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Mission+Plus International

Overview • Benefits

Mission+Plus International covers the Usual, Reasonable and Customary charges for eligible expenses in the area where treatment is received. Deductibles are per insured person per calendar year with a maximum of 2 deductibles per family per calendar year. For eligible expenses incurred in the United States and Canada: Once the deductible has been met, the plan will pay 80% of all eligible medical expenses up to US$5,000 then 100% of eligible expenses up the the policy maximum. For eligible expenses incurred outside of the U.S. and Canada: Once the deductible is met, the plan will pay 100% of eligible expenses up to the policy maximum.

MEDICAL INSURANCE
BENEFIT
Subject to deductible and
coinsurance
  
Coverage Area
Worldwide

Policy Maximum Per Individual US$1,000,000 lifetime
(may be increased to US$5,000,000)


Hospital Room & Board

Payable up to the average semi-private room rate, including nursing service

Hospital Pre-Admission Testing

Subject to deductible

Intensive Care Unit

Up to 3 times the average semi-private room rate

Second Surgical Opinion

Subject to deductible & coinsurance unless requested by the Company (payable at 100% if requested by the Company)

Eligible Medical Expenses

Usual, reasonable, & customary

Transplant Benefits
Subject to special transplan pre-certification requirements, and only when expense treatment is provided within the Managed Transplant System Network. Covered transplants are: heart, heart/lung, lung, kidney, kidney/pancreas, liver, and allogeneic and autologous bone marrow.

US$500,000 lifetime maximum for covered transplants
Maternity and Newborn Care

Subject to special maternity pre-certification requirements, same as any other illness
Mental/Nervous Disorders
Inpatient treatment
Limited to 15 days per calendar year per insured person

Outpatient treatment
Maximum of 40 visits per calendar year per insured person

 
Same as any other illness

50% reimbursement
Wellness Benefit
For you and your spouse for a physical examination, including immunizations and mammograms every 24 months. To qualify, you must have been covered under the Mission+Plus International plan for at least 24 months and must be at least age 35 if female, or at least age 40 if male.

Up to US$250 coverage (not subject to deductible or coinsurance)
Physical Therapy

Up to US$50 maximum per charge per visit
Chiropractic Care

US$500 maximum per year, reimbursable at 50%
Home Health Care

Limited to 30 days per occurrence of illness
Extended Care Facility

Limited to 100 days per occurrence of illness
Hospice Benefit

US$7,000 lifetime per insured person
Additional Benefits
•Life Insurance
•Dental Insurance
•Emergency medical evacuation insurance

 
Required
Optional
Optional

This is a summary of benefits only, and is subject to the specific terms and conditions of the plan concerning eligible benefits, limitations, eligibility and exclusions thereunder. Please refer to the policy wording for a complete description, available upon request.

 
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