Page 26 - Εταιρικό Comprehenshive
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6.5
We pay for eligible:
(a)
Surgical procedures listed in a technical document, called the schedule of procedures and
fees, which lists the surgical procedures we pay benefits for. We will pay for treatment not
listed if, before the treatment begins, it is established that the treatment is recognised as
appropriate by an authoritative medical body and we have agreed with the medical
practitioner and the hospital what the fees will be. If you would like a copy of the schedule
of procedures and fees please refer to the AXA PPP International website:
.
(b)
Reasonable costs incurred for a live donor to donate an organ or tissue provided that:
•
the operations to both the donor and the recipient are carried out simultaneously; and
either
•
both the donor and the recipient are immediate relatives (ie parent, child or sibling) and
either the donor or the recipient is covered on this policy; or
•
both the donor and the recipient are members of AXA PPP International at the time the
operations are carried out and both have been members since before the recipient
developed the medical condition requiring the transplant (see also
).
6.6
What we do not pay for:
(a)
The use of a drug which has not been established as being effective or which is
experimental. This means they must be licensed by the European Medicines Agency if you
are receiving treatment in Europe, or the US Food and Drug Administration (FDA) if you are
receiving treatment anywhere else in the world, and be used within the terms of that
licence.
(b)
Treatment which has not been established as being effective or which is experimental. For
established treatment, this means procedures and practices that have undergone
appropriate clinical trial and assessment, sufficiently evidenced in published medical
journals for specific purposes to be considered proven safe and effective therapies.
(c)
The cost of collecting donor organs or tissue or for any related administration costs (such
as, but not limited to, the cost of a donor search).
Childbirth, pregnancy and sexual health
If you have the pregnancy add-on: There is a benefit for normal pregnancy and childbirth shown
on your benefits table. We will pay for in-patient or out-patient antenatal consultations, delivery
and postnatal consultations for up to six weeks following birth as detailed in the benefits table.
This is in addition to the benefits available for treatment of a medical condition that is
experienced during pregnancy and/or childbirth as described below.
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