|
|
Schedule
of Benefits
| Claim Procedures | Medical
Limitation | Frequently Asked
Questions
Schedule
of Benefits
| HOSPITALIZATION |
| Daily
Room & Board |
$
250.00 |
| Maximum
No. Days per Disability |
31 |
| Miscellaneous
in Hospital Benefit |
$2,500.00 |
| |
|
| SURGICAL
BENEFIT |
| Maximum
per Disability |
$1,500.00 |
| |
|
| DOCTOR’S
VISITS (Payable from 1st visit) |
| (a)
Office |
$
60.00 |
| (b)
Home |
$
60.00 |
| (c)
Hospital |
$
60.00 |
| Maximum
per Disability |
31
visits |
| |
|
| SPECIALIST
CONSULTATION (On referral) |
| Maximum
per Consultation |
$
120.00 |
| Maximum
per disability |
10
visits |
| |
|
DIAGNOSTICS,
X-RAY & LABORATORY |
| Maximum
per Disability |
$
250.00 |
| |
|
| PRESCRIBED
DRUGS BENEFIT |
| Maximum
per Disability |
$
250.00 |
| |
|
| MAJOR
MEDICAL (Supplementary) |
| Maximum
Benefit |
$50,000.00 |
| Deductible
per Calendar Year |
$
50.00 |
| Benefit
period |
3
consecutive years |
| Co-Insurance
|
90%/10% |
|
|
