Page 6 - ALC Health

(treatment received but without admission to a hospital bed)
Prima Premier Prima Classic
Overall Limit Limited to the overall policy
limit of £2,500,000: €3,000,000:
US$3,750,000
Out-patient limit of £10,000:
€12,000: US$15,000 within
overall policy limit of £1,250,000:
€1,500,000: US$1,875,000
Professional Fees
Medical practitioner, specialist and qualified nurse fees
incurred for consultations and examinations.
Full Refund Full Refund within overall
out-patient limit
Diagnostics
Diagnostic procedures, including x-rays, pathology, computerised
tomography and magnetic resonance imaging (brain and body
scans).
Full Refund Full Refund within overall
out-patient limit
Surgical Treatment
Minor surgical procedures when carried out by a medical
practitioner or specialist .
Full Refund Full Refund within overall
out-patient limit
Medication
Drugs and medicines when prescribed by a specialist or medical
practitioner.
Full Refund Full Refund within overall
out-patient limit
Chronic Conditions
Acute episodes of a chronic condition.
Routine management, maintenance and palliative treatment of
a chronic condition.
Full Refund
Limited to £2,000 :€2,400:
US$3,000 each year
Full Refund within overall
out-patient limit
Not Covered
Oncology
Oncologist fees, radiotherapy and chemotherapy. Includes road
ambulance costs for transportation to and from the out-patient
unit of a hospital for the administering of this specific treatment.
Full Refund Full Refund within overall
policy limit of £1,250,000:
€1,500,000: US$1,875,000
Physiotherapy
Physiotherapy on recommendation by a medical practitioner or
specialist. A referral from your medical practitioner or specialist
is valid for six months only, after which time a new referral letter
would be required. If during this six month period you require
physiotherapy for a different medical condition, then a new
referral will be required.
Limited to £3,000: €3,600:
US$4,500 each year
Limited to £1,500: €1,800:
US$2,250 each year within
overall out-patient limit
Chiropody
Treatment by a Chiropodist without referral to a medical
practitioner.
Limited to £250: €300:
US$375 each year
Limited to £250: €300:
US$375 each year within
overall out-patient limit
Complementary Treatment
Treatment administered by chiropractors, osteopaths,
homeopaths, acupuncturists.
Dietician (limited to 1 visit per year).
Podiatrist (limited to 2 visits per year).
Recommendation by a medical practitioner or specialist is
required for all complementary treatments. A referral from your
medical practitioner or specialist is valid for six months only, after
which time a new referral letter would be required. If during this
six month period you require complementary treatment for a
different medical condition, then a new referral will be required.
Limited to £3,000: €3,600:
US$4,500 each year
Limited to £1,500: €1,800:
US$2,250 each year within
overall out-patient limit
3
Out-patient Treatment (OPTIONAL BENEFIT for Prima Premier)