全球医疗保险计划BenifitsScheduleQuote保障利益表及报价.doc

全球医疗保险计划Benifits Schedule & Quote 保障利益表及报价发布时间：Benefit Items保障项目Basic基本Standard标准Select精选Elite精英Annual Maximum Aggregate Limit年度总限额RMB 2,000,000200万RMB 4,000,000400万RMB 8,000,000800万RMB 8,000,000800万Geographic Coverage Area保障区域Greater China大中华Asia亚洲Worldwide excluding North America全球除美加Worldwide全球o Inpatient Benefits住院医疗费用保险金Pre-authorization required需要预授权Room, Board and Nursing (up to private/single room)床位费、膳食费、护理费(上限为私人/单人病房)Fully Covered （Max. 180 days/yr）全额理赔（最高180天/年）Fully Covered （Max. 180 days/yr）全额理赔（最高180天/年）Fully Covered （Max. 180 days/yr）全额理赔（最高180天/年）Fully Covered （Max. 180 days/yr）全额理赔（最高180天/年）Examination and laboratory tests, other inpatient treatment expenses检查检验费、治疗费Fully Covered 全额理赔Fully Covered 全额理赔Fully Covered 全额理赔Fully Covered 全额理赔Prescription Drugs, Doctors Fee including Surgeons, Physicians, Anaesthetist and Specialists药品费、医师费Non-organ Transplant Surgery and Organ Transplant Surgery非器官移植手术费、器官移植手术费Companion Bed and Intensive Care Unit加床费、重症监护费In-patient Psychiatric Treatment (up to 90 days per year)精神病治疗（最多90天/年）Not Covered不提供RMB 50,000/yr5万元/年RMB 50,000/yr5万元/年RMB 100,000/yr10万元/年Family Care (up to 100 days per year)家庭护理（最多100天/年）Not Covered不提供Not Covered不提供Fully Covered全额理赔Fully Covered全额理赔Hospice Care (up to 45 days per year)临终医疗费（最多45天/年）Not Covered不提供Not Covered不提供RMB 50,000/yr5万元/年RMB 50,000/yr5万元/年Ambulance救护车费Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔B. No Claim Hospital Income / 住院无理赔日额补贴In the event that the insured havent claimed from us or receives full compensation from any third party for the hospital expenses, we shall provide No Claim Hospital Income according to the duration of hospital stay (up to 30 days per year).被保险人因疾病或意外伤害事故进行住院治疗而发生的医疗费用，如被保险人不向本公司进行索赔或已通过其他途径取得全部补偿的, 本公司按被保险人实际住院日数给付住院日额补贴。（限30天/年）RMB 200/day200元/日RMB 200/day200元/日RMB 200/day200元/日RMB 200/day200元/日C. Out-patient Benefits / 门诊医疗费用保险金Annual Limit年度总限额RMB 50,000/yr5万元/年RMB 100,000/yr10万元/年Fully Covered全额理赔Fully Covered全额理赔Consultation fees, Examinations and Laboratory Tests, Out-patient Surgery and Other Out-patient Treatment expenses医生诊疗费、检查检验费、治疗费、门诊手术费Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔Prescription Drugs处方药品费RMB 20,000/yr2万元/年Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔Physiotherapy and Other Alternative Therapies物理治疗及其他特殊疗法（限10次/年）Not Covered不提供RMB 500/visit500元/次RMB 1,000/visit1000元/次RMB 1,500/visit1500元/次Out-patient Psychiatric Treatment精神病治疗（限20次/年）Not Covered不提供RMB 500/visit500元/次RMB 1,000/visit1000元/次RMB 1,500/visit1500元/次Emergency Dental Treatment意外牙科治疗RMB 5,000/yr5000元/年RMB 10,000/yr1万元/年RMB 20,000/yr2万元/年RMB 40,000/yr4万元/年Diabetes Treatment糖尿病治疗用品费RMB 20,000/yr2万元/年RMB 40,000/yr4万元/年RMB 40,000/yr4万元/年RMB 40,000/yr4万元/年Hormone Replacement Therapy激素替代治疗RMB 50,000/yr5万元/年RMB 100,000/yr10万元/年Fully Covered全额理赔Fully Covered全额理赔Infant Check-up and Vaccinations婴儿免疫和检查费RMB 2000/yr2000元/年RMB 2000/yr2000元/年RMB 2000/yr2000元/年RMB 2000/yr2000元/年Ambulance救护车费Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔Fully Covered全额理赔D. Special Out-patient Benefits / 特殊门诊保险金Outpatient Kidney Dialysis and Out-patient Cancer Treatment including Electrotherapy, Chemotherapy and Radiotherapy.门诊肾透析、门诊恶性肿瘤电疗、门诊化疗、门诊放疗RMB 150,000/yr15万元/年RMB 150,000/yr15万元/年RMB 200,000/yr20万元/年RMB 200,000/yr20万元/年E. Maternity(Optional) / 女性生育保险金Annual Limit年度总限额RMB 60,000/yr6万元/年RMB 60,000/yr6万元/年RMB 80,000/yr8万元/年RMB 80,000/yr8万元/年New-born infant care, treatment and immunizations新生儿护理费、治疗费、疫苗费（14天内）Fully Covered 全额理赔Fully Covered 全额理赔Fully Covered 全额理赔Fully Covered 全额理赔Hospital expenses related to delivery , abortion and pregnancy complications including pre-natal and post-natal examinations, pre-natal vitamins and calcium tonic分娩、流产期间住院医疗费用以及孕期并发症的治疗费用，包括产前产后检查费、产前维生素、钙剂Type-B