| Plan Information |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Overall Aggregate Maximum Sum Insured, per Period of Insurance, per Insured person | £27,777 / €35,000 | £27,777 / €35,000 | £50,000 / €63,000 | £50,000 / €63,000 | £250,000 / €315,500 | £250,000 / €315,500 | | Sum Insured Outside Country of Residence | Nil | Nil | Nil | Nil | £25,000 / €31,550*** | £25,000 / €31,550*** | | Treatment Territorial Limits | Country of Residence within Europe | Country of Residence within Europe | Country of Residence within Europe | Country of Residence within Europe | Europe plus 90 days Worldwide (exc. USA/ Canada) | Europe plus 90 days Worldwide (exc. USA/ Canada) | | Excess - per Insured Person, per Period of Insurance** | Minimum £100/€125 | Minimum £100/€125 | Minimum £100/€125 | Minimum £100/€125 | Minimum £75/€95 | Minimum £75/€95 | |
| Hospital Charges** |
| Policy Sections | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | i) Medical Practitioner or Specialist Fees as an In-Patient or Day Patient | Full Refund | Full Refund | Full Refund | Full Refund | Full Refund | Full Refund | | ii) Diagnostic and surgical Procedures as an In-Patient or Day Patent including scans, pathology, x-rays, oncology | | iii) Surgeons and Anaesthetist Fees | | iv) Theatre fees and nursing by a Qualified Nurse | | v) Prescribed Drugs and Dressings | | vi) Standard Private Room | Up to
£235/€300 per day
(Intensive Care: £575/€735) | Up to
£235/€300 per day
(Intensive Care: £575/€735) | Up to
£235/€300 per day
(Intensive Care: £575/€735) | Up to
£235/€300 per day
(Intensive Care: £575/€735) | Up to
£235/€300 per day
(Intensive Care: £575/€735) | Up to
£235/€300 per day
(Intensive Care: £575/€735) | | vii) Physiotherapy where referred by a Medical Practiitioner(max. 10 sessions per medical condition) | Up to £25/€30 per session | Up to £30/€38 per session | Full Refund | Full Refund | Full Refund | Full Refund | | ** When Treatment is not provided in a Participating Hospital or an Out-Patient Medical Practitioner’s office, all charges incurred will be subject to a 20% Co-Insurance. *** If Treatment can be obtained outside of Your Country of Residence at the same or less cost than within Your Country of Residence, the Outside of Country Residence sub-limit may be exceeded up to the Policy Limits. The Insured must provide proof of costs are equal or less than within the Country of Residence, prior to Treatment, and this will be subject to Pre-Certification. No Benefits will be paid for transportation to obtain Treatment outside of the Country of Residence. | |
| Parent Accommodation (Child Under 12 years) |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Parent Accommodation
(Child Under 12 years) | Not Covered | Not Covered | Full Refund | Full Refund | Full Refund | Full Refund | |
| Emergency Transportation to and from hospitals |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Emergency Transportation to and from hospitals | Up to £595 / €750 | Up to £595 / €750 | Full Refund | Full Refund | Full Refund | Full Refund | |
| Home Nursing on referral from a specialist |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Home Nursing on referral from a specialist | Up to £500/
€630 up to 10 days per medical condition and maximum of £50/€63 per day | Up to £500/€630 up to 10 days per medical condition and maximum of £50/€63 per day | Full Refund up to 30 days per medical condition and maximum of £80/€100 per day | Full Refund up to 30 days per medical condition and maximum of £80/€100 per day | Full Refund up to 30 days per medical condition and maximum of £80/€100 per day | Full Refund up to 30 days per medical condition and maximum of £80/€100 per day | |
| Reconstructive Surgery following an Accident or surgery for a covered event |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Reconstructive Surgery following an Accident or surgery for a covered event | Full Refund | Full Refund | Full Refund | Full Refund | Full Refund | Full Refund | |
| Out-Patient Charges inc.** |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Out-Patient Charges inc.** | Limited to combined maximum of £500/
€630 per Period of Insurance (Under Sections i.-ii.) | Limited to combined maximum of £595/€750 per Period of Insurance (Under Sections i.-iii.) | Limited to combined maximum of £1,000/
€1,260 per Period of Insurance (Under Sections i.-ii.) | Full Refund | Up to £1,000/
€1,260 per Period of Insurance | Full Refund | | i) Medical Practitioner or Specialist fees inc. home visits | Prior to admission to Hospital and for maximum 90 days after discharge | i) Per Visit £20/€25 Family Dr. £200/€250 Specialist | Prior to admission to Hospital and for maximum 90 days after discharge | Prior to admission to Hospital and for maximum 90 days after discharge | | ii) Diagnostic and surgical procedures inc. scans, pathology, x-rays and oncology | Prior to admission to Hospital and for maximum 90 days after discharge | Full Refund | Prior to admission to Hospital and for maximum 90 days after discharge | Prior to admission to Hospital and for maximum 90 days after discharge | | iii) Prescribed Drugs and Dressings | Not Covered | Not Covered | Not Covered | | iv) Physiotherapy where referred by a Medical Practioner | Not Covered | Full Refund (max 10 sessions per medical condition) | Full Refund (max 10 sessions per medical condition) | | ** When Treatment is not provided in a Participating Hospital or an Out-Patient Medical Practitioner’s office, all charges incurred will be subject to a 20% Co-Insurance. | |
| Alternative Medicines Limited to Acupuncture, Homeopathy, Chiropractic & Osteopathy on referral of Medical Practitioner |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Alternative Medicines Limited to Acupuncture, Homeopathy, Chiropractic & Osteopathy on referral of Medical Practitioner | Not Covered | Not Covered | Not Covered | Up to £250/€315 per Period of Insurance | Not Covered | Up to £250/
