Gold Plus

Gold Plus

Description: This plan is a full inpatient and outpatient plan and most take it with a low deductible. This plan is also called Global Fusion Gold Plus. There is another less expensive version of this plan called Gold which has identical benefits for the first 3 years. The coverage amounts decline after the 3rd renewal. So if you only want 3 years of cover then ask us for a quote on Gold.

A: In-Patient & Day-Patient Treatment
1. Surgery, Surgeons, Consultants, Second Surgical Opinion, Medical Practitioner and Nurse, Treatment, Services and Supplies routinely provided and Ancillary Charges. FULL COVER

2. Hospitalization/Room & Board. FULL COVER

3. Intensive Care Unit. FULL COVER

4. Anesthetist’s Charges associated with Surgery. FULL COVER

5. Diagnostic Tests and Procedures, X-Rays, Pathology, & MRI/CT Scans. FULL COVER

6. Prescribed Drugs, Dressings and Durable Medical Equipment. FULL COVER

7. Reconstructive Surgery-following an accident or following surgery for an eligible condition. FULL COVER

8. Cancer Tests, Drugs, Treatment and Consultants, including cover for Chemotherapy and Radiotherapy. FULL COVER

9. Physiotherapy. FULL COVER

10. Parental Hospital Accommodation. FULL COVER

11. Prosthetic Devices. FULL COVER

12. Transplants. $1,000,000 Lifetime Limit

B: Out-Patient Treatment, Wellness Benefits and Other Coverage

1. Out-Patient including:
Family Doctor, Treatment and Referrals, Specialists and Consultants, X-Rays, Pathology, Diagnostic Tests and Procedures. FULL COVER

2. Emergency Room Illness, Waived if admitted as an In-Patient or Day- Patient (Additional $250 Excess/Deductible if not admitted). FULL COVER

3. Emergency Room Accident. FULL COVER

4. Supplemental Accident Benefit. $300 per covered accident

5. Out-Patient Surgery. FULL COVER

6. MRI, CAT Scan Echocardiography, Endoscopy, Gastroscopy Colonoscopy, Cystoscopy. FULL COVER

7. Cancer Tests, Drugs, Treatment and Consultants, including cover for Chemotherapy and Radiotherapy. FULL COVER

8. Prescribed Out-Patient Drugs, Medicines, Dressings and Durable Medical Equipment. FULL COVER

9. AIDS/HIV Treatment. Up to $5,000 per Period of Insurance $50,000 Lifetime Limit

10. Home Nursing Care. 45 Day Limit: Up to $150 per visit

11. Rehabilitation. Full Cover Up to 90 Days

12. Extended Care Facility. Full Cover Up to 90 Days

13. Hospice Care. Full Cover Up to 180 Days

14. Adult Wellness and Health Check
– includes Hearing Test, Sight Test and Vaccinations/Inoculations (Not subject to Annual Excess or Co- Insurance)
– After 12 months continuous cover
Up to $250
Available for those age 30 and over

15. Child Wellness and Health Check (Under 18 years of age)
– includes Hearing Test, Sight Test and 17 Vaccinations/Inoculations (Not subject to Annual Excess or Co- Insurance)
– After 12 months continuous coverage (6 months on Platinum)
Up to $200

16. Pre-Existing Medical Conditions Standard Underwriting:
– After 24 months continuous cover
-Declared and Accepted conditions
Up to $5,000, $50,000 Lifetime Limit

17. Newly Diagnosed Chronic Conditions. Covered

18. Mental/Nervous
– After 12 months continuous coverage
Up to $10,000, $50,000 Lifetime Limit


C: Travel, Transportation and Out of Area Benefits

1. Emergency Local Ambulance. FULL COVER

2. Emergency Evacuation and Transportation To the Nearest Suitable Hospital Facility.
FULL COVER
Not subject to Annual Excess/Deductible or Co-Insurance

3. Accompanying Relative, Travel and Accommodation. $10,000 Lifetime Limit

4. Cremation/Burial or Return of Mortal Remains.
$25,000 Lifetime Limit
Not subject to Annual Excess/Deductible or Co-Insurance

5. Security & Political Evacuation & Repatriation. No Cover

6. Worldwide Accident & Emergency Out of Area Cover (USA Treatment Must Be within PPO Network)
30 Days Maximum

D: Dental Treatment

1. Emergency Dental Due to Accident. FULL COVER

2. Emergency Dental due to Sudden Unexpected Pain to Sound Natural Teeth . Up to $100


E: Additional Benefits & Services

1. High School Sports Injury. No Cover

2. Recreational Scuba. FULL COVER

F: Maternity

1.  Maternity – After 10 months of continuous cover
Benefits reduced 50% for births in the 11th or 12th month of policy Optional Add-On Coverage Additional Premium Applies *

2. Maternity Annual Excess
Not subject to Annual Excess/Deductible or Co-Insurance

3. Lifetime Maximum
*$50,000 Lifetime Limit

4. Normal Delivery
– Including Premature Birth Treatment, Pre, Post and Routine Natal Care. * Up to $5,000

5. Caesarian. * Up to $7,500

6. New born Baby Wellness
– Not subject to Annual or Annual Maternity Excess or Co-Insurance
– for the first 12 months of life
$200

7. Newborn cover includes non- hereditary birth defects and congenital abnormalities
*Up to $250,000 for the first 31 days
Annual Excess / Deductible Information
Annual Excess/Deductible Options:

Options from $250 to $10,000, annually per person
50% waived (max $2,500) for treatment in US PPO Network Out-Patient & Emergency In-Patient Treatment & Non-Emergency In-Patient US Medical Concierge Provider Treatment

Family Maximum Annual Excesses/Deductible:

Family pay max 3x Annual Excess

Co-Insurance Payable by Insured inside the USA:

When treatment is taken outside the US PPO Network
20% of first $5,000 after the Annual Excess/Deductible

Please refer to the full Policy documentation for all applicable terms, conditions, limitations and exclusions – Available upon request.


Search

Advertisement

Get a Quote

Do you need some help? Please contact us, we will be happy to answer any of your questions. Message Center: 1 800 507 0545 Email: info@protexplan.com