You are on page 1of 16

Quality health plans & benefits

Healthier living
Financial well-being
Intelligent solutions

International Healthcare Plan


Individual Policy Summary
Effective date: Policies issued from 1 July 2012

www.aetnainternational.com

This policy summary does not contain the terms and Major Medical 1
conditions of the noninvestment insurance contract and
should be read in conjunction with the policy booklet, Foundation 4
policy schedule and benefit schedule.
Lifestyle 7

Lifestyle Plus 10

Additional information 14

46.02.954.1-EU (6/12)
Major Medical
This document provides a summary of the cover provided. Full details can be found in the policy wording. Where you have purchased
cover you should refer to your own benefit schedule, policy wording and policy schedule including any endorsements which apply for
full details of your cover.
Your insurer is Aetna Health Insurance Company of Europe Limited.
Type of Insurance: International Private Medical Insurance
Period of Insurance: The policy will last for one year and will be renewable on an annual basis.

policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Cover under this policy is up to a maximum General exclusions Full details of the general exclusions noted,
of £1,000,000, €/US$1,600,000 per insured Cover is not provided for any medical and the other policy exclusions are shown
person per period of cover. condition in existence at the date of entry on pages 6 to 7 of the policy wording under
to the policy until it has been treatment, the section entitled “Exclusions”.
symptom and advice free for two consecutive
years following the date of entry.
General exclusions also include:
• chronic medical conditions
• normal pregnancy
• infertility/sterilisation
• dental treatment
• cosmetic treatment
• alcohol, drug or solvent abuse
• sexually transmitted diseases
• non-emergency treatment in the USA
• elective medical check-ups, vaccinations
General limitations
Costs are subject to a reasonable and
customary level based on the average
treatment costs applicable to the region
in which the treatment was received, as
determined by us.
The policy provides payment for treatment Below are noted the exclusions and
of an eligible medical condition including: limitations applied to each section.
Inpatient and day patient treatment Special limitations Full details of the benefits are shown in the
• accommodation charges Inpatient (including day patient) psychiatric benefit schedule and in the policy wording
• drugs and dressings treatment is restricted to a maximum of 30 on pages 4 to 5 in the section entitled “Cover”.
• theatre charges days per person, per period of cover and
• specialist fees must be pre-authorised.
• diagnostic tests Reconstructive surgery must be undertaken
• oncology, radiotherapy and chemotherapy within 12 months of an accident or injury
• scans and x-rays which has caused disfigurement.
• anaesthetist fees
Rehabilitation cover is limited 120 days per
• nursing
medical condition.
• intensive care unit costs
• psychiatric treatment
• reconstructive surgery
• organ transplant
• rehabilitation
Outpatient treatment Special limitations Major Medical cover has restrictions from
• CT/MRI scans Outpatient treatment immediately prior to the benefits shown in the policy wording on
• outpatient surgery and up to 60 days following hospitalisation, pages 4 to 5 in the section entitled “Cover”.
• oncology treatment limited to £1,000, US$/€1,700 per medical The restrictions in benefits are shown under
• outpatient follow-up treatment following condition. option 001 of section 4 entitled “Product
treatment as an inpatient Ancillary charge up to £625, US$/€1,000 per Options” on page 8.
• ancillary charges medical condition. Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.

