招商信诺寰球至尊高端个人医疗保险责任清单2011

招商信诺寰球至尊高端个人医疗保险责任清单2011 招商信诺寰球至尊高端个人医疗保险责任清单 List of benefits of Cigna-CMC 上海保险超市 秦先生 1XXXXXXXXXX 我们专注高端医疗详情请电话咨询 Part1 国际医疗保障 核心保障 International Medical Insurance Part2 国际医疗补充保障可选保障International Medical Insurance Plus Part3 国际紧急转移服务保障可选保障International Emergency Evacuation Part4 国际健康与体检保障可选保障International Health and Wellbeing Part5 国际眼科与牙科保障可选保障International Vision and Dental Part6 上海高端医疗全球医疗外籍人士医疗保险超市咨询和联系方式 一国际医疗保障 International Medical Insurance 总保障限额 Core Plan – Overall Benefit Limit 每一保险期间内每一被保险人所有保险责任赔付限额 Annual Benefit – 20000000 Up to 20 imum per beneficiary This includes claims paid across all sections Million per period of cover of the International Medical Insurance 您所享有的基本医疗保险责任 Your Standard Medical Benefits 赔付限额 Benefit Limit 住院费用具体包括 Hospital Charges for 住院治疗的护理费及病房费 Nursing and accommodation for in-patient treatment 日间治疗费用 Day case treatment 全额 手术室及手术观察室费用 Paid in Full Operating theatre and recovery room 住院或日间治疗的处方药及敷药剂费用 Prescribed medicines drugs and dressings for in-patient or day case Treatment 门诊手术的治疗室费用 Treatment room fees for outpatient surgery 重症监护室冠心病监护室及高度医护室费用 全额 Intensive care intensive therapy coronary care and Paid in full high dependency unit 父母陪同病房费用 Parental Accommodation 本项责任仅适用于未满 18 周岁的未成年人如被保险人须过夜留院治疗我 方 全额 将支付合理的在同一医院的父母陪同住宿费用 Paid in Full This applies to dependent children under the age of 18 CIGNA will pay for reasonable costs for a parent staying in the same hospital with the child where the child is required to stay in the hospital overnight 外科医生及麻醉师费用 Surgeons and Anaesthetists Fees 全额 适用于任何基于住院日间治疗或门诊而施行的手术 Paid in Full Whether surgery is provided on an in-patient day case or out-patient basis 专业医师咨询费用 Specialists consultation fees 本项责任适用于在被保险人住院时专科医师的常规巡查并包括因医疗必要而须 全额 专业医生执导的重症紧急护理 Paid in Full This benefit is paid in full for regular visits by a specialist during stays in hospital including intensive care by a specialist for as long as is required by medical necessity 移植服务 Transplant Services 全额 适用于住院或日间治疗期间 Paid in Full Where treatment is provided on an in-patient or day patient basis 物理疗法 Physiotherapy 全额 适用于住院或日间治疗期间 Paid in Full Where treatment is provided on an in-patient or day patient basis 放射病理检测X 光及诊断检测 Radiology Radiotherapy Pathology X rays diagnostic tests 全 额 适用于住院或日间治疗期间 Paid in Full Where treatment is provided on an in-patient or day patient basis 高清影像 Advanced imaging 适用于门诊住院或日间治疗期间的核磁共振成像MRI计算机断层扫描 全额 CT以及正电子发射断层扫描 PET Paid in Full Includes MRI CT and PET scans performed whether staying in hospital overnight or as a day-case patient or as an out-patient 家庭护理费用 Home nursing charges 适用于在专业医师建议下于出院治疗后立即开始基于全天侯治疗情况下与 一般 医院提供的医疗护理相同的家庭护理每一保险期间内以 30 天为限 全额 This benefit will be paid if recommended by a specialist immediately Paid in Full after hospital treatment or on a full time basis for treatment which would normally be provided in a hospital for up to 30 days in any one year of insurance 康复 Rehabilitation 全额 每一保险期间内以 30 天为限 Paid in full Up to 30 days per year of insurance 临终住宿及安乐护理 全额 Hospice stay to receive Palliative Care Paid in Full 内用假体设备手术及医疗用品 Internal prosthetic devicessurgical and medical appliances 我方将支付被保险人治疗过程中施用内用植入假体设备或医疗用品的费用 We pay for internal prosthetic implants devices or medical appliances needed as part of the beneficiarys treatment 全额 本项责任应符合 Paid in Full This benefit will be paid in respect