Bupa Panama Essential Care
Type of plan
Essential Care
Maximum coverage per insured
US$1,000,000 per policy year
Age limit to apply
75
Waiting period
30 days
Coverage outside USA
Outside the country of residence
• 100% without restrictions of doctors and hospitals, a 20% coinsurance applies with a cap of US$5,000 per insured and a maximum of US$10,000 per family
Within country of residence
• 100% without restrictions of doctors and hospitals
• 100% without restrictions of doctors and hospitals, a 20% coinsurance applies with a cap of US$5,000 per insured and a maximum of US$10,000 per family
Within country of residence
• 100% without restrictions of doctors and hospitals
Coverage inside USA
100% without restrictions of doctors and hospitals, a 20% coinsurance applies with a cap of US$5,000 per insured and a maximum of US$10,000 per family
Inpatient Benefits
Standard private hospital room
100% up to the coverage limit
Special benefit for suite
N/A
Intensive care unit
100% up to the coverage limit
Adult companion accommodation during a hospitalization
100% up to one person
Prescribed medications while hospitalized
100% up to the coverage limit
Psychiatric treatments
N/A
Outpatient Benefits
Emergency room
100% up to the coverage limit and at emergency centers and convenience clinics in the U.S. within the Essential Preferred Provider Network a US$50 co-payment applies, if the deductible has not been met
Physician and specialist visits
100% up to the coverage limit
Physician and specialist home visits
Not specified
Prescribed medications
US$4,000, a 20% coinsurance applies, outside the country of residence
Complementary therapy
N/A
Nurse care at home
Home nursing for rehabilitation or palliative care
• US$200 per day, up to 30 days
• US$200 per day, up to 30 days
Preventive health checkup
Vaccines such as HPV, influenza, pneumococcal, malaria and travel vaccinations
• 80% up to US$150, no deductible applies, 20% coinsurance outside the country of residence
• 80% up to US$150, no deductible applies, 20% coinsurance outside the country of residence
Hearing aids
100% up to the coverage limit
Alzheimer’s disease
N/A
Autism
N/A
Outpatient surgery
100% up to the coverage limit
Hormone replacement therapy to relieve the symptoms of menopause
N/A
General Benefits
Surgeon and anesthesiologist fees
100% up to the coverage limit
Diagnostic study services
Laboratory tests, pathology, X-rays, MRI/CT/PET scans
• 100% up to the coverage limit
• 100% up to the coverage limit
Oncology: cancer tests, treatment (chemotherapy and/or radiotherapy) and medication
100% up to the coverage limit
Dialysis
100% up to the coverage limit
Surgery to reduce the risk of cancer or prophylactic surgery
Preventive surgery
• 100% up to the coverage limit
• 100% up to the coverage limit
Prostheses and medical appliances implanted during surgery
100% up to the coverage limit
Organ and tissue transplant
Per diagnostic
• US$500,000 per lifetime, a 20% coinsurance applies outside the country of residence
• US$500,000 per lifetime, a 20% coinsurance applies outside the country of residence
Benefits for live donors
Included in the organ and tissue transplant benefit up to US$500,000, no limit specified
Durable medical equipment
US$10,000, a 20% coinsurance applies, outside the country of residence
Allergy treatments
Not specified
Physical therapy and rehabilitation
Multidisciplinary rehabilitation
• US$100 per day, up to 30 days
• US$100 per day, up to 30 days
Specialized treatments
Inpatient
• Physical therapy, occupational therapy, kinesiology, speech therapy and nutritionist, 100% up to the coverage limit
Outpatient
• Physical therapy, osteopathy and chiropractics, 100% up to 15 visits, up to the coverage limit
• Physical therapy, occupational therapy, kinesiology, speech therapy and nutritionist, 100% up to the coverage limit
Outpatient
• Physical therapy, osteopathy and chiropractics, 100% up to 15 visits, up to the coverage limit
Congenital conditions diagnosed before age 18
US$200,000 per lifetime, a 20% coinsurance applies, outside the country of residence
Congenital conditions diagnosed after age 18
US$500,000 per lifetime, a 20% coinsurance applies, outside the country of residence
HIV-AIDS