1
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Home nursing Exclusions Full details of the benefits are shown in the
The services only of a qualified nurse Nursing for domestic reasons or convenience. benefit schedule and in the policy wording
immediately after a period of inpatient Special limitations on pages 4 to 5 in the section entitled “Cover”.
treatment and on the recommendation Costs are limited to 30 days of nursing Policy exclusions are shown on pages 6 to
of a specialist. care provided per condition and subject to 7 of the policy wording under the section
pre-authorisation. entitled “Exclusions”.
Additional hospital accommodation costs Special limitations Full details of the benefits are shown in the
• parental accommodation • limited to an adult staying with a child benefit schedule and in the policy wording
• new born accommodation under the age of 18. on pages 4 to 5 in the section entitled “Cover”.
• limited to a new born, which is defined
as under the age of 16 weeks.
AIDS cover Exclusions Full details of the benefits are shown in the
Covers treatment for HIV/AIDS/ARC. Does not cover sexually transmitted benefit schedule and in the policy wording
HIV/AIDS. on pages 4 to 5 in the section entitled “Cover”.
Special limitations Policy exclusions are shown on pages 6 to
Cover limited to £6,250, €/US$10,000 per 7 of the policy wording under the section
period of cover. entitled “Exclusions”.
Accidental damage to teeth Special limitations Full details of the benefits are shown in the
Limited to treatment undertaken in an benefit schedule and in the policy wording
emergency room in a hospital within seven on pages 4 to 5 in the section entitled “Cover”.
days of the accident. Must be damage
caused to sound, natural teeth.
Complications of pregnancy Special limitations Full details of the benefits are shown in the
Treatment in the antenatal stages of Caesarean sections are not classed as benefit schedule and in the policy wording
pregnancy that requires a recognised medically necessary if they are as a result on pages 4 to 5 in the section entitled “Cover”.
obstetric procedure, including medically of a previous elective caesarean section. Policy exclusions are shown on pages 6 to
necessary caesarean sections. 7 of the policy wording under the section
entitled “Exclusions”.
New born care Special limitations Full details of the benefits are shown in the
Inpatient treatment of an acute medical Benefit limited to 30 days hospital stay and benefit schedule and in the policy wording
condition given to a new born baby within to a maximum of £62,500, €/US$100,000. on pages 4 to 5 in the section entitled “Cover”.
30 days of its birth. Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.
Emergency transportation Exclusions Full details of the benefits are shown in the
To and from hospital where medically Does not include the costs of car hire. benefit schedule and in the policy wording
necessary. Special limitations on pages 4 to 5 in the section entitled “Cover”.
Limited to inpatient/day patient treatment Policy exclusions are shown on pages 6 to
only and must be pre-authorised. 7 of the policy wording under the section
entitled “Exclusions”.
Evacuation Exclusions Full details of the benefits are shown in the
Where appropriate inpatient/day patient All maternity or childbirth costs except benefit schedule and in the policy wording
emergency treatment is not available treatment as a result of complications on pages 4 to 5 in the section entitled “Cover”.
at the place of incident, the costs of of pregnancy. Policy exclusions are shown on pages 6 to
evacuation transport to the nearest Special limitations 7 of the policy wording under the section
appropriate medical facility. Must be pre-authorised by us and under entitled “Exclusions”.
Covers one other person to act as escort. our supervision.
Additional travel expenses Special limitations Full details of the benefits are shown in the
• to and from medical appointments Covers costs only following an evacuation. benefit schedule and in the policy wording
• costs of accompanying person to and from Pre- and post-hospitalisation on pages 4 to 5 in the section entitled “Cover”.
the hospital to visit the insured person accommodation costs limited to £95,
• immediate pre and post-hospitalisation €/US$150 per person per day to a total of
accommodation costs £3,000, €/US$5,000 per Evacuation.
Economy class ticket to return insured
person and escort back to their country
of residence or to where the evacuation
occurred.

