BLA Prestige Health Supplementary Contract

BLA Prestige Health Supplementary Contract​​​
Click to View Benefits and Coverage
 
Supplementary contract BLA
Prestige
Health
(Special)
BLA Prestige Health
Coverage area Thailand Thailand Thailand / Asia / Worldwide
excluding the USA / Worldwide
Maximum benefits per policy year (baht) 10 million 30 million 50 million 80 million 100 million
Coverage Maximum benefits (baht)
1. Inpatient Benefits
1.1 Room and board, daily nursing and other hospital service charge coverage per admittance 8,000 10,000 12,000 15,000 25,000
1.1.1 Room and board, daily nursing charge coverage (up to 365 days)
1.1.2 ICU room (not exceeding 365 days); after including benefits, room and board, and daily nursing charge coverage under 1.1.1, this shall not exceed 365 days Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount
1.2 Other medical expense coverage in the hospital Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount
1.3 Cost of medical instruments and prosthesis, lifelong benefits of up to​ 50,000 80,000 100,000 200,000 400,000
1.4 Daily doctors’ fees in the hospital and medical specialists’ consultation fees Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount
1.5 Cost of surgeon and medical procedures
1.6 Fees for anesthetist and/or nurse anesthetist
1.7 Charges for operating room and equipment
1.8 Inpatient rehabilitation charges (up to 30 days per disease)
1.9 Costs for organ transplantation (maximum 1 time per lifetime)
1.10 Cost of private nursing care according to doctor’s advice after being hospitalized (up to 60 days of policy year)
1.11 Inpatient rehabilitation fee (within 30 days after being discharged from the hospital)
2. Benefits for emergency medical treatment
2.1 Ambulance fee Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount
2.2 Dentistry expense due to accidental injury
2.3 Outpatient medical expense due to accident within 24 hours
3. Outpatients benefits​
3.1 General practitioners and specialists’ consultation fees, including cost of diagnostic test and cost of medicines (not exceeding 2 times per day; up to 360 times per year). Maximum benefits throughout policy year not exceeding - 15,000 15,000 30,000 Pay by actual amount
3.2 Cost of physical therapy - 5,000 5,000 10,000 50,000
3.3 Acupuncture, naturopathy, osteopathy and chiropractic
3.4 Medical expenses for cancer treatments including chemotherapy, targeted therapy, and radiation therapy Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount Pay by actual amount
3.5 Cost of kidney dialysis
3.6 Cost of Advanced Diagnostic Body Imaging; for instance, MRI
The Company will pay benefits for necessary and appropriate expenses incurred due to necessary medical treatments and standards at the coverage areas according to actual amounts paid but not exceeding the maximum benefits per policy year as specified in the Table of Benefits.

Remarks:

  • A choice of 1 coverage area, with the premium being different for each area.
  • Asia includes Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, Pakistan, The Philippines, Singapore, South Korean, Sri Lanka, Taiwan, Tajikistan, Turkmenistan, Uzbekistan, Vietnam, and Thailand.
  • Worldwide excluding the USA means worldwide excluding the USA and the United States Minor Outlying Islands.
Click to view coverage exemptions
 
  1. Pre-existing conditions, namely chronic disease, illness (including complications) or injury which had not been treated and cured before effective coverage date of the Supplementary Contract or the latest Reinstatement, whichever is the latest, except if
    - The insured has declared to the Company and the Company has approved to accept risk without exclusions of such coverage; or
    - This Supplementary Contract has been effective for at least 3 years consecutively where such chronic disease, injury or illness (including its complications) is asymptomatic and has not been treated or diagnosed by a physician, or has not been seen or consulted by a physician within 5 years before the first effective date of the Supplementary Contract.
  2. Illnesses which occur within the waiting period, namely
    - any illness that occurs within 30 days from the effective coverage date of the Supplementary Contract or the latest Reinstatement, whichever is the latest, or
    - Illnesses caused by the following diseases that occur within 120 days from the effective coverage date of the Supplementary Contract or the latest Reinstatement, whichever is the latest
    • Tumors, cysts, or all types of cancer
    • All types of hernia
    • Tonsillectomy or Adenoidectomy
    • Varicose vein
    • Hemorrhoid
    • Pterygium or Cataract
    • All types of stone
    • Endometriosis

For more details, please contact our life insurance agents or financial advisors nationwide.

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