Major Medical Group Plan
Group Major Medical Plan is a broad benefit Inpatient only plan with a yearly deductible. A plan designed to provide cover in the event of a medical condition that requires hospitalization or emergency medical treatment.
The plan is designed to have an affordable premium with a yearly deductible. The deductible can be increased to reduce the premium further.
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Key Features
Free Choice of doctors and hospitals | Guaranteed renewability regardless of age, medical condition or location | Flexible geographic cover | Free coverage for recreational sports | Direct payment to hospitals and 24 hour Worldwide Emergency Assistance | Consideration of pre-existing conditions | 14-day Free Look Period. You may return your policy within fourteen days after receipt for full refund of the premiums paid
| Schedule of Benefits (in USD) | Major | Upgrade Plan |
|---|---|---|
| Maximum Benefit For Any One Disability and Sequelae | US$250,000 | US$1,000,000 |
| Deductible (per person per year) | US$1,000 (US$2,500 & US$5,000 option) | US$1,000 (US$2,500 & US$5,000 option) |
| Covers normal, usual and customary charges for: | ||
| Inpatient Benefits | ||
| Room and Board | Semi-Private up to US$350 per day (Private in Indonesia, Malaysia, Philippines & Thailand) | Semi-Private up to US$500 per day (Private in Indonesia, Malaysia, Philippines & Thailand) |
| Parent Accommodation - An extra bed in the same room for a parent accompanying an insured child under 12 years old | 100% | 100% |
| Intensive Care Unit, Coronary Care Unit and Operating Room | 100% | 100% |
| Surgeon’s Fee - Includes pre-surgical assessment and normal post-surgical care for each operation as per Surgical Schedule up to | US$30,000 | US$50,000 |
| Anaesthetist’s Fee | 35% of eligible Surgeon’s Fee | 35% of eligible Surgeon’s Fee |
| Miscellaneous Inpatient Charges - For required diagnostic laboratory tests, x-rays, prescribed medicines; professional fees; blood and plasma; wheel chair rentals; outpatient surgery; surgical appliances and devices; and intra-operative standard prosthetics (as approved by the Company) | 100% | 100% |
| Organ Transplant - Fees for kidney, heart, lung, liver or bone marrow transplants (up to 50% for donor and the remaining percentages for recipient, at the option of the Insured Person) to a total of This benefit is a lump sum maximum per organ and no other policy benefits are payable in respect of Organ Transplant | US$100,000 | US$100,000 |
| HIV / AIDS - Coverage will apply when HIV and/or its related illnesses present for the first time after 5 years continuous coverage under the Policy and any renewal thereof, with lifetime limit of | US$100,000 | US$100,000 |
| Hospital Cash Benefit - For inpatient treatment received without charge for up to 15 nights | US$100 per night | US$100 per night |
| Home Nursing - Immediately after a hospital confinement and certified to be medically necessary by the attending physician for up to 30 days | 100% | 100% |
| Rehabilitation - When certified necessary by the attending physician for up to 45 days of inpatient, day case or outpatient treatment starting within 14 days of hospitalization | 100% | 100% |
| Oncology - Radiotherapy and chemotherapy (by way of infusion and injection) received as inpatient, day case or outpatient treatment | 100% | 100% |
| Hospice Care - For terminal illnesses with lifetime limit of | US$10,000 | US$10,000 |
| Psychiatric and Mental Disorders - Hospital charges with lifetime limit of | US$5,000 | US$5,000 |
| Follow-up Care - For up to 90 days of normal care immediately after hospitalization. Outpatient physician and physiotherapist when certified medically necessary by the attending physician; and, for required diagnostic laboratory tests, x-rays and prescribed medicines | US$2,500 | US$2,500 |
| Emergency Benefits | ||
| Emergency Room Treatment | 100% | 100% |
| Accidental Damage to Teeth - Emergency treatment for up to 7 days following accidental loss or damage caused to sound natural teeth | 100% | 100% |
| Emergency Local Ambulance Service | 100% | 100% |