€315 per Period of Insurance | |
| Hospital Emergency Room Accidental Damage to Teeth (within 7 days caused to sound natural teeth). |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Hospital Emergency Room Accidental Damage to Teeth (within 7 days caused to sound natural teeth). | Not Covered | Full Refund | Not Covered | Full Refund | Not Covered | Full Refund | |
| Hospital Cash Benefit |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Hospital Cash Benefit | £50/€65 / 24 hours first 3 days then £35/€45 per day for next 17 days | £50/€65 / 24 hours first 3 days then £35/€45 per day for next 17 days | £80/€100 / 24 hours first 3 days then £50/€65 per day for next 28 days | £80/€100 / 24 hours first 3 days then £50/€65 per day for next 28 days | £80/€100 per day for the first 30 complete days | £80/€100 per day for the first 30 complete days | |
| Routine Pregnancy and Childberth - After 12 months from Date of Entry |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Routine Pregnancy and Childberth - After 12 months from Date of Entry | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Up to £1,000/
€1,260 After 12 months from Date of Entry | |
| Complications of Pregnancy & Childbirth |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Complications of Pregnancy & Childbirth | Not Covered | Not Covered | Not Covered | Not Covered | Full Refund after 12 months from Date of Entry | Full Refund after 12 months from Date of Entry | |
| Routine Dental Treatment |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Routine Dental Treatment | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Up to £400/€505 (Crown limited to £150/€190) | |
| Emergency Evacuation |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Emergency Evacuation | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Full Refund | |
| Transportation of Mortal Remains or local Cremation/Burial where death occurs outside Country of Residence |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Transportation of Mortal Remains or local Cremation/Burial where death occurs outside Country of Residence | Up to £2,500/ €3,155 only when Treatment was unavailable in Country of Residence and death occurred while receiving that Treatment | Up to £2,500/ €3,155 only when Treatment was unavailable in Country of Residence and death occurred while receiving that Treatment | Up to £2,500/ €3,155 only when Treatment was unavailable in Country of Residence and death occurred while receiving that Treatment | Up to £2,500/ €3,155 only when Treatment was unavailable in Country of Residence and death occurred while receiving that Treatment | Up to £2,500/ €3,155 | Up to £2,500/ €3,155 | |
| Personal Accident (Refer to Policy Wording for full details) |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Personal Accident (Refer to Policy Wording for full details) | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Up to £50,000/ €63,000 (Age 21-74 yrs) | |
| Compassionate Home Visit (Relative under 75 years) |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Compassionate Home Visit (Relative under 75 years) | Not Covered | Not Covered | Not Covered | Up to £1,000/ €1,260 | Not Covered | Up to £1,000/ €1,260 | |
| Vision Accident contribution |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Vision Accident contribution | Not Covered | Not Covered | Not Covered | Up to £200/ €250 | Not Covered | Up to £200/€250 | |
| Worldwide (excluding USA/Canada) Accident and Emergency Out Of Area Cover |
| Coversure Sub-Plan: | Core | Core | Prime | Prime | Prime Plus | Prime Plus | | Cover Option: | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | Standard | Premier
(Includes Out-Patient) | | Worldwide (excluding USA/Canada) Accident and Emergency Out Of Area Cover | Not Covered | Not Covered | Not Covered | Not Covered | 90 Days Maximum, Up to £25,000 / €31,550 | 90 Days Maximum, Up to £25,000 / €31,550 | |
| Additional Notes & Information - REFER TO POLICY WORDING FOR FULL TERMS, CONDITIONS, LIMITATIONS & EXCLUSIONS |
| Optional Add-Ons | Global Personal Accident Plan & / or Global Daily Indemnity Hospital Income Plan | | Key Exclusions | Refer to Policy Wordings. Key Exclusions include:
- Chronic Conditions
- HIV/AIDS / Durg and Alcolhol Abuse
- Birth Defects and Congenital Illnesses
- Routine Medical Examinations
| | Important Notes & Policy Terms | - Pre-Existing Conditions that existed prior to this Insurance: Any Pre-Existing Condition (As defined within the Policy Wording - available upon request) IS EXCLUDED FROM COVER. After two years of continuous insurance cover following the Effective Date (five in the case of heart or cancer conditions) Pre-Existing Conditions which have not been specifically excluded via a Personal Medical Exclusion, will then become eligible for Benefit if at the first time of receiving Treatment the Insured has not:
- consulted any physician for Medical Treatment or Advice (other than routine check ups); or
- taken medication (including prescription Drugs, special diets or injections), for that condition or any Related Condition for a continuous period of two years (five years in the case of heart or cancer conditions) – refer to Policy Wording for further details
- 30 Day Wait Period from Effective Date for Hospitalisation due to Illness (other than Emergency Treatment or cover allowed at Insurers sole discretion when insured is transferring from another Health Plan provided cover has been continuous)
- 20% Co-Insurance is payable by the Insured if treatment is not taken within a Participating Hospital or an Out-Patient Medical Practitioner's office. (Refer to Coversure for details of Participating Hospitals.)
| |