of 植入假体设备或用品是在手术期间使用 a prosthetic implant device or appliance which is inserted during surgery 外用假体设备手术及医疗用品 External prosthetic devicessurgical and medical appliances 我方将支付被保险人治疗过程中施用外用植入假体设备或医疗用品的费用 We pay for external prosthetic devices or appliances needed as part of the beneficiarys treatment 本项责任应符合 每一假体设备以 20000 为限 This benefit will be paid in respect of Up to 20000 for each 作为治疗必要组成的假体设备或用品基于医疗必要紧接手术而施用 prosthetic device a prosthetic device or appliance which is a necessary part of the treatment immediately following surgery for as long as is required by medical necessity 在短期恢复阶段基于医疗必要而施用的假体设备或用品 a prosthetic device or appliance which is medically necessary and is part of the recuperation process on a short-term basis 注意外用假体设备包括义肢或人造耳 Please note Examples of prosthetic devices include a prosthetic limb or prosthetic ear 我方为成年人仅支付一次外用假体费用我方为 16 周岁及以下的未成年人 支付 初始的假体设备费用及最多两次用于替换的假体设备费用 For adults we will pay for one external prosthetic device For children up to the age of 16 we will pay for the initial prosthetic device and up to two replacement devices 当地救护车 Local Road Ambulance 全额 因医疗必要而须使用当地救护车前往医院进行治疗 Paid in Full Medically necessary travel by local road ambulance when related to covered hospitalisation 当地空中救护 Local Air Ambulance 全额 因医疗必要而须使用当地空中救护例如直升机前往医院进行治疗 Paid in Full Medically necessary travel by local air ambulance such as helicopter when related to covered hospitalisation 住院津贴 Hospitalization Cash Benefit 我方将在满足下述条件的基础上向您支付每日住院津贴 Paid instead of us making a payment for treatment provided under the plan when you 您所接受的治疗在本责任规定范围内 1200 元天每一保险期间内 received treatment in hospital which is covered under this plan 以 30 天为限 您需要的住院治疗须过夜 1200 per night up to 30 stay in hospital overnight nights per period of cover 您未曾报销任何病房费 have not been charged for your room and board and 您未曾报销任何治疗费 have not been charged for your treatment 紧急牙科治疗 Emergency dental treatment 全额 因遭受严重意外事故而导致住院接受牙科治疗 Paid in full Dental treatment in hospital after a serious accident 您所享有的精神科护理责任 Your Psychiatric Care 精神科护理 Psychiatric Care 本项责任将在被保险人因精神疾病及精神障碍而接受住院日间治疗或门诊 治疗 的基础上予以支付 This benefit will be paid in respect of psychiatric conditions and mental health disorders whether the beneficiary is staying in a hospital overnight or receiving treatment as a day-patient or out-patient basis 每一保险期间以 90 天为限其中住院治疗最多可达 30 天日间治疗及门诊 治 疗中每一次指每一天最多达 90 次 全额 A total of 90 days cover is available in the period of cover and a Paid in Full imum of 30 days can be used for in-patient treatment For day- patient and outpatient treatment the phrase 90 days cover means 90 visits 请注意每五个连续的保险期间以 180 天为限其中住院治疗最多可达 60 天 日 间治疗及门诊治疗中每一次指每一天最多可达 180 次 Please note that an overall 5 year total limit of 180 days will apply of which a imum of 60 days can be used for in-patient treatment For day-patient and out-patient treatment the phrase 180 days cover means 180 visits 您所享有的癌症护理责任 Your Cancer Care 癌症治疗 Cancer Treatment 所有与癌症有关的必要治疗包括住院日间治疗或门诊治疗以及化疗放 疗肿瘤治疗诊断测试及药物 全额 All medically necessary treatment a beneficiary receives for or related Paid in Full to cancer whether staying in a hospital overnight as a day-patient or as an outpatient including Chemotherapy Radiotherapy Oncology Diagnostic Tests and Drugs 您所享有的生育与新生儿护理及治疗责任 Your Mother And Baby Care 常规妊娠及分娩保障 Routine Maternity and Childbirth Cover 连续持有本合同 10 个月及以上且在此期间内持续有效的女性被保险人可 享有本 保障 每一保险期间以 90000 