| 24-Hour Emergency Assistance Services and Emergency Medical Evacuation Service - Additional Travel Expenses(following Evacuation) One economy class airline ticket to return an Insured Person to the country of residence | Included | Included |
| Repatriation of Mortal Remains - Covers costs for repatriation of mortal remains of the Insured Person to home country or country of residence | 100% | 100% |
| Additional Benefits | ||
| Dental Benefit - 80% reimbursement up to an Yearly limit of | US$2,000 | US$2,000 |
| Personal Accident Benefit - Covers loss of life, loss of one or both hands or feet, loss of vision in one or both eyes, or permanent and total disability caused directly and solely by an accident. (Maximum benefit is US$100,000 after age 65 and coverage is terminated after age 75. Child benefit limits are US$10,000 to US$50,000) | US$100,000 to US$500,000 | US$100,000 to US$500,000 |
| Travel Benefit - Covers the following eligible expenses worldwide when travelling outside your country of residence on trips lasting up to 90 days: | ||
| Emergency Medical Expenses - Covers illness or injury including “Emergency Evacuation” - (up to US$25,000) with a maximum of US$300 per day for hospital room and board which is doubled when the room fee includes medical service costs and tripled when the room fee also includes all professional services; and “Get You Home Benefit” - covers the additional cost of your own travel and accommodation necessarily incurred as a result of a covered disability to get you back home. | US$35,000 | US$35,000 |
| Baggage & Travel Documents - Covers loss and damage of baggage and personal items including laptop computer; and loss of travel documents up to | US$750 | US$750 |
| Baggage Delay - Covers purchase of essential clothing and toiletries if your checked baggage is delayed on arrival at your destination for over 12 hours up to | US$125 | US$125 |
| Personal Money - Covers theft, burglary and robbery of cash, bank notes and travellers checks up to | US$500 | US$500 |
| Hospital Cash Income - Pays US$50 per day for each day you are hospitalized over 24 hours up to | US$600 | US$600 |
| Travel Delay - Covers transportation expenses incurred as a direct consequence of travel delay resulting from serious weather conditions, industrial action, hijack, mechanical derangement if an Insured Person has to re-route his trip due to cancellation of a prior confirmed booking; or “Cash Allowance” - pays US$25 for each full 12 hours delay up to a maximum of US$100. | US$650 | US$650 |
| Curtailment of Trip & Cancellation Charges - Covers irrecoverable prepaid travel arrangement deposits or any increased cost of travel in the event of death, serious injury or illness of the Insured Person, immediate family members or close business partner or travel companion of the Insured Person, witness summons, jury service, compulsory quarantine; natural disasters at the planned destination or complete destruction of the Insured Person’s principal residence. | US$2,500 | US$2,500 |
| Optional Rental Car Protection - Covers loss and damage occurs to a rental car result directly from fire, theft, collision or vandalism. Deductible: US$500 | US$10,000 | US$10,000 |
| Discount Options | ||
| Increase Deductible US$2,500 (you pay the first US$2,500 of eligible expenses) | 25% Discount | 25% Discount |
| Increase Deductible US$5,000 (you pay the first US$5,000 of eligible expenses) | 35% Discount | 35% Discount |
| Treatment Area Limit (TAL): when selected by the policyholder in respect of the policy provides coverage in Hong Kong (SAR), Japan, North America and Singapore provided the Insured Person has not been travelling to these locations for more than 30 accumulated days in one policy year. The coverage is for inpatient treatment in the event of an emergency resulting from an accident and/or the onset of an acute disability which the Insured Person had not suffered from or had been symptomatic prior to travelling. | 25% Discount | 25% Discount |
We understand insurance can be confusing and that it is one of the most important decisions you will make to protect yourself, your family and your employees. nib NZ Limited has an experienced team of customer service representatives who are waiting to answer any questions or comments you may have.
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