BENEFIT
COVERED EXPENSES
MAXIMUM COVER
> Heart valve replacement surgery.
Prior approval must be obtained before any dental evaluation or treatment takes place.
Covers reasonable charges of specialist consultations and diagnostic procedures directly relating to a medical condition covered above and when referred by a specialist . Period covered is for six months before and twelve months after a covered medical hospitalisation or surgery. Physiotherapy and prescription costs directly relating to the approved surgery performed within six months after surgery. Covers reasonable charges incurred with an outpatient surgical procedure when recommended by a specialist (including related diagnostic testing performed in connection with the procedure). This benefit provides coverage for medically necessary angiograms, MRI and CT scans, regardless of whether surgery is performed or not. This benefit also covers reasonable charges incurred for the following procedures when recommended by a specialist :
Included as part of the above hospitalisation or surgery maximum cover .
Pre-admission and post discharge from a private hospital or day stay clinic
$100,000 per life assured , per policy year .
Outpatient care received at a private hospital , day stay clinic or specialist rooms approved by Sovereign
> Arthroscopy
> Cystoscopy
> Colonoscopy*
Excess applies.
> Dilatation and curettage
> Gastroscopy
> Hysteroscopy
> Laparoscopy
> Myelogram
*Cover is not provided for routine screening or periodic testing.
Covers reasonable charges incurred with any of the following outpatient surgical procedures performed by a registered medical practitioner under local anaesthesia in general practice surgery rooms.
This benefit only provides coverage for the medically necessary :
$500 per life assured per treatment to a maximum $1,000 per life assured per policy year .
> Excision of lesions, moles and cysts;
Non-specialist outpatient minor surgery
> Biopsies of lesions, moles and cysts;
> Wedge resection of toenails;
> Allergy desensitisation injections;
No excess applies.
> Skin prick testing;
> Varicose vein treatment;
> Vasectomy – only applies after two continuous years of cover. The vasectomy does not need to be medically necessary .
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711 ABH-BS version 8 Effective 08 April 2022
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