2
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Mortal remains Special limitations Full details of the benefits are shown in the
In the event of death, the cost of Cover limited to £5,300, €/US$8,500 benefit schedule and in the policy wording
transportation of the body or ashes of an per person. on pages 4 to 5 in the section entitled “Cover”.
insured person to his/her country of residence
or country of nationality, or the costs of a
burial or cremation at the place of death.
Hospital cash benefit Special limitations Full details of the benefits are shown in the
Where inpatient treatment of an eligible Cash benefit is limited to £75, €/US$125 benefit schedule and in the policy wording
medical condition is received and where per night for a maximum of 20 nights on pages 4 to 5 in the section entitled “Cover”.
accommodation and treatment is free hospital stay.
of charge. Not applicable to accident and emergency
admissions.
Additional options All additional options have the same Full details of the general exclusions
exclusions and limitations as those noted, and the other policy exclusions
shown under the inpatient, day patient are shown on pages 6 to 7 of the policy
and outpatient sections above unless wording under the section entitled
specifically stated. “Exclusions”.
Semi-private room restriction Special limitations Full details of this product option are shown
(Available to residents of Hong Kong only). Hospital accommodation is restricted to a in the policy wording under the “Product
semi-private room and corresponding rates Options” section on page 9 as option 006.
when receiving treatment as an inpatient/
day patient.
China private room restriction Special limitations Full details of this product option are shown
(Available to residents of mainland Hospital accommodation is restricted to a in the policy wording under the “Product
China only). semi-private room and corresponding rates Options” section on page 9 as option 007.
when receiving treatment as an inpatient/
day patient outside of mainland China.
Extended evacuation Special limitations Full details of this product option are shown
Where appropriate inpatient/day patient The nominated country of choice must have in the policy wording under the “Product
emergency treatment is not available at the medical facilities which are appropriate. Options” section on page 9 as option 009.
place of incident, the costs of evacuation
transport to the nearest appropriate medical
facility, or to your country of choice.
Covers one other person to act as escort.

3
Foundation
This document provides a summary of the cover provided. Full details can be found in the policy wording. Where you have purchased
cover you should refer to your own benefit schedule, policy wording and policy schedule including any endorsements which apply for
full details of your cover.
Your insurer is Aetna Health Insurance Company of Europe Limited.
Type of Insurance: International Private Medical Insurance
Period of Insurance: The policy will last for one year and will be renewable on an annual basis.

policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Cover under this policy is up to a maximum General exclusions Full details of the general exclusions noted,
of £1,000,000, €/US$1,600,000 per insured Cover is not provided for any medical and the other policy exclusions are shown
person per period of cover. condition in existence at the date of entry on pages 6 to 7 of the policy wording under
to the policy until it has been treatment, the section entitled “Exclusions”.
symptom and advice free for two consecutive
years following the date of entry.
General exclusions also include:
• chronic medical conditions
• normal pregnancy
• infertility/sterilisation
• dental treatment
• cosmetic treatment
• alcohol, drug or solvent abuse
• sexually transmitted diseases
• non-emergency treatment in the USA
• elective medical check-ups, vaccinations
General limitations
Costs are subject to a reasonable and
customary level based on the average
treatment costs applicable to the region
in which the treatment was received, as
determined by us.
The policy provides payment for treatment Below are noted the exclusions and
of an eligible medical condition including: limitations applied to each section.
Inpatient and day patient treatment Special limitations Full details of the benefits and specific
• accommodation charges Inpatient (including day patient) psychiatric limitations are shown in the benefit schedule
• drugs and dressings treatment is restricted to a maximum of and in the policy wording on pages 4 to 5 in
• theatre charges 30 days per person, per period of cover and the section entitled “Cover”.
• specialist fees must be pre-authorised.
• diagnostic tests Reconstructive surgery must be undertaken
• oncology, radiotherapy and chemotherapy within 12 months of an accident or injury
• scans and x-rays which has caused disfigurement.
• anaesthetist fees
Rehabilitation cover is limited 120 days per
• nursing
medical condition.
• intensive care unit costs
• psychiatric treatment
• reconstructive surgery
• organ transplant
• rehabilitation
Outpatient treatment Special limitations Full details of the benefits and specific
• medical practitioner visits Psychiatric treatment must be pre-authorised, limitations are shown in the benefit schedule
• diagnostic procedures limited to £3,125, US$/€5,000 per period and in the policy wording on pages 4 to 5 in
• specialist consultations of cover. the section entitled “Cover”.
• drugs and dressings Acupuncture, homeopathic, osteopathic,
• physiotherapy podiatry and chiropractic treatment limited
• CT/MRI scans to 10 sessions in aggregate per person per
• outpatient surgery period of cover.
• oncology treatment
Traditional Chinese medicine cover is limited
• psychiatric treatment
to £20,€/US$30 per session and to
• acupuncture, homeopathic, osteopathic,
a maximum of 10 sessions.
podiatry, chiropractic treatment
• traditional Chinese medicine Ancillary charge up to £625, US$/€1,000 per
• ancillary charges medical condition.
4
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Home nursing Exclusions Full details of the benefits and specific
The services only of a qualified nurse Nursing for domestic reasons or limitations are shown in the benefit schedule
immediately after a period of inpatient convenience. and in the policy wording on pages 4 to 5 in
treatment and on the recommendation Special limitations the section entitled “Cover”.
of a specialist. Costs are limited to 30 days of nursing Policy exclusions are shown on pages 6 to
care provided per condition and subject to 7 of the policy wording under the section
pre-authorisation. entitled “Exclusions”.
Additional hospital accommodation costs Special limitations Full details of the benefits and specific
• parental accommodation • limited to an adult staying with a child limitations are shown in the benefit schedule
• new born accommodation under the age of 18. and in the policy wording on pages 4 to 5 in
• limited to a new born, which is defined as the section entitled “Cover”.
under the age of 16 weeks.
AIDS cover Exclusions Full details of the benefits are shown in the
Covers treatment for HIV/AIDS/ARC Does not cover sexually transmitted benefits Schedule and in the policy wording
HIV/AIDS. on pages 4 to 5 in section 2 entitled “Cover”.
Special limitations Policy exclusions are shown on pages 6 to
Cover limited to £6,250, €/US$10,000 per 7 of the policy wording under the section
period of cover. entitled “Exclusions”.
Accidental damage to teeth Special limitations Full details of the benefits and specific
Limited to treatment undertaken in an limitations are shown in the benefit schedule
emergency room in a hospital within seven and in the policy wording on pages 4 to 5 in
days of the accident. Must be damage the section entitled “Cover”.
caused to sound, natural teeth.
Complications of pregnancy Exclusions Full details of the benefits and specific
Treatment in the antenatal stages of Any complications of pregnancy where the limitations are shown in the benefit schedule
pregnancy that requires a recognised date of conception is within the first 12 and in the policy wording on pages 4 to 5 in
obstetric procedure, including medically months from the date of entry. the section entitled “Cover”.
necessary caesarean sections. Special limitations Policy exclusions are shown on pages 6 to
Caesarean sections are not classed as 7 of the policy wording under the section
medically necessary if they are as a result of entitled “Exclusions”.
a previous elective caesarean section.
New born care Special limitations Full details of the benefits and specific
Inpatient treatment of an acute medical Benefit limited to 30 days hospital stay and limitations are shown in the benefit schedule
condition given to a new born baby within to a maximum of £62,500, €/US$100,000. and in the policy wording on pages 4 to 5 in
30 days of its birth. the section entitled “Cover”.
Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.
Emergency transportation Exclusions Full details of the benefits and specific
To and from hospital where medically Does not include the costs of car hire. limitations are shown in the benefit schedule
necessary. Special limitations and in the policy wording on pages 4 to 5 in
Limited to inpatient/day patient treatment the section entitled “Cover”.
only and must be pre-authorised. Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.
Evacuation Exclusions Full details of the benefits and specific
Where appropriate inpatient/day patient All maternity or childbirth costs except limitations are shown in the benefit schedule
emergency treatment is not available at the treatment as a result of complications and in the policy wording on pages 4 to 5 in
place of incident, the costs of Evacuation of pregnancy. the section entitled “Cover”.
transport to the nearest appropriate Special limitations Policy exclusions are shown on pages 6 to
medical facility. Must be pre-authorised by us and under 7 of the policy wording under the section
Covers one other person to act as escort. our supervision. entitled “Exclusions”.
Additional travel expenses Special limitations Full details of the benefits and specific
• to and from medical appointments Covers costs only following an Evacuation. limitations are shown in the benefit schedule
• costs of accompanying person to and from Pre- and post-hospitalisation and in the policy wording on pages 4 to 5 in
the hospital to visit the insured person accommodation costs limited to £95,€/ the section entitled “Cover”.
• immediate pre and post-hospitalisation US$150 per person per day to a total of
accommodation costs £3,000, €/US$5,000 per Evacuation.
Economy class ticket to return insured person
and escort back to their country of residence
or to where the evacuation occurred.

