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In-Patient
Treatment |
The benefits must be reasonable and customary |
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Accomodation, nursing care, ward prescribed drugs |
Maximum 5 nights at €174.70 (Lm75) €116.47 (Lm50) per episode
for Day Surgery) |
Full Refund |
Full Refund |
|
Use of operating theatre, surgical drugs and dressings, intensive care, diagnostic procedures, including Pathology and Radiology |
Major Operation: €349.41(Lm150)
Intermediate Operation:€232.94 (Lm100)
Minor Operation:
€116.47 (Lm50) |
Full Refund |
Full Refund |
|
Professional fees for Surgeons, Anaesthetists and Physicians and medical consultants |
Major Operation:
€931.75 (Lm400)
Intermediate Operation:
€698.81 (Lm300) Minor Operation:€349.41 (Lm150)
|
Full Refund |
Full Refund |
|
Psychiatric, Nervous
And Mental conditions |
None |
Full Refund |
Full Refund |
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Charges made to you as a parent staying overnight in hospital with a child of under 14 years of age |
€23.29 (Lm10) per
night (maximum 5 nights) |
Full Refund |
Full Refund |
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Out-Patient Treatment |
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Professional fees for specialist consultations , Diagnostic procedures including pathology and Radiology computerised Tomography, second surgical opinion |
Maximum of €232.94 (Lm100) (30 days prior and 30 days after hospital stay) |
Maximum of €465.87 (Lm200) (30 days prior and 30 days after hospital stay) |
Full Refund |
|
Professional fees for specialist consultations , Physiotherapy, Pathology, Radiology, ECG |
Maximum of €232.94 (Lm100)
|
Maximum of €465.87 (Lm200)
|
Full Refund
|
|
Professional fees for Oncology, Chemotherapy And radiotherapy |
Maximum 2 courses per year, up to €349.41 (Lm150) for each complete course |
Maximum of 2 courses per year, up to €349.41 (Lm150) for each complete course |
Full Refund
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Alternative Therapy |
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Osteopathy,
Homeothapy,
Acupuncture,
Chiropractic
Treatment
And the like |
None |
Maximum of €465.87 (Lm200) |
Full Refund |
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Emergency Dental Treatment |
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Emergency dental treatment necessary to
restore or replace sound
natural teeth lost or damaged following an accidental injury |
None |
Maximum of €465.87 (Lm200) per year |
Maximum of €698.81 (Lm300) per year |
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Nursing Care |
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Home nursing by a professional nurse Following a surgical intervention and if prescribed by a specialist |
€186.35 (Lm80) per week up to 15 weeks |
€186.35 (Lm80) per week up to 15 weeks |
€185.35 (Lm80) per week up to 15 weeks |
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MMDNA |
As required |
As required |
As required |
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Private Ambulance |
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Private ambulance (provided by the medical profession on medical grounds) |
Maximum of €582.34 (Lm250) per year |
Maximum of €582.34 (Lm250) per year |
Full Refund |
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General Practitioner Charges |
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General Practitioner Charges |
Maximum of €58.23 (Lm25) per year |
Maximum of €58.23 (Lm25) per year |
Maximum of €58.23 (Lm25) per year |
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Cash Benefits - |
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First 30 nights
|
€34.94 (Lm15) p/night |
€34.94 (Lm15) p/night |
€46.59 (Lm20) p/night |
|
Next 30 nights |
€23.29 (Lm10) p/night |
€23.29 (Lm10) p/night |
€23.29 (Lm10) p/night |
|
Day care (following surgery) |
€23.29 (Lm10)
per day/episode |
€23.29 (Lm10)
per day/episode |
€23.29 (Lm10)
per day/episode |
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Maternity cash benefit |
none |
none |
€465.87 (Lm200) p/child |
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Overall Maximum
Payable |
€116,468.67
(Lm50,000) |
€116,468.67
(Lm50,000) |
€174,703
(Lm75,000) |
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Optional Benefits |
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Funeral expenses |
€1,164.69 (Lm500) per event |
€1,164.69 (Lm500) per event |
€1,164.69 (Lm500) per event |
|
(Additional premium of €5.24 Lm2.25 per person) |
up to a maximum of €3,494.06 (Lm1,500)
per policy |
up to a maximum of €3,494.06 (Lm1,500)
per policy |
up to a maximum of €3,494.06 (Lm1,500)
per policy |
|
Cover for Medicines (Additional premium of €4.66 Lm2.00 per person) |
None |
Maximum of €104.82 (Lm45) per person per year, following a major operation |
Maximum of €104.82 (Lm45) per person per year, following a major operation |
