Home > Now Health International - Worldcare Apex

Now Health International - Worldcare Apex

WorldCare covers reasonable and customary charges for medically necessary treatment of disease, illness or injury. This is a summary of the WorldCare benefit schedule, which briefly outlines the cover available under each plan, per period of cover. For the full schedule, see the WorldCare Members’

Benefits

Key Facts - In-patient & Day Case Charges
Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
	i) Hospital charges for in-patient and day-patient treatment: Full refund ii) Related ancillary charges up to: USD 2,500 : EUR 2,000 : GBP 1,550 per medical condition
Surgeon / Consultant / Specialist & Anaesthetists fees
	Full refund
Physicians fees & diagnostic tests
	Full refund
Cancer Treatment Costs - Chemotherapy / Radiotherapy
	Full refund
Organ transplant
	i) Treatment: Full refund ii) Donor medical costs: Up to USD 50,000 : EUR 40,000 : GBP 31,250 Renal Failure and Renal Dialysis as Day-Patient or Out-Patient: Up to USD $75,000 : EUR 60,000 : GBP 46,875
Outside area of cover limit for USA / Canada
	Optional cover: Up to USD 1.5m : EUR 1.2m : GBP 937,500
Prosthetic devices
	Not covered
Psychiatric treatment
	Full refund for up to 30 days
Key Facts - Out-patient Charges
Complementary medicine
	Full refund
Diagnostic tests (excluding scans)
	Full refund
GP referred consultations
	i) Medical practitioner / Specialist fees: Full refund ii) Physiotherapy: Full refund
Physiotherapy consultant referred
	Full refund
Physiotherapy GP referred
	Full refund
Psychiatric cover
	Up to USD 7,500 : EUR 6,000 : GBP 4,600
Radiotherapy / Chemotherapy
	Full refund
Scans - MRI / CT / PET
	Full refund when received as an in-patient, day-patient or out-patient
Surgical Procedures
	Full refund
Vaccinations administered by a medical practitioner
	Not covered
Key Facts - Additional Benefits
Cash benefit if the treatment is received completely free of charge
	Up to 30 nights, USD 275 : EUR 220 : GBP 165 per night
Nursing at home
	i) Care given by a qualified nurse: Full refund up to 120 days ii) Emergency out-of-hours medical practitioner (GP) home visits: Up to 5 visits
Parental accommodation
	Full cover for the cost of one parent staying in hospital overnight with an insured child
Private ambulance
	Full refund
Additional Benefits
24 Hour emergency helpline
	24/7 helpline provided
Accompanying relative travel & accomodation
	Evacuation i) Transportation costs: Full refund ii) Reasonable local travel costs to and from medical appointments: Full refund iii) Reasonable travel costs for a locallyaccompanying person: Full refund iv) Non-hospital accommodation costs: Up to USD 300 : EUR 240 : GBP 185 per day, up to USD 10,000 : EUR 8,000 : GBP 6,250 per person, per evacuation Repatriation to country of residence following treatment : Full refund
AIDS / HIV treatment
