The Millennium SAGE U Plan for LinCU Visa Debit Cardholders ADVANTAGES of the SAGE U Plan: MILLENNIUM INSURANCE BROKERS LIMITED Introduces LifeCare The MILLENNIUM SAGE U PLAN A Comprehensive Major Medical Health Insurance Plan Available Exclusively for LinCU Visa Debit Cardholders 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. A Pro –Active Health Care Card Coverage for the Lifetime of the Insured Benefits are portable Coverage can be converted to Individual Health Plan No Claim Forms to be completed Small cash outlay at time of receiving Medical Attention Access to an extensive, growing Network of Health Care Providers throughout Trinidad & Tobago Choice of using the Preferred Provider Organisation Network or your own Provider No restrictions on Reasonable and Customary as with traditional Group Health Plans Coverage for Substance Abuse and Mental Illness Extended Prescription Drug Coverage for Chronic Problems 24 Hour Answering Service Emergency Air Ambulance Total confidentiality The Millennium SAGE U Plan Active Employees MAXIMUM BENEFIT $500,000.00 $250,000.00 BENEFIT PERIOD 3-Year Revolving Lifetime SPECIFIC LIMITS CO PAYMENT In Network CO PAYMENT Out Network 80% 70% Individual None $200.00 Family None $400.00 Overseas & Local - Average Semi- Private 80% 70% PRESCRIPTION DRUGS – Eligible prescribe drugs 80% 80% MATERNITY BENEFIT Normal Delivery - $4,000 100% 100% Caesarean Section/Extra uterine Pregnancy Surgical benefit 80% 80% Miscarriage - $1,500. 100% 100% AIRFARE BENEFIT 80% 80% 100% 100% 30.00 Co pay (80%) 70% Home, Hospital - (Limit $200.00) SPECIALISTS VISITS Office - (limit $200.00) $40.00 Co pay (80%) 70% COINSURANCE – Unless Otherwise Specified DEDUCTIBLE – CALENDAR YEAR DAILY ROOM & BOARD MILLENNIUM INSURANCE BROKERS LIMITED Introduces LifeCare The MILLENNIUM SAGE U PLAN A Comprehensive Major Medical Health Insurance Plan Available Exclusively for LinCU Visa Debit Cardholders Retirees Maximum per Trip - $4,000. ( Max 2 trips per yr) AIR AMBULANCE BENEFIT Maximum per trip - US$18,000. (Max 1 trip per yr.) DOCTORS VISITS Office - (Limit $120.00) Home, Hospital - (limit $300.00) Millennium SAGE U Plan SPECIFIC LIMITS IN NETWORK Out Network EMERGENCY ACCIDENT 90% 90% $3,500.00 $50.00 Preventative 80% 70% Basic Restorative 80% 70% Major Restorative 80% 70% 75% 50% WAITING PERIOD - 3 Months VISION CARE Maximum Benefit = $1,500.00 80% 70% Deductible per Calendar Year $50.00 80% 70% Frames 24 consecutive Months Lenses 12 consecutive Months WAITING PERIOD - 3 months Per disability - $500 DENTAL CARE Maximum Benefit per Calendar Year Deductible per Calendar Year Benefits MILLENNIUM INSURANCE BROKERS LIMITED Introduces LifeCare The MILLENNIUM SAGE U PLAN A Comprehensive Major Medical Health Insurance Plan Available Exclusively for LinCU Visa Debit Cardholders CO PAYMENT Orthodontic Treatment Included in Maximum Yearly Benefit Contact Lenses = $750.00 Millennium SAGE U Plan SPECIFIC LIMITS MILLENNIUM INSURANCE BROKERS LIMITED Introduces LifeCare The MILLENNIUM SAGE U PLAN A Comprehensive Major Medical Health Insurance Plan Available Exclusively for LinCU Visa Debit Cardholders PREVENTATIVE CARE BENEFIT Males Lipid Profile $150.00 Annual Medical Examination $400.00 Annual Test for Prostate Cancer $200.00 Annual Glaucoma Test $100.00 Females Lipid Profile $150.00 Annual Medical Examination $400.00 Annual Mammogram – $250.00 Annual Pap Smear – Female $75.00 Annual Glaucoma Test $100.00 Annual CA125 Test for Ovarian Cancer $400.00 Vaccinations/Immunizations $1,000.00 MILLENNIUM INSURANCE BROKERS LIMITED Introduces LifeCare The MILLENNIUM SAGE U PLAN A Comprehensive Major Medical Health Insurance Plan Available Exclusively for LinCU Visa Debit Cardholders Millennium SAGE U Plan OTHER COVERED BENEFITS CO-INSURANCE In Network – 80% (Reasonable & Customary) Out Network – 70% Surgical Benefits Lithotripsy * Acupuncture Assistant Surgeon Anesthesia *Home Nursing Care Organ Transplant Blood & Derivatives >Repatriation of Mortal Remains Use of Medical Equipment Laboratory < Congenital Birth Defects X-rays Other Diagnostic Tests Allergy Testing ^Chemotherapy ^Renal Dialysis *Speech Physiotherapy *Psychiatric Care Well Baby Care *Maximum $5000.00 per calendar year ^Maximium $50,000 per calendar year >Maximium $20,000 per calendar year <Maximium $100,000 per calendar year N/B Pre Existing Conditions are not covered PRE- CERTIFICATION REQUIRED FOR: • All non-emergency inpatient hospital admissions • Surgical Procedures • MRI’s & CAT Scans:
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