


Non-Emergency Benefits

Physical and Eye Examination -

PSYCHIATRIC / PSYCHOLOGICAL -


Waiting period (Due to purchasing insurance after

Sickness-related medical treatment -

Physical injury treatment -


Stable Pre-existing Medical Conditions Coverage

Stable Pre-existing Medical Conditions Coverage -

Stability Period -


Deductible Type

Deductible Type -


Customer Care

24-HOUR EMERGENCY ASSISTANCE CALL CENTER -

Underwritten by -

Policy Wording -

CLAIM MNGT. COMP. -

CLAIM PHONE# -

ONLINE CLAIM PORTAL -

CLAIM FORM -

Summary of Benefits -