Schedule of International Personal Health Insurance Policies & Benefits

We offer the most comprehensive international health insurance plans available in the marketplace. After satisfaction of the annual deductible of your plan, the Personal Health plan underwritten by Lamp Insurance Company will pay the benefits set forth in this section at the percentage payable of the allowable charge. Once the coinsurance requirement (Out-of-Pocket) has been met, benefits are payable at 100% of the allowable charge for the remainder of the calendar year unless otherwise stated in your individual international health insurance plan.

In
North America
Plan 1 Members only		 Outside
North America
Plan 1 & 2
PPO Non PPO 1

Hospital Inpatient & Surgery

Accommodation: Hospital's average semi-private charge per day of confinement

 90%/100%  2 70% 100%

Intensive Care Unit

 90%/100%  2 70% 100%

Inpatient ancillary services *

* Blood transfusions, plasma - $5,000 per person per policy year

 90%/100%  2 70% 100%

Physician Office Visits & Specialist Fees

 90%/100%  2 70% 90/100%

Outpatient Surgery

 90%/100%  2 70% 100%

Emergency Room

 90%/100%  2 70% 100%

Diagnostic and Therapeutic Services (Outpatient) **

** Physical Therapy: per visit limit US$ 75, policy year max 30 visits;
** Occupational therapy: per visit limit US$ 75, policy year max 30 visits

 90%/100%  2 70% 90%/100%  2

Other Medical expenses

 90%100%  2 70% 90%/100%  2

Maternity Expense:

(12 month waiting period)
Normal delivery limited to $10,000 per pregnancy. Treated the same as any other condition for Insured and eligible dependents.
This benefit does not extend to dependent children. Caesarean Section and Complications of Pregnancy limited to $12,000 per pregnancy.

Routine Nursery, as any other treatment including accommodation, physician charges and circumcision for males prior to discharge.

 90%/100%  2 70% 90%/100%  2

New-Born Cover

Including Premature Births, Congenital Conditions and Birth Anomalies.
Life Time Maximum: US $25,000

 90/100%  2 70% 100%

Prescription Program

In PPO no deductible applies brand name drugs at 80% and generic drugs at 90%. Out of network (in USA only) deductible applies and no out-of-pocket lime applies. Overseas deductible applies.

 80/90%  2 70% 90%

Mental Health Benefits (Inpatient & Outpatient)

Lifetime Maximum - US $25,000
Lifetime Mental Illness, Maximum Per Insured (In-Hospital)*** 60 days
Lifetime Mental Illness, Maximum Per Insured (Out-of-Hospital)*** 80 visits
Policy Year Mental Illness, Maximum (Out-of-Hospital)*** 15 visits - US$2,500 per year

*** Does not count towards Out-Of-Pocket Maximum

 90% 70% 90%

Notes:

1 There is no Out-of-Pocket limit for treatment outside of PPO network.

2 Benefits are payable at 90% until out of pocket limit has been met. Thereafter at 100%.

Out of Pocket limits per Policy Year

Individual US $1,000. Family US $3,000
Applicable to in-PPO network treatment only. There is no Out-of-Pocket limit for treatment out of PPO network in North America.

Transplant Procedures

Lifetime maximum of US $500,000 (Tissue Transplant: Lifetime maximum of US$250,000)
Only available through the Managed Transplant Program. Transplant must be pre-certified and approved by LAMP Insurance Company Limited. Failure to comply will result in treatment not being covered by your individual or group health insurance policy.

Dental Care

Dental Care is limited to accidental injury of sound, natural teeth sustained while covered under the plan (see Dental Option for additional optional cover beyond our regular international health insurance policies)

Preventive Care / Wellness Benefits

(Subject to Policy Year Maximums (CYM) with no deductible)
6 Month Waiting Period for both Adults and Children - this does not apply if premium is paid annually.

Child Immunizations & Routine Medical Exams
100% coinsurance not subject to deductible for children from birth to age 18 for immunization against diphtheria, hepatitis B, measles, mumps, pertussis, polio, rubella, tetanus, varicella, haemophilias, influenza B, and hepatitis A, up to the dollar limits indicated.

Child Preventive Care Services
100% coinsurance not subject to deductible. Services include: health history, physical examinations, development assessments, anticipatory guidance, appropriate immunizations and laboratory tests.

Child Preventive Care is subject to the following limitations:

Policy Year Maximum

Child - Birth to age 12 months

 US $350

Child -13 months through age 1

US $200

Child - Age 18 to 23 (only if full time student)

 US $200

Adult Routine Physical Exams
90% coinsurance not subject to the deductible for charges made for or in connection with the overall health and well being for Insureds and Spouses or Domestic Partners age 18 years and over. Policy Year Maximum US$ 500.

Papanicolaou Screening Test
Treated like any other illness but not subject to deductible. Up to one test per policy year for all eligible females.

Prostate Cancer Screening
Treated like any other illness but not subject deductible. One test per policy year for males age 50 or over.

Mammograms
Treated like any other illness not subject to deductible per the following schedule:

Vision Care Cover

(6 Month Waiting Period applies) Percentage of Reasonable and Customary Cost: 100%
During a 24-Month period Maximum Benefit Per Insured: US $300

Medical Evacuation and Assistance

Insured and Insured Dependents

Other Medical Benefits

HIV/Aids Treatment: Lifetime Maximum: US $25,000

Private Duty Nursing: Lifetime maximum US $7,5000. Per Calendar year 240 hours Benefit payable at 90%

Skilled Nursing Facility: As any other treatment up a US $7,500 Lifetime Maximum

Home Health Care: As any other treatment up to a US $7,500 Lifetime Maximum.

Chiropractic Services: As any other treatment up to a US$ 750 Policy Year Maximum. Referral letter required from medical physician.

Durable Medical Equipment: As any other treatment up to a US $15,000 lifetime maximum.

Hospice Care Services: As any other treatment up to a US $10,000 Lifetime Maximum.

TMJ Treatment: As any other treatment US $1,000 Lifetime Maximum.

Personal Health Record Storage (in partnership with, and powered by Zaptag)

A secure means of storing and managing your Personal Health information. A personal Medical Card, combining a portable USB device with a online medical records storage facility, which provides the capability for individuals to take ownership of and build their complete medical history and records. The Personal Health management portal empowers individuals to securely control and access their medical and health insurance information, from any computer, anywhere in the world. A lifeline particularly for expatriates and their families when traveling away from their home medical environment and for medical staff to check critical medical information in the event of a medical emergency.

Policy Limitations & Exclusions

Pre-Existing Condition Limitation (Applies to Medical coverage Only) Pre-Existing conditions are covered after a 12 month waiting period. Thereafter, at US $5,000 annual maximum and US $50,000 maximum lifetime unless otherwise stated.

New-Born Cover, Premature Births Congenital conditions and birth anomalies: Life Time Maximum $25,000

Infertility: Procedures directly related to diagnosis are covered. Treatment, prescription drugs, and or other methods to bypass (i.e. In-vitro) are not covered.

Expenses for oral contraceptives and contraceptive devices are excluded. Expenses for prenatal vitamins, and smoking cessation products are excluded. Over the counter medications are excluded.

Plan 2 does not include any cover for North America (USA and Canada)

Overall Lifetime Maximum Per Insured: US $2,500,000

Annual Maximum Per Insured:US $1,500,000

For more information regarding our international health plan, take a tour or select the many options available to you on our navigation panel.