US$250,000 per lifetime, after a 12-month waiting period, a 20% coinsurance applies, outside the country of residence
Surgical treatment of symptomatic foot disorders
N/A
Psychology
N/A
Mental health prescription medication
N/A
Maternity Benefits
Maternity
No deductible, after a 10-month waiting period
Options I, II, III & IV within country of residence and option I outside the country of residence
• US$4,000 per pregnancy, for normal or c-section, a 20% coinsurance applies, outside the country of residence
Options I, II, III & IV within country of residence and option I outside the country of residence
• US$4,000 per pregnancy, for normal or c-section, a 20% coinsurance applies, outside the country of residence
Maternity and newborn complications
No deductible, after a 10 month waiting period
Options I, II, III & IV
• US$250,000 per lifetime, a 20% coinsurance applies, outside the country of residence
Options I, II, III & IV
• US$250,000 per lifetime, a 20% coinsurance applies, outside the country of residence
Inclusion of the newborn
Options I, II, III & IV
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
• Without underwriting if born from a covered maternity as long as the newborn is added to the policy within 90 days of birth
Extraction and storage of umbilical cord blood stem cells
N/A
Fertility treatment
N/A
Neonatal Intensive Care Unit (NICU)
Options I, II, III & IV
• Included in the maternity and newborn complications benefit up to US$250,000
• Included in the maternity and newborn complications benefit up to US$250,000
Pre-natal and post-natal care
Options I, II, III & IV
• Included in the maternity benefit up to US$4,000
• Included in the maternity benefit up to US$4,000
Medical Evacuation Benefits
Emergency transportation by ground ambulance
Outside Panama
• US$60,000 for hospital medical evacuation, a 20% coinsurance applies
Within Panama
• 100%
• US$60,000 for hospital medical evacuation, a 20% coinsurance applies
Within Panama
• 100%
Emergency transportation by air ambulance
Outside Panama
• Included in the hospital medical evacuation benefit up to US$60,000, a 20% coinsurance applies
Within Panama
• 100%
• Included in the hospital medical evacuation benefit up to US$60,000, a 20% coinsurance applies
Within Panama
• 100%
Insured’s and companion’s return ticket after an evacuation by air ambulance
N/A
Repatriation of mortal remains
US$5,000, a 20% coinsurance applies, outside the country of residence
Other Benefits
Injuries during the training or practice of hazardous hobbies and sports (non-professional)
100% up to the coverage limit
Injuries during the training or practice of professional sports
N/A
Emergency dental coverage
100% up to the limits of coverage, provided that the first expense is incurred within 30 days after the accident
Reconstructive surgery after an accident or illness
100% if medically necessary and as a result of a medical condition covered by the policy
Refractive eye surgery
N/A
Palliative care for terminal cases
100% up to the coverage limit
Temporary coverage for accidents while application is being underwritten
N/A
Free extended coverage for eligible dependents after policyholder’s death
1 year
Free coverage for dependents
N/A
Deductible elimination/reduction for no claims made
N/A
Deductible elimination
N/A
Second medical opinion
Included
Prosthetic limbs
100% up to the coverage limit
Routine and major dental treatment
N/A
Travel reimbursement for treatment in centers of excellence Latam network
N/A
War and terrorism
N/A
Term life insurance
N/A
Declared pre-existing conditions
Covered when disclosed in the application, benefit will be previously evaluated
Catastrophic and chronic illnesses that survive the contracting of the service
N/A
Catastrophic and unusual conditions
N/A
Medical emergency
100% in Panama and at emergency centers and convenience clinics in the U.S. within the Essential Preferred Provider Network a US$50 co-payment applies, no deductible applies
Illness or injury in private aircraft
N/A
Contraceptive treatments
N/A
Patient concierge services
N/A
Travel assistance
N/A
Hospital cash benefit
N/A
Optional additional benefits
Evacuation to country of choice, country of residence or home country
N/A
Non-emergency evacuation
N/A
Pre-existing conditions waiting period waiver
N/A