为限 Available once the mother has been covered by the policy for 10 months or more Up to 90000 per period of 涵盖门诊及住院治疗费用包括医院收费妇产医生及助产医护人员费用 cover In-patient and out-patient treatment including hospital charges obstetricians and midwives fees 复杂妊娠及分娩保障 Complicated Maternity and Childbirth Cover 连续持有本合同 10 个月及以上且在此期间内持续有效的女性被保险人可 享有本 保障 Available once the mother has been covered by the policy for 10 months or more 涵盖门诊及住院治疗费用包括医院收费妇产医生及助产医护人员费用 每一保险期间以 180000 为限 In-patient and out-patient treatment including hospital charges Up to 180000 per period of obstetricians and midwives fees cover 本项责任含因医疗必要而发生的剖腹产如果我方无法确定您的剖腹产确因 医疗 必要而发生我方将按常规妊娠及分娩责任限额进行支付 Caesarean sections are only covered under this benefit where they are required by medical necessity If we are unable to determine that your Caesarean section was medically necessary it will be paid from the beneficiarys routine maternity and childbirth benefit limit 家中分娩 每一保险期间以 7000 为限 Childbirth at home Up to 7000 per year of insurance 新生儿护理 自出生之日起享有最多 90 天以 Newborn care 1000000 为限的保障新 若父母亲任何一方目前在保于本合同 生儿于出生之日起 30 天内加入本 If parent is already covered by the policy 合同无须经医学核保 Up to 1 Million for treatment within first 90 days following birth No medical underwriting so long as child added within 30 days from birth 新生儿护理 自出生之日起享有最多 90 天以 Newborn care 1000000 为限的保障新 若父母亲任何一方目前均不在保于本合同 生儿加入本合同须经医学核保 If parent is not already covered by the policy Up to 1 Million for treatment within first 90 days following birth Subject to medical underwriting 先天性疾病 Congenital conditions 包括对先天性疾病的住院或日间治疗费用且该先天性疾病须证明是在被保 险人 以 250000 为限 18 周岁以前患有 Up to 250000 Where treatment is provided on an in-patient or day patient basis and the congenital condition manifested itself before the patients 18th birthday 您可选择的免赔额 Your deductible options 免赔额多项 Deductible various 免赔额作为理赔的组成部分将不涵盖于您的保险责任当中例如您为所购买的国 际医疗保险选择了 5000 的免赔额那么您在任何一个保险期间内理赔时我 0 2500 5000 方将在扣除 5000 的基础上向您支付理赔款项 10000 20000 50000 A deductible is a portion of a claim or claims that is not covered by your plan So for example if you choose a deductible of 5000 for International Medical Insurance youll need to pay the first 5000 of a covered claim or covered claims in any period of cover 如果您已经选择了免赔额您所支付的任一保险期间内的保险费将不 含在该保险期间内您所选择的免赔额的部分您选择的免赔额越高您所应支 付的保险费则越低免赔额适用于本合 同内的所有被保险人 If a deductible is chosen you would only have to pay this once during any period of cover irrespective of the number of claims The higher the deductible you apply the lower your premium will be The deductible is payable by each person covered by the policy 二国际医疗补充保障可选保障 International Medical Insurance Plus Optional 门诊护理责任 Out-patient Healthcare Benefits 赔付限额 Benefit Limit 每一保险期间内每一被保险人所有保险责任赔付限额 限额 500000 Annual Benefit – imum per beneficiary Up to 500000 per period of cover 专业医师及专科医生会诊 全额 Consultations with Medical Practitioners and Specialists Paid in Full 非手术治疗病理科及放射科 全额 Non-surgical treatment Pathology Radiography Radiology Paid in Full 物理治疗 全额 Physiotherapy Paid In Full 脊椎指压治疗及正骨治疗 Chiropractic and Osteopathy 全额 每一保险期间内全部组合总计不超过 30 次 Paid in Full 30 visits per period of cover overall combined total 针灸中医及顺势疗法 Acupuncture Homeopathy and Chinese Herbal Medicine 全额 每一保险期间内全部组合总计不超过 20 次 20 visits per period of cover Paid in Full overall combined total 言语治疗 Speech Therapy 全额 基于遭受疾病例如中风而接受的短期治疗 Paid in Full Provided on a short-term basis following a condition such