Corporate Prepaid Medicine Plans Comparison
| Solicitar Cotización | Solicitar Cotización | Solicitar Cotización | Solicitar Cotización | Solicitar Cotización |
|---|---|---|---|---|
| Daily Room and Board with no Deductible or Copayment applied | ||||
|
170 USD.
|
170 USD.
|
200 USD.
|
220 USD.
|
250 USD.
|
| Maximum days for Room and Board | ||||
|
240 Days
|
240 Days
|
240 Days
|
240 Days
|
240 Days
|
| Daily Intensive Care Unit with no Deductible applied | ||||
|
According to the hospital Copay percentage described in this Table and Annexes
|
|
|
|
|
| Maximum days in the Intensive Care Unit | ||||
|
240 Days
|
240 Days
|
240 Days
|
240 Days
|
240 Days
|
| Inpatient Disability Copayment (Company / Member and/or Dependent) | ||||
|
80/20 %
|
80/20 %
|
80/20 %
|
90/10 %
|
100/0 %
|
| OUTPATIENT SERVICES | ||||
|
|
|
|
|
|
| Outpatient Disability Copayment (Company / Member and/or Dependent) | ||||
|
80/20 %
|
80/20 %
|
80/20 %
|
80/20 %
|
80/20 %
|
| Medical Emergency due to Accident with no Deductible or Copayment applied | ||||
|
1000 USD.
|
1000 USD.
|
1000 USD.
|
1000 USD.
|
1000 USD.
|
| Medications at | ||||
|
80 %
|
80 %
|
80 %
|
80 %
|
80 %
|
| Sublimit for Normal Delivery, with no Deductible or Copay applied | ||||
|
1500 USD.
|
2000 USD.
|
2500 USD.
|
3200 USD.
|
3700 USD.
|
| Sublimit for Cesarean Section, with no Deductible or Copay applied | ||||
|
1500 USD.
|
2000 USD.
|
2500 USD.
|
3200 USD.
|
3700 USD.
|
| Sublimit for Spontaneous Abortion, with no Deductible or Copay applied | ||||
|
1500 USD.
|
2000 USD.
|
2500 USD.
|
3200 USD.
|
3700 USD.
|
| Sublimit for Maternity Complications, with no Deductible or Copay applied | ||||
|
5000 USD.
|
5000 USD.
|
10000 USD.
|
15000 USD.
|
20000 USD.
|
| Sublimit for Newborn Complications, with no Deductible or Copay applied | ||||
|
5000 USD.
|
10000 USD.
|
20000 USD.
|
30000 USD.
|
50000 USD.
|
| Waiting Period for onset of pregnancy | ||||
|
60 Days
|
60 Days
|
60 Days
|
60 Days
|
60 Days
|
| ORGAN TRANSPLANT: Maximum limit for Organ Transplants | ||||
|
5000 USD.
|
10000 USD.
|
35000 USD.
|
100000 USD.
|
250000 USD.
|
| Tubal Ligation only for the Female Member and/or her spouse or common-law partner | ||||
|
Like any Disability
|
|
|
|
|
| Vasectomy only for the Member and/or their spouse or common-law partner | ||||
|
Like any Disability
|
|
|
|
|
| Temporary contraceptives per contract year, per Member and/or Dependent | ||||
|
100 USD.
|
100 USD.
|
100 USD.
|
100 USD.
|
100 USD.
|
| Third molar extraction (Maximum limit per molar) | ||||
|
120 USD.
|
120 USD.
|
120 USD.
|
120 USD.
|
120 USD.
|
| Excimer laser (from 5.5 diopters only at: Quito - Vistotal, Guayaquil - Dr. Francisco Rivera / Dr. Antonio Ordónez) at | ||||
|
80 %
|
80 %
|
80 %
|
80 %
|
80 %
|
| Hospital and/or Clinic accommodation charges for one companion of patients under sixteen and over seventy-five years of age (Maximum limit per day, up to 10 days) | ||||
|
50 USD.
|
50 USD.
|
50 USD.
|
50 USD.
|
50 USD.
|
| Coverage for Disabilities arising from the use or consumption of alcohol, drugs or narcotics | ||||
|
500 USD.
|
500 USD.
|
500 USD.
|
500 USD.
|
500 USD.
|
| Coverage for Injuries due to mental health disorders, states of dementia, including those resulting from attempted suicide | ||||
|
500 USD.
|
500 USD.
|
500 USD.
|
500 USD.
|
500 USD.
|
| Prostheses and corrective devices that are not surgically necessary at the | ||||
|
80 %
|
80 %
|
80 %
|
80 %
|
80 %
|
| Mammogram per contract year only for the Member and/or her spouse or common-law partner over 40 years of age, with no Deductible applied | ||||
|
60 USD.
|
60 USD.
|
60 USD.
|
60 USD.
|
60 USD.
|
| Prostate antigen test per contract year only for the Member and/or their spouse or common-law partner over 40 years of age, with no Deductible applied | ||||
|
60 USD.
|
60 USD.
|
60 USD.
|
60 USD.
|
60 USD.
|