All Eligible Benefits described in this section are excess
of the chosen Deductible to the Maximum Benefit stated. Each Benefit Maximum is "per sickness or injury".
Treatment received inside the
United States and Canada (Area A)
Treatment received outside the
United States and Canada (Area B)
Lifetime Maximum Benefit
$500,000 per Insured Person
$5,000,000 per Insured Person
Deductibles Available Deductible Options, per person per Injury/Sickness
$70, $100, $150, $250, $500, $1,000
After the per Injury / Sickness Deductible, the program will pay up to the
amount listed below for each Injury / Sickness.
Inpatient
Maximum Benefit
Maximum Benefit
Private or semi-private room, per day (maximum
of 240 consecutive days)
$600
$900
Intensive care room, per day (maximum of
180 consecutive days)
$1,500
$2,000
Surgery
$3,000
$5,000
Anesthetist's charges, payable as a percentage
of surgery
$600
$1,000
Assistant Surgeon
$600
$1,000
Physician’s Non-Surgical / Urgent Care Visit
$60/visit, max 10
$75/visit, max 10
Laboratory Tests, X-rays, other treatment
$450
$600
Prescription medication during hospitalization
$100
$125
Chemotherapy and radiation therapy
$1,000
$1,250
Organ Transplant
$100,000
$130,000
Durable Medical Equipment
$100
$200
Maternity
Normal & complicated child delivery
maximum. including pre and post
natal care is reimbursed according to the other medical treatment benefit
schedule. Waiting period of 12 months before maternity benefit
begins.
$2,500
$4,000
Professional service related to hospitalization, per day
Well Child Care (not subject to Deductible) 12-month waiting period
$60/visit, max 2
$75/visit, max 2
Preventative Benefit (females and males, age 30 and over for checkups, routine physical exams, female preventative exams and mammograms,
not subject to Deductible) 12-month waiting period
$60/visit, max 1
$75/visit, max 1
Newborn Benefit
Lifetime maximum for the first 31 days
after birth, per limits as stated in the Certificate of Coverage
$5,000
$10,000
Transportation
Local ground ambulance
$1,500
$2,000
Emergency Evacuation, when treatment not available locally, pre-approved
transportation to a location where appropriate treatment is available. Includes
cost of return trip.
$50,000
$50,000
Return of Mortal Remains
$20,000
$25,000
24 Hour Accidental Death and Dismemberment
Principal Sum
Principal Sum
- Insured and Spouse
$10,000
$10,000
- Dependent Children
$2,000
$2,000
Common Carrier Accidental Death and Dismemberment
- Insured and Spouse
$40,000
$40,000
- Dependent Children
$8,000
$8,000
You have your choice of six per Injury / Sickness Deductibles:
$70, $100, $150, $250, $500, $1000.
Reside does not have a coinsurance amount, apart from the chosen
deductible and the limits described in the Schedule of Benefits. The
Lifetime Maximum amount is listed in the Schedule of Benefits.
Should you travel during the course of treatment from one area to
another (whether being treated inside the United States and Canada
or outside the United States and Canada), the limitations of the new area shall apply.
The Reside Worldwide Medical Plan is underwritten by Certain Underwriters at
Lloyds, London. As the largest insurance entity in the world, Lloyds has earned
an A (Excellent) rating from AM Best and an A+ (Strong) rating from Standard
and Poors.
Atlas