as a stroke 处方药物及敷药剂 全额 Prescribed Medicines Drugs and Dressings Paid In Full 病理检查X 光及诊断性检查 全额 Pathology X-rays Diagnostic Tests Paid in Full 医疗设备租赁 Durable Medical Equipment 全额 每一保险期间内最多 45 天的租赁时长 Paid In Full Rental for up to a imum of 45 days in the period of cover 成人旅行疫苗接种 全额 Adult Travel Vaccinations Paid in Full 牙科意外治疗 Accidental Dental Treatment 本项责任仅对被保险人因遭受意外事故而导致牙损伤并在该意外事故发生 之日起 30 天内接受的牙科门诊治疗费用进行支付 30 天以后的治疗费用将不包括 在内 全额 This benefit is payable for treatment received immediately after an Paid In Full accident for treatment incurred within 30 days following the date ot the accident for damage to the beneficiarys sound natural teeth No benefit is payable after 30 days 儿童体检及检查 Well Child Tests 本项责任对于 18 周岁及以下的未成年被保险人在适当的年龄间隔内享有 详情请 全额 联系我方咨询 Paid in Full This benefit will be payable for dependent children up to the age of 18 at appropriate age intervals For full details please contact CIGNA 每年常规检查 Annual Routine Tests 15 周岁以下儿童一次的视力及听力检查 全额 One eye test and hearing test for children under the age of 15 Paid in Full 您可选择的免赔额 Your deductible options 赔额多项 Deductible various 免赔额作为理赔的组成部分将不涵盖于您的保险责任当中例如您为所购买的国际 医疗补充保险选择了 1000 的免赔额那么您在任何一个保险期间内理赔时我 方将在扣除 1000 的基础上向您支付理赔款项如果您已经选择了免赔额您所 支付的任一保险期间内的保险费将不含在该保险期间内您所选择的免赔额的部分 您选择的免赔额越高您所应支付的保险费则越低免赔额适用于本合同内的 所有 被保险人 0 1000 A deductible is a portion of a claim or claims that is not covered by your plan So for example if you choose a deductible of 1000 for International Medical Insurance Plus youll need to pay the first 1000 of a covered claim or covered claims in any period of cover If a deductible is chosen you would only have to pay this once during any period of cover irrespective of the number of claims The higher the deductible you apply the lower your premium will be The deductible is payable by each person covered by the policy 三国际紧急转移服务保障可选保障 International Emergency Evacuation Optional 转移服务 Evacuation Services 赔付限额 Benefit Limit 医疗转移他地 Medical Evacuation 全额 如被保险人所需要的治疗无法在当地获得将转移至最近的医疗机构进行治 疗 Paid in Full Transfer to the nearest center of medical excellence if the treatment the beneficiary needs is not available locally 医疗转移回国 全额 Medical Repatriation Paid in Full 遗体转移回国 全额 Repatriation of Mortal Remains Paid in Full 第三方运送费用 全额 Travel cost for an accompanying person Paid in Full 未成年人运送费用 全额 Travel cost for the transfer of minor children Paid in Full 家属探访津贴 终生以 5 次为限 Compassionate visit allowance Up to five trips per lifetime 探访旅行费用 每一保险期间以 8000 为限 Travel costs Up to 8000 for each period of cover 探访生活津贴 Living allowance costs 每次探访旅行最多给付 10 天 每天以 1000 为限 For a imum of 10 days per visit each day up to 1000 四国际健康与体检保障可选保障 International Health and Wellbeing Optional 国际健康与体检责任 International Health and Wellbeing Benefits 赔付限额 Benefit Limit 成人常规健康检查 Routine Adult Physical Exams 每一保险期间以 3000 为限 本项责任仅适用于 18 周岁以上的被保险人 Up to 3000 per period of This benefit will be paid for or in connection with routine physical cover examinations for beneficiaries over the age of 18 years old 巴氏涂片 Pap Smear 全额 我方将支付每年的巴氏涂片检查费用 Paid in Full CIGNA will pay charges for an annual Papanicolaou screening 前列腺癌症筛查 Prostate Cancer Screening 全额 我方将为 50 周岁以上的男性被保险人支付每年的前列腺筛查费用 Paid in Full CIGNA will pay charges for an annual prostate cancer screening for eligible males over 50 years old 以乳癌筛查或诊断为目的的乳腺 X 线摄影检查 Mammograms for Breast Cancer Screening or Diagnostic Purposes 本项责任具体包括 This