| BENEFITS | Diamond Plus | Diamond | Platinum | Gold | Silver | Bronze | Family |
|---|---|---|---|---|---|---|---|
| Annual Limit Per Person | US$35,000 | US$32,000 | US$22,000 | US$18,500 | US$15,000 | US$5,740 | US$4,000 |
| Hospitalization Limit | US$14,000 | US$12,500 | US$8,500 | US$7,750 | US$7,000 | US$2,320 | US$1,500 |
| Prescribed Medication: Up To Three (3) Beneficiaries | US$1,500 | US$1,100 | US$700 | US$575 | US$450 | US$300 | US$125 |
| Prescribed Medication: Above Three (3) Beneficiaries | US$2,500 | US$1,700 | US$1,200 | US$950 | US$700 | US$480 | US$200 |
| Chronic Drugs | US$1,900 | US$1,550 | US$900 | US$630 | US$360 | US$360 | US$275 |
| Dental Cover | US$1,860 | US$1,400 | US$580 | US$500 | US$380 | US$350 | US$300 |
| General Practitioners - Initial Consultation | 2/Month | 2/Month | 2/Month | 2/Month | 2/Month | 2/Month | 1/Month |
| General Practitioners - Subsequent Consultation | 2/Month | 2/Month | 2/Month | 2/Month | 2/Month | 2/Month | 1/Month |
| Ante Natal Visits | 9/Event | 7/Event | 6/Event | 6/Event | 3/Event | 3/Event | 1/Event |
| Post Natal Visits | 5/Event | 4/Event | 4/Event | 3/Event | 2/Event | 2/Event | 1/Event |
| Pregnancy Scans | 2/Event | 2/Event | 2/Event | 2/Event | 2/Event | 2/Event | 1/Event |
| Optical | US$300 | US$250 | US$230 | US$200 | US$180 | US$150 | US$130 |
| Psychiatric | US$930 | US$480 | US$480 | US$385 | US$290 | US$290 | US$100 |
| Rehabilitative Services (Physiotherapy) | US$1,620 | US$930 | US$780 | US$680 | US$580 | US$340 | US$200 |
| Prosthetics Appliances Treatment | US$2,090 | US$1,270 | US$580 | US$460 | US$340 | US$340 | US$200 |
| Pathology | US$1,400 | US$1,100 | US$780 | US$670 | US$560 | US$240 | US$180 |
| Specialized Radiology (MRI & CT Scans) | US$4,860 | US$4,420 | US$2,660 | US$2,170 | US$1,680 | US$580 | US$200 |
| Hearing Aids | US$1,860 | US$1,210 | US$930 | US$745 | US$560 | US$580 | US$460 |
| Ancillary Services (According To Tariff) | In Full | In Full | In Full | In Full | In Full | In Full | In Full |
| Private Ambulance Services (According To Tariff) | In Full | In Full | In Full | In Full | In Full | In Full | In Full |
| Wellness | In Full | In Full | In Full | In Full | In Full | In Full | In Full |
| Funeral Cash Benefit Adult | US$500 | US$500 | US$500 | US$500 | US$500 | US$500 | US$500 |
| Funeral Cash Benefit Child | US$200 | US$200 | US$200 | US$200 | US$200 | US$200 | US$200 |