	As result of proven occupational accident or blood transfusion. Cover only available after three years of continuous membership: Up to USD 50,000 : EUR 40,000 : GBP 31,250
Alcohol & drug abuse
	Not covered
Annual maximum limit
	USD 4.5m : EUR 3.6m : GBP 2.8m
Children covered
	Up to the age of 18, unless the child is in full time education and then we can cover up to the age of 28
Chinese medicine
	USD 150 : EUR 120 : GBP 90 per visit up to an overall maximum for complementray treatment of 15 visits
Chiropractors & Osteopaths
	USD 150 : EUR 120 : GBP 90 per visit up to an overall maximum for complementray treatment of 15 visits
Chronic conditions & palliative care
	Maintenance of Chronic Medical Conditions : Up to USD 35,000 : EUR 28,000 : GBP 21,875 Terminal Illness – Palliative and Hospice Care: Up to USD 100,000 : EUR 80,000 : GBP 62,500 lifetime limit
Compassionate home visit
	Not covered
Cover for new born children
	Up to USD 150,000 : EUR 120,000 : GBP 93,750
Cremation / burial or repatriation of remains
	i) Transportation of body or ashes of insured person to country of residence or country of nationality: Full refund ii) Burial or cremation costs at the place of death: Up to USD 20,000 : EUR 16,000 : GBP 12,500
Dental treatment
	In-Patient Emergency Dental Treatment: Full refund i) Routine dental treatment: Up to USD 1,500 : EUR 1,200 : GBP 930 ii) Complex dental treatment: Up to USD 3,000 : EUR 2,400 : GBP 1,875 Costs incurred within nine months of plan start date are excluded. A co-insurance of 20% applies.
Emergency medical evacuation & medical repatriation
	Evacuation i) Transportation costs: Full refund ii) Reasonable local travel costs to and from medical appointments: Full refund iii) Reasonable travel costs for a locallyaccompanying person: Full refund iv) Non-hospital accommodation costs: Up to USD 300 : EUR 240 : GBP 185 per day, up to USD 10,000 : EUR 8,000 : GBP 6,250 per person, per evacuation Repatriation to country of residence following treatment : Full refund
Extended care facility
	Not covered
Health Screening
	Not covered
Hormone replacement therapy
	Not covered
Infertility investigations
	Not covered
Maternity cash benefit
	Not covered
Overseas cover
	Not covered
Personal & total disability benefit
	Not covered
Policy excess
	Standard Excess: USD 100 : EUR 80 : GBP 60 Optional Excess: Nil USD 50 : EUR 40 : GBP 30 USD 250 : EUR 200 : GBP 155 USD 500 : EUR 400 : GBP 310 USD 1,000 : EUR 800 : GBP 625 USD 2,500 : EUR 2,000 : GBP 1,550 Out-patient per visit excess USD 25 : EUR 20 : GBP 15
Pre-existing conditions
	Not covered
Pregnancy complications
	Full refund
Presciption drugs, dressings and medicines
	Full refund
Rehabilitation
	Full refund
Routine maternity cover
	Up to USD 15,000 : EUR 12,000 : GBP 9,375, Costs incurred within 12 months of plan start date are excluded
Sight / vision benefit
	Not covered
Stabilisation of acute chronic episode
	Full refund