5
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Mortal remains Special limitations Full details of the benefits and specific
In the event of death, the cost of Cover limited to £5,300, €/US$8,500 limitations are shown in the benefit schedule
transportation of the body or ashes of an per person. and in the policy wording on pages 4 to 5 in
insured person to his/her country of residence the section entitled “Cover”.
or country of nationality, or the costs of a
burial or cremation at the place of death.
Hospital cash benefit Exclusions Full details of the benefits and specific
Where inpatient treatment of an eligible Nursing for domestic reasons or limitations are shown in the benefit schedule
medical condition is received and where convenience. and in the policy wording on pages 4 to 5 in
accommodation and treatment is free Special limitations the section entitled “Cover”.
of charge. Costs are limited to 30 days of nursing care policy exclusions are shown on pages 6 to
provided per condition and subject to pre- 7 of the policy wording under the section
authorisation. entitled “Exclusions”.
Additional options All additional options have the same Full details of the general exclusions
general exclusions and limitations as noted, and the other policy exclusions
those shown under the inpatient, day are shown on pages 6 to 7 of the
patient and outpatient sections above policy wording under section 3 entitled
unless specifically stated. “Exclusions”.
USA elective treatment Special limitations Full details of this product option are shown
Extends cover to provide for choosing to Any inpatient or day patient treatment in the policy wording under the “Product
have treatment in the USA which is not only which is not undertaken within our provider Options” section on page 9 as option 005.
due to an accident or emergency. network is subject to a 50% co-insurance
and an annual limit of £625,000,
€/US$1,000,000.
Semi-private room restriction Special limitations Full details of this product option are shown
(Available to residents of Hong Kong only). Hospital accommodation is restricted to a in the policy wording under the “Product
semi-private room and corresponding rates Options” section on page 9 as option 006.
when receiving treatment as an inpatient/
day patient
China private room restriction Special limitations Full details of this product option are shown
(Available to residents of mainland Hospital accommodation is restricted to a in the policy wording under the “Product
China only). semi-private room and corresponding rates Options” section on page 9 as option 007.
when receiving treatment as an inpatient/
day patient outside of mainland China.
Direct settlement network Special limitations Full details of this product option are shown
Allows for nil excess to be paid should Restricted to clinics in selected countries in the policy wording under the “Product
outpatient treatment be undertaken in one only. treatment not undertaken in one of Options” section on page 9 as option 008.
of our direct settlement network clinics. the listed clinics is subject to an excess of
£65, €/US$100.
Extended evacuation Special limitations Full details of this product option are shown
Where appropriate inpatient/day patient The nominated country of choice must have in the policy wording under the “Product
emergency treatment is not available at the medical facilities which appropriate. Options” section on page 9 as option 009.
place of incident, the costs of evacuation
transport to the nearest appropriate medical
facility, or to your country of choice.
Covers one other person to act as escort.

