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Schedule of
Coverage
(in US Dollars)
ISIS
will pay 100% of your covered medical expenses up to the
policy maximum after the $100 policy period deductible.
Plan
|
Coverage
|
Standard Plan
|
Super Plan
|
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Benefit A
|
Medical
Expenses within the USA*
|
$100,000.00
|
$250,000.00
|
|
Medical
Evacuation, including Air Ambulance |
Included |
Included |
|
Extension
of Medical Expense Benefits (for Accident ONLY) Upon
return Country of Origin, excluding Air Ambulance
|
$10,000.00
|
$10,000.00
|
| |
Maternity
expenses |
$50,000.00 |
$50,000.00 |
|
Emergency Dental treatment, within the USA |
$150.00 |
$200.00 |
| |
Accidental
Dental Treatment |
$250.00 |
$500.00 |
| |
Physiotherapy |
$1,000.00 |
$2,000.00 |
| |
Outpatient
mental or nervous disorders |
$250.00 |
$500.00 |
| |
Mental
or nervous disorders inpatient treatment (max. 30
days) |
50%
of eligible expenses with a maximum of :
|
Benefit B
|
Accidental
Death
|
$15,000.00
|
$25,000.00
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Benefit C
|
Transportation
costs in case of death
|
$15,000.00
|
$20,000.00
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Benefit D
|
Permanent
disablement as per sliding scale with a maximum of:
|
$15,000.00
|
$15,000.00
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Benefit E
|
Extra
traveling Expenses
|
$2,500.00
|
$5,000.00
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| Benefit
F |
Hazardous
Sports |
Covered |
Covered |
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| Benefit
G |
Cancellation
Charges |
Covered |
Covered |
- Amounts insured for Benefit A will be paid for all Sickness
and Accidents.
- Amounts insured for the other Benefits are the maximum amounts to
be paid while coverage is in force for the Covered Person.
- An excess of $100 applies to each benefit.
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