CareEssential

The CareEssential option is our base-level international healthcare plan, offering expats a comprehensive hospitalization coverage including full emergency room, surgery and emergency medical evacuation.

Plan Highlights

  • Worldwide coverage (U.S. optional)
  • Hospitalization (semi-private room)
  • Intensive Care Unit
  • Emergency Room coverage
  • Emergency medical evacuation

Lifetime Maximum Benefits

Up to $125,000 for human organ transplant

$1,000,000 per insured

General
GeneralCoverage
Area of CoverageWorldwide (including or excluding U.S. Coverage)
Policy Lifetime Maximum per Insured$1,000,000
Policy Year Deductible
(Certificate of Coverage defines your selection)
• Individual
• Family
Deductible for Family is a maximum of two (2) individually met deductibles per policy year.
$5,000
Co-Insurance Limit (Out-of-Pocket) Outside the U.S.No co-insurance applies
Co-Insurance Limit (Out-of-Pocket) U.S. In-NetworkAfter the deductible, 20% of the first $5,000 of
covered medical charges
Co-Insurance Limit (Out-of-Pocket) U.S. Out-of-NetworkAfter the deductible, 50% of covered
medical charges
Policy Waiting Period90 days
Deductible Carry Over
(Applies to the last 3 months of the Policy Year)
Not included
Inpatient Benefits
Benefit DescriptionU.S. In NetworkU.S. Out of NetworkOutside the U.S.
Hospital Room & Board
60 days per hospital admission.
240 days per policy year.
80%
Semi-Private room, up to $600 per day
50%
Semi-Private room, up to $600 per day
100%
Semi-Private room, up to $600 per day
Intensive Care Unit (ICU)
45 days per confinement.
180 days per policy year.
80%
Up to $1,500
per day
50%
Up to $1,500
per day
100%
Up to $1,500
per day
Inpatient Ancillary Hospital Services
Including, but not limited to X-rays, drugs, bandages, operating room fees, surgical implants
80%50%100%
Inpatient Physician / Specialist Visits
Limited to one visit per day per specialty
80%50%100%
Inpatient Surgery80%50%100%
Surgeon’s Fees80%50%100%
Assistant’s Surgeon’s Fees20% of the Primary Surgeon approved fees
Anesthesiologist’s Fees30% of the Primary Surgeon approved fees
Pre-Admission Testing
Must be performed before non-emergency hospitalization
80%50%100%
Extended Care Facility
30 days per policy year
80%50%100%
Human Organ Transplant & Acquisition
Subject to 12-month waiting period
80%
$125,000 lifetime maximum
Not covered100%
$125,000 lifetime maximum
Dialysis80%50%100%
Emergency Room Services resulting in hospital admission80%50%100%
Oncology / Cancer Treatment80%50%100%
Reconstructive Surgery
Due to covered injury or illness
80%50%100%
Rehabilitation / Therapeutic Services following a hospitalization
Physical, Speech, Occupational Therapy
30 visits per policy year30 visits per policy year30 visits per policy year
Durable Medical Equipment80%50%100%
Emergency Dental Treatment
To restore natural teeth damaged in a covered accident
80%
Up to $1,000
per policy year
50%
Up to $1,000
per policy year
100%
Up to $1,000
per policy year
Non-Professional Sports$50,000 lifetime maximum$50,000 lifetime maximum$50,000 lifetime maximum
Additional Benefits
Benefit DescriptionU.S. In NetworkU.S. Out of NetworkOutside the U.S.
Emergency Medical Evacuation / Air Ambulance100%
Up to $10,000 policy year
Deductible waived
100%
Up to $10,000 policy year
Deductible waived
100%
Up to $10,000 policy year
Deductible waived
Emergency Ground Ambulance80%
Up to $1,500 per event
50%
Up to $1,500 per event
100%
Up to $1,500 per event

Optional Riders

In addition to a comprehensive insurance package, we have several options available to enhance the CareEssential plan option.

Life Insurance and Accidental Death & Dismemberment

Coverage is available for the primary insured only.

 

Coverage OptionsPremium Fee
Option 1: $10,000$40 annually
Option 2: $25,000$100 annually
Option 3: $50,000$200 annually
Option 4: $75,000$300 annually
Option 5: $100,000$400 annually
Travel Assistance

Travel Assistance is a great option for those who are regular travelers. Some key benefits include:

 

  • Hotel convalescence expenses
  • Round-trip airfare ticket for a family member
  • Supplemental indemnity for lost luggage
  • Legal assistance
Premium Fee
Primary$150 annually
Primary and Dependents$300 annually
CoverageMaximum Amount in U.S. Dollars
Medical, hospital and pharmaceutical expenses$10,000
Emergency dental expenses$250
In-office medications$300
Repatriation to domicile after treatment$10,000
Hotel convalescence expenses$100 per day
Maximum of 10 days
Transfer of accompanying minors$2,000
Round-trip ticket for a family member$1,000
Hotel expenses for a family member$50 per day
Maximum of 10 days
Search and transportation of luggage and personal belongings$500
Legal assistance$1,500
Supplemental indemnity for loss of luggage$1,000

All benefits are subject to Usual, Customary and Reasonable (UCR) fees. The benefits, coverage and exclusions listed herein are only a summary, and are subject to the specific terms and conditions of the plan concerning eligible benefit, limitations, eligibility and exclusions. Please refer to the Policy Wording for details.

Penalties to the benefits payable under this plan may apply if the requirements are not met. Please refer to the section labeled Pre-Certification Requirements and Procedures in the plan’s Policy Wording. You must contact the pre-certification provider number listed on your identification card.

The following services require Pre-Certification: Hospitalization | Surgeries | Diagnostic Testing | Oncology Treatment | Repatriation of Mortal Remains | Therapy | Organ Transplant | Medical Air Evacuation / Air Ambulance | Rehabilitation | Home Health Care | Extended Care Facility / Diagnostic Testing

Failure to perform the pre-certification requirements within a minimum of 5 business days prior to the planned treatment of a non-emergency service or within 72 hours of an emergency service, will result in a penalty of 30% of the allowable charge for the entire episode of care. The penalty will not count toward the deductible or co-insurance maximum as defined on the Certificate of Coverage.

Usual Customary and Reasonable Charges = UCR. All amounts are in USD.

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