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Medical and Dental, Hospital and Ancillary Benefits
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the event of an illness or injury sustained by You and happening during the Period of Cover, We will pay benefits for:
(i) Out of hospital medical services for doctors, pathology and x-rays.
(ii) In hospital medical services for doctors, pathology and x-rays.
(iii) Hospital shared ward accommodation, hospital day care services or accident and emergency and outpatient services.
(iv) Surgically implanted prostheses.
(v) Prescription medicines at the rate of 100% of the cost up to the maximum stated in any 12 month period.
(vi) Ambulance or medical transport services at the rate of 100% of the charge when medically necessary for admission to hospital or for emergency treatment.
(vii) Ancillary services provided by acupuncturist, osteopaths, chiropractors or homeopath up to maximum in any 12 month period of £320/€/$500.
(viii) Rehabilitation or occupational therapy services up to the maximum stated in any 12 month period.
(ix) Emergency dental services for the relief of pain or to restore dental functions at the rate of up to the maximum stated in any 12 month period.
(x) Emergency dental services for treatment following accidental and violent injury to sound and natural teeth.
(xi) Emergency maternity services - Complications to pregnancy/childbirth following injury or illness or where medically necessary at the rate of 100% of the cost up to a maximum in any 12 month period of £1600/€/$2500.
(xii) Providing you return home (to your Country of origin) on a temporary basis for a period not xceeding 3 months You are covered for medical expenses and loss of deposits.
The maximum we will pay for medical expenses is £54,000/€/$86,000 The maximum We will pay in respect of all claims under this section is £325,000/€/$500,000 for the “StudentCare Plus” Plan and £160,000/€/$250,000 for the “StudentCare” Plan.
Some of these benefits may only be paid once in the period of insurance. The Schedule of Benefits clearly defines the amounts You are covered for and any co-insurance amount to be contributed by You.
WE WILL NOT PAY FOR
(i) Hospital private room accommodation unless authorised by First Assistance.
(ii) Medications, drugs or other treatments not prescribed by a doctor.
(iii) Expenses incurred for cosmetic, elective or plastic surgery (except and to the extent that it is necessary as a result of an injury).
(iv) All routine dental treatment, crowns, denture, bridges or cosmetic dentistry.
(v) Your excess or the amount equal to the co-insurance required under the “StudentCare” Plan
Medical and Hospital Benefits, whichever is the lesser.
(vi) Pregnancy, childbirth, infertility, abortion or birth control (except where covered under the
emergency maternity section)
(vii) Medical, Hospital or Ancillary services arising from any event listed as a General Exclusion.
(viii) Medical treatment inpatient claims in your country of origin unless authorised by First Assistance.
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