16
17
core cover: worldwide medical insurance
Benefits
level of cover
Explanation of benefits
Childbirth at home or
birthing centre
Each
membership year
, up to
GBP 650, USD 1,105 or EUR 810
We
pay for midwives’ or other
specialists’
fees for childbirth at home or
birthing centre
after the mother has been a
member for 24 months.
Medically essential Caesarean section
Each
membership year
, up to
GBP 13,000, USD 22,100 or
EUR 16,250
We
pay for
hospital
, obstetricians’ and other medical fees for the cost of the delivery of
your
baby by Caesarean section,
after the mother has been a member of this plan for 24 months, when it is medically essential for a Caesarean section for
example as a result of non progression during labour
(eg dystocia, foetal distress, haemorrhage).
Note: if
we
are unable to determine that
your
Caesarean section was medically essential, it will be paid from
your
maternity
and childbirth benefit limit.
We
do not pay for
treatment
directly related to surrogacy.
We
will not pay maternity benefits:
{
{
to
you
if
you
act as a surrogate, or
{
{
to anyone else acting as a surrogate for
you
We
do not pay for
treatment
received as an
out-patient
before or after the birth unless
you
have bought the Worldwide
Medical Plus option.
Please read the ‘Adding members to
your
plan’ section in the ‘How to use
your
plan’ booklet.
Newborn care
Each
membership year
, up to
GBP 75,000, USD 127,500 or
EUR 93,750
We
pay newborn care benefits:
{
{
for all
treatment
required for the newborn during the first 90 days’ following birth, instead of any other benefit. (The
first seven days of routine care for
your
baby will be paid from the mother’s maternity benefit, whether
your
baby is
entitled to newborn cover benefits or not)
{
{
only for children covered under this plan within 30 days after birth and who are added from their date of birth
We
do not pay newborn care benefits for children joining on their own membership (where they are the
main member
), as
these children can only join once they are 5 years old, or children born as a result of
assisted reproduction technologies
,
ovulation induction treatment
, born to a surrogate or who have been adopted, as these children can only join once they are
91 days old.
Please read the ‘Adding members to
your
plan’ section in the ‘How to use
your
plan’ booklet.
Cancer
treatment
Paid in full
We
pay for
treatment
of cancer, once it has been diagnosed, including:
{
{
fees that are related specifically to planning and carrying out
treatment
for cancer. This includes tests, scans,
consultations and drugs (such as cytotoxic drugs or chemotherapy), and
{
{
when the acute phase of cancer
treatment
(by which
we
mean surgery, radiotherapy or chemotherapy) has been
completed,
we
will continue to pay this benefit for all cancer
treatment
specifically related to the original diagnosis for
up to a further five years
The five years will begin on the first
out-patient
consultation following completion of the acute phase of
treatment
. Cover
during this period includes any follow-up tests, scans and consultations
you
may require. It also includes any drugs that may
be required to keep the cancer in remission or to prevent relapse, for up to five years.
If
your treatment
needs to continue for more than five years, please contact
us
for prior approval. It may be necessary for
us
to seek a second opinion as part of
our
approval process.
