CiTY - page 3

The four levels of cover you can
choose from
Prestige Plus
Prestige
Comprehensive
Standard
Palliative care
Up to 30 days
Up to 30 days
(Cancer diagnosis only)
Not included
Not included
Emergency treatment
Emergency treatment in the USA. Emergency in-
patient and day-patient treatment which arises
suddenly whilst you are in the USA. Applicable only
for plans with worldwide excluding USA area of cover
Up to 10 weeks up to a limit of
£30,000/
38,250/$48,000
Up to 10 weeks up to a limit of
£20,000/
25,500/$32,000
Up to 6 weeks up to a limit of
£15,000/
19,125/$24,000
Up to 6 weeks up to a limit of
£10,000/
12,750/$16,000
Emergency out-patient treatment whilst you are in
the USA (not applicable with USA upgrade)
Up to
£2,000/
2,550/$3,200
Not included
Not included
Not included
Ambulance transport for emergency transport to or
between hospitals
Up to £700/
890/$1,120 Up to £500/
635/$800
Up to £500/
635/$800
Up to £500/
635/$800
Evacuation and repatriation service (International
emergency in-patient treatment)
Included
Included
Included
Included
Health and wellbeing cover
Non-routine dental care. For example, replacing
crowns
80% of costs incurred up to
£3,500/
4,450/$5,600
50% of costs incurred up to
£500/
635/$800
50% of costs incurred up to
£320/
405/$510
50% of costs incurred up to
£320/
405/$510
Routine dental care. For example, check ups, scale
and polish
Not included – optional
add-on available
Not included – optional
add-on available
Not included
Accidental damage to teeth
Up to
£10,000/
12,750/$16,000
Up to
£10,000/
12,750/$16,000
Up to
£10,000/
12,750/$16,000
Up to
£10,000/
12,750/$16,000
Optical cover
Up to £200/
255/$320
Up to £100/
125/$160
Up to £100/
125/$160
Not included
Eyesight test cover
Paid in full for one eyesight test Paid in full for one eyesight test Paid in full for one eyesight test
Not included
Health check
Up to £400/
510/$640
towards a health check for
each member on the policy
Up to £300/
380/$480 each
year towards a health check
for each member on the policy
Not included
Not included
Disability compensation cover
Up to £100,000/
127,500/
$160,000
Up to
£50,000/
63,750/$80,000
Not included
Not included
External prosthesis
Up to £3,500/
4,450/$5,600 Up to £2,500/
3,200/$4,000 Up to £2,000/
2,550/$3,200 Up to £1,500/
1,900/$2,400
Support and helplines
Health at Hand
Included
Included
Included
Included
Security Hotline
Included
Included
Included
Included
Doctor, Dental, Optical helpline
Included
Included
Included
Included
Interpretation service helpline
Included
Included
Included
Included
Personal Medical Case Management
Included
Included
Included
Included
International Travel Plan
Included
Included
Optional
Optional
healthcare
Summary of Benefits
Excess
You can help control the cost of your premium by adding
an excess to your policy. We offer five levels of excess,
per person, per year.
Excess amounts:
£100
125 $160
£250
320 $400
£500
640 $800
£1,000
1,275 $1,600
£2,000
2,550 $3,200
Exclusions: What’s not
included in the health plans
Our International Health Plans are designed to cover treatment of
medical conditions that respond quickly to treatment – known as acute
conditions. Like most health insurance policies, there are a number of
exclusions and limitations on the plans and this is just a summary of the
most significant exclusions and limitations:
– Pre-existing medical conditions; options to include these are available
for company schemes of five or more
– Routine dentist check-ups for Standard, Comprehensive or Prestige
plans (available as an add-on to Comprehensive and Prestige plans)
– Routine pregnancy and childbirth on Standard or Comprehensive
plans (available as an add-on to Comprehensive plans for corporate
schemes only)
– Preventative treatment
– Ongoing, recurrent or long-term treatment of long-term illnesses
(usually referred to as Chronic conditions) if you have the Standard
plan
– Any treatment costs incurred as a result of engaging in or training for
any sport for which you receive a salary or monetary reimbursement,
including grants or sponsorship (unless you receive travel costs only).
Full details of what members are and are not covered for are provided
in the membership handbook, or are available on request.
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