Page 7 - ALC Health

Prima Premier Prima Classic
Hormone Replacement Therapy
Medical practitioner or specialist consultations and prescribed
patches or implants when administered for the sole purpose of
treating a hormone imbalance condition.
Full Refund Not Covered
Optical
Eye examination carried out by an optometrist or ophthalmologist.
Prescribed glasses and contact lenses to correct vision when your
prescription has changed.
One examination each year
Limited to £130: €156: US$195
each year
One examination each year
Limited to £130: €156: US$195
each year within overall
out-patient limit
Well-being Benefit
(excluding costs incurred within the first 12 months of purchase
date of this benefit or your date of entry, whichever is the latter)
Hearing Test
Annual Hearing Test carried out by a medical practitioner.
Routine Health Checks
Tests/screenings that are undertaken without any clinical
symptoms being present including the following examinations
performed at an appropriate age interval for the early detection
of illness or disease:
n Vital signs (blood pressure, cholesterol, pulse, respiration,
temperature etc)
n Cardiovascular examination
n Neurological examination
n Cancer screening
n Well child test
Vaccinations
Cost of drugs and consultations to administer all basic
immunisations and booster injections required under regulation
of the country in which treatment is being given and any
medically necessary travel vaccinations and malaria prophylaxis.
Emergency Dental Treatment
Emergency out-patient dental treatment received in a dental
surgery or hospital emergency room for the immediate relief
of dental pain, including temporary fillings limited to 3 fillings
per period of cover , and/or the repair of damage caused in an
accident. The treatment must be received within 36 hours of
the emergency event. This does not include any form of dental
prosthesis or root canal treatment.
The total of the benefits
available within the Well-being
Benefit is limited to £500: €600:
US$750 each year
One test each year
Full Refund within Well-being limit
Full Refund within Well-being limit
Children up to the age of
6 years, limited to 15 visits per
lifetime
Full Refund within Well-being limit
Full Refund within Well-being limit
Full Refund
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Not Covered
Full Refund
4
Psychiatric Illness
Specialist consultations, assessments and treatment. All
treatment under this benefit is subject to pre-authorisation by us.
If treatment is not pre-authorised by us, then we reserve the right
to decline the claim in full.
Limited to £5,000: €6,000:
US$7,500 each year
Not Covered
Traditional Chinese Medicine
Chinese herbal medicine and treatment administered by a
recognised traditional Chinese herbalist or practitioner.
Limited to £500: €600:
US$750 each year
Limited to £500: €600: US$750
each year within overall
out-patient limit