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings

i) Hospital charges for in-patient and day-patient treatment: Full refund
ii) Related ancillary charges up to: USD 2,500 : EUR 2,000 : GBP 1,550 per medical condition

Surgeon / Consultant / Specialist & Anaesthetists fees

Full refund

Physicians fees & diagnostic tests

Full refund

Cancer Treatment Costs - Chemotherapy / Radiotherapy

Full refund

Organ transplant

i) Treatment: Full refund
ii) Donor medical costs: Up to USD 50,000 : EUR 40,000 : GBP 31,250

Renal Failure and Renal Dialysis as Day-Patient or Out-Patient: Up to USD $75,000 : EUR 60,000 : GBP 46,875

Outside area of cover limit for USA / Canada

Optional cover:
Up to USD 1.5m : EUR 1.2m : GBP 937,500

Prosthetic devices

Not covered

Psychiatric treatment

Full refund for up to 30 days

Key Facts - Out-patient Charges

Complementary medicine

Full refund

Diagnostic tests (excluding scans)

Full refund

GP referred consultations

i) Medical practitioner / Specialist fees: Full refund
ii) Physiotherapy: Full refund

Physiotherapy consultant referred

Full refund

Physiotherapy GP referred

Full refund

Psychiatric cover

Up to USD 7,500 : EUR 6,000 : GBP 4,600

Radiotherapy / Chemotherapy

Full refund

Scans - MRI / CT / PET

Full refund when received as an in-patient, day-patient or out-patient

Surgical Procedures

Full refund

Vaccinations administered by a medical practitioner

Not covered

Key Facts - Additional Benefits

Cash benefit if the treatment is received completely free of charge

Up to 30 nights, USD 275 : EUR 220 : GBP 165 per night

Nursing at home

i) Care given by a qualified nurse: Full refund up to 120 days
ii) Emergency out-of-hours medical practitioner (GP) home visits: Up to 5 visits

Parental accommodation

Full cover for the cost of one parent staying in hospital overnight with an insured child

Private ambulance

Full refund

Additional Benefits

24 Hour emergency helpline

24/7 helpline provided

Accompanying relative travel & accomodation

Evacuation
i) Transportation costs: Full refund
ii) Reasonable local travel costs to and from medical appointments: Full refund
iii) Reasonable travel costs for a locallyaccompanying person: Full refund
iv) Non-hospital accommodation costs: Up to USD 300 : EUR 240 : GBP 185 per day, up to USD 10,000 : EUR 8,000 : GBP 6,250 per person, per evacuation
Repatriation to country of residence following treatment : Full refund

AIDS / HIV treatment

As result of proven occupational accident or blood transfusion. Cover only available after three years of continuous membership: Up to USD 50,000 : EUR 40,000 : GBP 31,250

Alcohol & drug abuse

Not covered

Annual maximum limit

USD 4.5m : EUR 3.6m : GBP 2.8m

Children covered

Up to the age of 18, unless the child is in full time education and then we can cover up to the age of 28

Chinese medicine

USD 150 : EUR 120 : GBP 90 per visit up to an overall maximum for complementray treatment of 15 visits

Chiropractors & Osteopaths

USD 150 : EUR 120 : GBP 90 per visit up to an overall maximum for complementray treatment of 15 visits

Chronic conditions & palliative care

Maintenance of Chronic Medical Conditions : Up to USD 35,000 : EUR 28,000 : GBP 21,875
Terminal Illness – Palliative and Hospice Care: Up to USD 100,000 : EUR 80,000 : GBP 62,500 lifetime limit

Compassionate home visit

Not covered

Cover for new born children

Up to USD 150,000 : EUR 120,000 : GBP 93,750

Cremation / burial or repatriation of remains

i) Transportation of body or ashes of insured person to country of residence or country of nationality: Full refund
ii) Burial or cremation costs at the place of death: Up to USD 20,000 : EUR 16,000 : GBP 12,500

Dental treatment

In-Patient Emergency Dental Treatment: Full refund

i) Routine dental treatment: Up to USD 1,500 : EUR 1,200 : GBP 930
ii) Complex dental treatment: Up to USD 3,000 : EUR 2,400 : GBP 1,875

Costs incurred within nine months of plan start date are excluded. A co-insurance of 20% applies.

Emergency medical evacuation & medical repatriation

Extended care facility

Not covered

Health Screening

Not covered

Hormone replacement therapy

Not covered

Infertility investigations

Not covered

Maternity cash benefit

Not covered

Overseas cover

Not covered

Personal & total disability benefit

Not covered

Policy excess

Standard Excess: USD 100 : EUR 80 : GBP 60
Optional Excess:
Nil
USD 50 : EUR 40 : GBP 30
USD 250 : EUR 200 : GBP 155
USD 500 : EUR 400 : GBP 310
USD 1,000 : EUR 800 : GBP 625
USD 2,500 : EUR 2,000 : GBP 1,550

Out-patient per visit excess USD 25 : EUR 20 : GBP 15

Pre-existing conditions

Not covered

Pregnancy complications

Full refund

Presciption drugs, dressings and medicines

Full refund

Rehabilitation

Full refund

Routine maternity cover

Up to USD 15,000 : EUR 12,000 : GBP 9,375, Costs incurred within 12 months of plan start date are excluded

Sight / vision benefit

Not covered

Stabilisation of acute chronic episode

Full refund


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