BENEFITS

 

Cover

 

 

Cover

 

TDC is “Tarif de Convention” (the official price list set up by the French National Healthcare System CPAM)

HOSPITAL CHARGES

ARGENT

100

ARGENT

150

1. Hospital Charges including :

i) Medical Practitioner or Specialist  fees as an In-Patient or Day Patient

 

 

ii) Diagnostic and surgical procedures as an

In-Patient or Day Patient including scans,

pathology, X rays, oncology.

 

iii) Surgeons and Anaesthetist fees

including “Depassement

 

 

iv) Theatre fees and nursing by a Qualified Nurse

 

 

v) Daily food charge and bottled water

 

 

vi) Prescribed Drugs and Dressings

 

 

vii) Private Room

(max 30 days per Medical  Condition)

 

viii) Physiotherapy

 

 

Up to 100%

of TDC

 

 

Up to 100%

of TDC

 

 

Up to 100%

of TDC

 

 

Up to 100%

of TDC

 

Full

refund

 

Up to 100%

of TDC

 

Not covered

 

 

Up to 100%

of TDC

 

 

Up to 150%

of TDC

 

 

Up to 150%

of TDC

 

 

Up to 150%

of TDC

 

 

Up to 150%

of TDC

 

Full

refund

 

Up to 150%

of TDC

 

Up to €25

Per day

 

Up to 150%

of TDC

 

 

2. Parent Accommodation.

Standard private Hospital accommodation in respect of

a parent or legal guardian staying with an Insured

Person who is under 12 years of age and is admitted as

an In-Patient in a Hospital

Up to €25

per day

Up to €25

per day 

3. Routine Pregnancy and Childbirth.

(Incl. Private Room limited to maximum of 5 days). Maximum payable in any one policy period for all

benefits in this section is €600

 

 

Full

 difference

 

Private room 

Not covered

 

Full

difference

 

Private room

€25 per day

4. Transportation. The cost of emergency transport necessarily incurred to and from Hospitals for Medical Conditions covered by this Policy

 

Up to 100%

of TDC

 

Up to 150%

of TDC

 

 

5. Home Nursing. Nursing care given outside a Hospital which is immediately received subsequent to Treatment

as an In-Patient or Day Patient. This must be provided

by a Qualified Nurse

Up to 100%

of TDC

 

 

Up to 150%

of TDC

 

 

 

6. Reconstructive Surgery. Reconstructive surgery following an Accident or following surgery for an event covered by this Policy

 

Up to 100%

of TDC

 

Up to 150%

of TDC

 

7. Registered Convalescent Home where prescribed

by and under the control of a Specialist

(maximum 30 days per Medical Condition)

Up to 100%

of TDC

Up to 150%

of TDC

 

OUTPATIENT CHARGES

ARGENT

100

ARGENT

150

 

8. Out-Patient charges including:

i) Medical Practitioner or Specialist fees as an

Out-Patient including home visits

 

ii) Diagnostic and surgical procedures as an Out-Patient including scans, pathology, Xrays, oncology.

 

iii) Prescribed Drugs and Dressings

 

 

iv) Physiotherapy Home Nursing

 

 

Thermal cures

(where reimbursed by the Social Security

 

Tiers Payant Card.

 

 

Up to 100%

of TDC

 

 

Up to 100%

of TDC

 

 

Full

difference

 

Up to 100%

of TDC

 

Up to 100%

of TDC

 

Yes

 

 

Up to 150%

of TDC

 

 

Up to 150%

of TDC

 

 

Full

difference

 

Up to 150%

of TDC

 

Up to 100%

of TDC

 

Yes

 

DENTAL CHARGES

ARGENT

100

ARGENT

150

9. Dental charges including:

 

i) Accidental Damage to Teeth -

Treatment received in an Emergency room in a Hospital within 7 days of incurring Accidental damage caused to sound, natural teeth when given by a Medical or Dental Practitioner

 

ii) Routine Dental Treatment.

The fees of a Dental Surgeon in respect of routine dental Treatment received at a dental surgery

 

 

iii) Reimbursable Dental Prostheses

 

 

Maximum payable for all dental benefits in any one period up to:

 

In respect of Benefits 9i), 9ii) and 9iii) there is a

waiting period of 180 days for new clients before

Benefits are payable.

If you already have an corresponding insurance in

an other company and you transfer your insurance to us, no waiting period will apply.

 

 

 

 

 

 

 

Up to 100%

of TDC

 

 

 

 

Up to 100%

of TDC

 

 

Up to 100%

of TDC

 

 

€150

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Up to 150%

of TDC

 

 

 

 

Up to 150 %

of TDC

 

 

Up to 150%

of TDC

 

 

€250

 

 

 

 

 

 

 

 

 

 

 

TDC is ”Tarif de Convention” (the official price list set up by the French National Healthcare System CPAM)