Ultrasonic InspectionB超检查费（2次）F. Dental Treatment (Optional)/ 牙科医疗保险金Annual Limit年度总限额RMB 2,0002000元RMB 4,0004000元RMB 6,0006000元RMB 8,0008000元Basic Treatment基础修补治疗-Includes amalgams or composite fillings and simple extractions, periodontal scaling, and root planning包括简单补牙(包括银汞合金或复合树脂充填)、简单拔牙、牙周治疗(包括牙周刮治、牙根平整术等)80% Covered80%赔付80% Covered80%赔付80% Covered80%赔付80% Covered80%赔付Major Treatment重大修补治疗-Includes root fillings, crowns and inlays, bridges (including laboratory and anesthetic fees), wisdom teeth extractions. Tooth alignment is also included for the insured under 18.包括根管治疗、牙冠修复、义齿（包括化验和麻醉费用）、智齿拔除费。对于年龄未满18周岁的被保险人，重大修补治疗费还包括牙齿矫正治疗费。50% Covered50%赔付50% Covered50%赔付50% Covered50%赔付50% Covered50%赔付G. Vision Benefits(Optional) / 眼科保险金Routine Vision Examination眼科检查费RMB 600/yr600/年RMB 600/yr600/年RMB 600/yr600/年RMB 600/yr600/年Lens and Frames眼镜费（框架眼镜或隐形眼镜任选其一）RMB 1,000/yr1000/年RMB 1,000/yr1000/年RMB 1,000/yr1000/年RMB 1,000/yr1000/年H. Emergency Medical Benefits(Optional) / 紧急医疗保险金Emergency medical care services received outside the geographic coverage area due to accidental injuries or acute diseases被保险人在合同约定的保障区域以外的其他国家和地区旅行时，因意外伤害事故或突发急性病而导致的紧急治疗的医疗费用Fully Covered Up to RMB 500,000/yr全额理赔 年限额50万元/年Fully Covered Up to RMB 500,000/yr全额理赔 年限额50万元/年Fully Covered Up to RMB 500,000/yr全额理赔 年限额50万元/年-I. Preventative Care(Optional) / 预防保健服务Health Check-up(Limit to one per year)健康体检(1年1次)Includes general examination(height, weight, and blood pressure), routine physical examination of internal medicine, eye, ear, nose and throat, EKG, abdominal ultra-sonography, urine routine, stool routine, blood routine, blood sugar(AC), liver function, renal function, lipid profile, hepatitis B etc. at designated check-up institutions with a comprehensive evaluation report provided. Items may vary in different packages.在指定体检机构的年度健康体检服务包括一般检查（身高、体重、血压等）、内科、外科、眼科、五官科、胸部X光检查、心电图、腹部超声波、小便常规、显微镜检查、大便常规、血常规、血糖（空腹血糖）、肝胆功能、肾功能、血脂、乙肝检测等。体检项目在不同计划中可能会有差异。Preventative Dental Care(Limit to one per year)预防牙科保健（1年1次）-Includes basic items: Oral examination, ultrasonic scaling, and polishing. Optional Items: Panoramic X-ray, sand blasting and topical fluoride (one in three only).基本项目包括口腔检查，洗牙，抛光。客户还可以从口腔全景片，喷砂，进口材料氟化治疗等三个项目中任意选取一项。JWorldwide Emergency Assistance / 全球紧急救援服务Emergency Assistance Services紧急救援服务Includes medical referral and emergency medical evacuation, accommodation for compassionate visit, repatriation to the country of residence安排就医和紧急医疗转送, 陪同住院, 转送回国RMB 500,000/yr50万元/年RMB 500,000/yr50万元/年RMB 500,000/yr50万元/年RMB 500,000/yr50万元/年Mortal Remains Handling遗体安排Includes repatriation of mortal remains or ashes, local cremation or local burial.遗体转送回国, 遗体火化和骨灰转送回国, 就地安葬Not Covered不提供RMB 500,000/yr50万元/年RMB 500,000/yr50万元/年RMB 500,000/yr50万元/年KValue-added Services/ 健康增值服务Second Medical Opinion第二诊疗意见Medical opinions from domestic and international experts for 18 specified major illnesses.对于指定30种重大疾病，我们会免费协助您联系全球相关领域的医学专家咨询疾病诊断及治疗意见Direct Billing直接结算服务Direct billing service is available at our widely located network hospitals to save your large-sum cash payment and the trouble of submitting claim materials. 当您在我们的网络医院里就诊时，可以享受直接结算服务, 省去了大量现金垫付和传统理赔提交各种材料所带来的麻烦。Out-patient Appointment 门诊预约服务Our customer service specialist will help you make out-patient appointment with our network hospitals and specialists according to your medical needs. (currently available at network hospitals in Beijing, Shanghai and Guangzhou). 我们会根据您需求帮您预约网络医院内合适的医院和专家。（目前仅限北京，上海，广州）Care Facilitation导医导诊服务Our experienced health personnel may accompany you to facilitate your medical services such as registration, examination, getting drugs and making payment if you are not familiar with the hospitals or if you have language problems.如果您不熟悉医院环境或有语言障碍，我们经验丰富的健康专员可以协助您就医如取号、化验、取药、交费等。Health Consultation Servic