6
Lifestyle
This document provides a summary of the cover provided. Full details can be found in the policy wording. Where you have purchased
cover you should refer to your own benefit schedule, policy wording and policy schedule including any endorsements which apply for
full details of your cover.
Your insurer is Aetna Health Insurance Company of Europe Limited.
Type of Insurance: International Private Medical Insurance
Period of Insurance: The policy will last for one year and will be renewable on an annual basis.

policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Cover under this policy is up to a maximum General exclusions Full details of the general exclusions noted,
of £1,000,000, €/US$1,600,000 per insured Cover is not provided for any medical and the other policy exclusions are shown
person per period of cover. condition in existence at the date of entry on pages 6 to 7 of the policy wording under
to the policy until it has been treatment, the section entitled “Exclusions”.
symptom and advice free for two consecutive
years following the date of entry.
General exclusions also include:
• chronic medical conditions which
pre-date your original date of entry
• normal pregnancy
• infertility/sterilisation
• dental treatment
• cosmetic treatment
• alcohol, drug or solvent abuse
• sexually transmitted diseases
• non-emergency treatment in the USA
• elective medical check-ups, vaccinations
General limitations
Costs are subject to a reasonable and
customary level based on the average
treatment costs applicable to the region
in which the treatment was received, as
determined by us.
The policy provides payment for treatment Below are noted the exclusions and
of an eligible medical condition including: limitations applied to each section.
Inpatient and day patient treatment Special limitations Full details of the benefits are shown in the
• accommodation charges Inpatient (including day patient) psychiatric benefit schedule and in the policy wording on
• drugs and dressings treatment is restricted to a maximum of pages 4 to 5 in the section entitled “Cover”.
• theatre charges 30 days per person, per period of cover
• specialist fees and must be pre-authorised.
• diagnostic tests Reconstructive surgery must be undertaken
• oncology, radiotherapy and chemotherapy within 12 months of an accident or injury
• scans and x-rays which has caused disfigurement.
• anaesthetist fees
Rehabilitation cover is limited 120 days per
• nursing
medical condition.
• intensive care unit costs
• psychiatric treatment
• reconstructive surgery
• organ transplant
• rehabilitation
Outpatient treatment Special limitations Full details of the benefits are shown in the
• medical practitioner visits Psychiatric treatment must be pre-authorised, benefit schedule and in the policy wording on
• diagnostic procedures limited to £3,125, US$/€5,000 per period pages 4 to 5 in the section entitled “Cover”.
• specialist consultations of cover.
• drugs and dressings Acupuncture, homeopathic, osteopathic,
• physiotherapy chiropractic treatment limited to 10 sessions
• CT/MRI scans in aggregate per person per period of
• outpatient surgery cover. Traditional Chinese medicine cover
• oncology treatment is limited to £20, €/US$30 per session and to
• psychiatric treatment a maximum of 10 sessions.
• acupuncture, homeopathic, osteopathic,
Ancillary charge up to £625, US$/€1,000 per
podiatry, chiropractic treatment
medical condition.
• traditional Chinese medicine
• ancillary charges
7
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Home nursing Exclusions Full details of the benefits are shown in the
The services only of a qualified nurse Nursing for domestic reasons or convenience. benefit schedule and in the policy wording on
immediately after a period of inpatient Special limitations pages 4 to 5 in the section entitled “Cover”.
treatment and on the recommendation Costs are limited to 28 weeks of nursing Policy exclusions are shown on pages 6 to
of a specialist. care provided per condition and subject to 7 of the policy wording under the section
pre-authorisation. entitled “Exclusions”.
Additional hospital accommodation costs Special limitations Full details of the benefits and specific
• parental accommodation • limited to an adult staying with a child limitations are shown in the benefit schedule
• new born accommodation under the age of 18. and in the policy wording on pages 4 to 5 in
• limited to a new born, which is defined as the section entitled “Cover”.
under the age of 16 weeks.
AIDS cover Exclusions Full details of the benefits are shown in the
Covers treatment for HIV/AIDS/ARC Does not cover sexually transmitted benefit schedule and in the policy wording on
HIV/AIDS. pages 4 to 5 in the section entitled “Cover”.
Special limitations Policy exclusions are shown on pages 6 to
Cover limited to £6,250, €/US$10,000 per 7 of the policy wording under the section
period of cover. entitled “Exclusions”.
