Standard Hospital Room 200 days/100%
Intensive Care Unit 100%
Other Services and Supplies in the Hospital 100%
Physician / Surgeon 100%
Surgeon’s Assistant according to the approved standard of Surgeon’s fees 30% of the approved amount
Anesthesiologist according to the approved standard of the Surgeon’s fees 40% of the approved amount
Reconstructive Surgery 100%
Surgical Implants or Prostheses 100%
Emergency Room 100%
Second Medical Opinion 100%
In-House Patient Rehabilitation limit 30 days or US$ 8,000
Medical Consultations, Specialists and Medical Exams with Primary Healthcare Network US$ 3,000 or 20 visits
Dialysis 100%
Radiotherapy, Chemotherapy and Brachitherapy US$ 25,000
ALL 100% COVERAGE IS UNDER THE AVERAGE RANGE COST CLAUSE (CAR)