benefit will be paid in respect of 35 周岁到 39 周岁无症状女性被保险人限一次的基准乳腺 X 线摄影检查 one baseline mammogram for asymptomatic women aged 35-39 40 周岁到 49 周岁无症状女性被保险人每两年一次的乳腺 X 线摄影检查 全额 a mammogram for asymptomatic women aged 40-49 every two years Paid in Full or more if medically necessary 50 周岁及以上女性被保险人每年一次的乳腺 X 线摄影检查 a mammogram every year for women aged 50 and over 肠癌筛查 Bowel cancer screening 我方将支付每两年一次为 55 周岁至 69 周岁被保险人进行肠癌筛查的费 用 全额 CIGNA will pay charges for an annual bowel cancer screening for eligible Paid in Full male and females over 55 years old 骨密度扫描 Bone densitometry 全额 我方将支付每年一次的的骨密度扫描 Paid in Full CIGNA will pay charges for an annual scan to determine the density of the beneficiarys bones 饮食咨询 Dietetic consultations 全额 我方将提供每一保险期间内不多于 4 次的营养师咨询服务 Paid in Full CIGNA will pay charges for 4 meetings per period of cover with a dietician 个人关爱服务 Life Management EAP services 全年 24 小时私人健康服务热线 24-hour365-days telephonic access to confidential consultation regarding behavioural health issues 全额 危机响应服务及紧急情况的救护 Paid in Full Crisis response services and triage to emergency care 转介至非医疗咨询服务机构 Referrals to non-clinical services such as expatriate support groups 与行为健康专家最多三次的正式面谈 Up to 3 face-to-face sessions with a behavioural health professional 网络健康教育及网络健康风险评估指导项目 Online health education health assessment and web-based coaching programmes 五国际眼科与牙科保障可选保障 International Dental and Vision Optional 牙科治疗 Dental Treatment 赔付限额 Benefit Limit 每一保险期间内每一被保险人所有保险责任赔付限额 35000 Annual benefits -imum per beneficiary Up to 35000 per period of cover 预防治疗 Preventive 适用于持续购买本保障 6 个月及以上的被保险人 全额 Available after the beneficiary has been covered on this option for six Paid in Full months 包括研究性及预防性治疗费用 Investigative and Preventative Treatment 常规治疗 Routine 适用于持续购买本保障 6 个月及以上的被保险人 全额 Available after the beneficiary has have been covered on this option for Paid in Full 6 months 牙科疾病治疗 Treatment for a dental problem 牙科修复性治疗 Major Restorative 适用于持续购买本保障 12 个月及以上的被保险人若被保险人在购买后 12 个月内 申请理赔我方将按 50的治疗费用支付 全额 Available after the beneficiary has been covered on this option for 12 Paid in Full months If the beneficiary needs to claim within the first 12 months then this will be covered with a 50 coinsurance 牙科疾病治疗 Treatment for a dental problem 正畸治疗 Orthodontic Treatment 适用于持续购买本保障达 2 年且年龄在 18 周岁及以下的被保险人 每一保险期间内退还 50 Orthodontic treatment for ages 18 and under after the beneficiary has 50 Refund per period of been covered on this option for two years cover 牙错位反颌覆咬合的治疗 Treatment of misaligned teeth under-bite over-bite 眼科护理 Vision Care 赔付限额 Benefit Limit 每一保险期间一次验光师或眼科专家实施的眼科检查 全额 One eye examination per period of cover by an Optometrist or an Paid in Full Ophthalmologist 费用包含 Expenses for Spectacle lenses 眼镜镜片 每一保险期间以 2000 为限 Contact lenses 隐形眼镜 Up to 2000 per period of cover Spectacle frames 眼镜镜框 Prescription sunglasses 根据医嘱所配墨镜 上海高端医疗全球医疗外籍人士医疗保险超市 1高端医疗保障的重点 第一部分 住院保障往往保额高达 1000 万以上包括紧急援助日间治疗等 第二部分 门急诊保障保额3 万6 万12 万甚至1000 万 第三部分 健康体检疫苗等额度在3000-5000 之间 第四部分 牙科眼镜等一年几千-几万 第五部分 生育保障保额在4-6 万甚至更高 结论第一二是最基本的保障以治疗为目的保险公司可以控制风险 第三四五部分客户的意愿决定了费用了大小保险公司很难控制 2 产品特色 无被保险人国籍限制 无医院诊所级别限制 无药品类别限制 灵活的地域选择全球的保障范围 一般分为全球全球除美加地区 门诊住院尊贵的直接付费服务根据地区 3 保险顾问Bupa保柏 GBG太平 MSH InterGlobal金盛 AXA丰泰 Atena 中国人寿 等多家 秦华 『上海买保险』上海地区人寿保险规划师外籍人士医疗全球医疗高端医疗 免费咨询1XXXXXXXXXX Email 1XXXXXXXXXX163com 107242375 个人网站httpquanqiuyiliaocom 全球医疗维基百科 httpquanqiuycom 个人博客 httpcomcngaoduanyiliao