What you should know

We make it simple

We know sometimes insurance policies are hard to understand; that’s why we have made it simple for you.

• Coverage: the amount of money we cover for a specific service or medical treatment.
• Maximum limit: the maximum amount we pay in total for all the benefits per insured, per policy year.
• Premium: the amount of money you pay for your medical insurance. Usually, it may be paid quarterly, semi-annually, or annually.
• Deductible: the amount of money you must cover each policy year before we start paying any expenses.
• Coinsurance: the percentage applied to the total expenses covered that you are responsible for after paying the deductible.
• Waiting periods: some benefits are subject to a waiting period, which is the time you have to wait after the effective date of coverage for benefits to be paid.
• Copay: small fixed amount of money you cover during each visit to the doctor.
• Pre-authorization: a decision made by the company to determine if a medical service, treatment, prescribed medication, or durable medical equipment is medically necessary.
• Pre-existing condition: an illness, ailment, or healthcare condition diagnosed prior to the effective date of coverage, which can be determined by a medical diagnosis or through medical records.
• Hospitalization: admittance to a hospital, clinic or medical facility for more than 23 hours to receive medical or surgical treatment.
• Loss: a specific incident covered by the insurance policy that we must reimburse totally or partially according to the contract.
• Claim: a detailed invoice for medical services received.
• Exclusion: a specific circumstance or medical condition that is not covered by your policy.
• Direct Payment: the easiest way to pay for a medical service. We pay the healthcare provider directly for any covered expenses, and you only pay any deductible and/or coinsurance due. Click here for additonal information.
• Reimbursement: we pay you for any amount you may have paid a healthcare provider for covered services or treatment received. Click here for additonal information.
• Expert opinion or second medical opinion: provides access to independent international medical experts that perform a comprehensive review of the case and make diagnostic or therapeutic recommendations if necessary.
• Out-patient treatment: does not require hospitalization. You may receive ambulatory treatment at a clinic or medical office and return home the same day.