Accidental damage to teeth Special limitations Full details of the benefits are shown in the
Limited to treatment undertaken in an benefit schedule and in the policy wording on
emergency room in a hospital within seven pages 4 to 5 in the section entitled “Cover”.
days of the accident. Must be damage
caused to sound, natural teeth.
Complication of pregnancy Exclusions Full details of the benefits are shown in the
Treatment in the antenatal stages of Any complications of pregnancy where benefit schedule and in the policy wording on
pregnancy that requires a recognised the date of conception is within the first pages 4 to 5 in the section entitled “Cover”.
obstetric procedure, including medically 12 months from the date of entry. Policy exclusions are shown on pages 6 to
necessary caesarean sections. Special limitations 7 of the policy wording under the section
Caesarean sections are not classed as entitled “Exclusions”.
medically necessary if they are as a result
of a previous elective caesarean section.
New born care Special limitations Full details of the benefits are shown in the
inpatient treatment of an acute medical Benefit limited to 30 days hospital stay and benefit schedule and in the policy wording on
condition given to a new born baby within to a maximum of £62,500, €/US$100,000. pages 4 to 5 in the section entitled “Cover”.
30 days of its birth. Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.
Emergency transportation Exclusions Full details of the benefits are shown in the
To and from hospital where medically Does not include the costs of car hire. benefit schedule and in the policy wording on
necessary. Special limitations pages 4 to 5 in the section entitled “Cover”.
Limited to inpatient/day patient treatment Full details of the specific exclusions noted,
only and must be pre-authorised. and the other policy exclusions are shown
on pages 6 to 7 of the policy wording under
section 3 entitled “Exclusions”.
Extended evacuation Exclusions Full details of the benefits are shown in the
Where appropriate inpatient/day patient Does not include treatment as a result benefits Schedule and in the policy wording
emergency treatment is not available at the of complications of pregnancy. Excludes on page 8, in the section entitled “Product
place of incident, the costs of Evacuation outpatient treatment. Options” as option 003.
transport to the nearest appropriate medical Special limitations Full details of the specific exclusions noted,
facility, or to your country of choice. Must be pre-authorised by us and under and the other policy exclusions are shown
Covers one other person to act as escort. our supervision. on pages 6 to 7 of the policy wording under
Where choosing your country of choice, this section 3 entitled “Exclusions”
is limited to appropriate medical facilities
being in place and where it is medically
suitable at our discretion.
Additional travel expenses Special limitations Full details of the benefits are shown in the
• to and from medical appointments Covers costs only following an Evacuation. benefit schedule and in the policy wording on
• costs of accompanying person to and from Pre- and post-hospitalisation pages 4 to 5 in the section entitled “Cover”.
the hospital to visit the insured person accommodation costs limited to £95,€/
• immediate pre and post-hospitalisation US$150 per person per day to a total of
accommodation costs £3,000, €/US$5,000 per evacuation.
Economy class ticket to return insured person
and escort back to their country of residence
or to where the evacuation occurred.
8
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Mortal remains Special limitations Full details of the benefits and specific
In the event of death, the cost of Cover limited to £5,300, €/US$8,500 limitations are shown in the benefit schedule
transportation of the body or ashes of per person. and in the policy wording on pages 4 to 5 in
an insured person to his/her country of the section entitled “Cover”.
residence or country of nationality, or the
costs of a burial or cremation at the place
of death.
Hospital cash benefit Special limitations Full details of the benefits are shown in the
Where inpatient treatment of an eligible Cash benefit is limited to £75, €/US$125 benefit schedule and in the policy wording
medical condition is received and where per night for a maximum of 20 nights on pages 4 to 5 in the section entitled
accommodation and treatment is free hospital stay. “Cover”.
of charge. Not applicable to accident and emergency
admissions.
Routine treatment of chronic conditions Does not cover chronic medical conditions Full details of the benefits are shown in the
Routine management and palliative which pre-date your original date of entry. benefits Schedule and in the policy wording
treatment in respect of a chronic medical Special limitations on page 8, in the section entitled “Product
condition to include: Limited to £9,375, €/US$15,000 per period Options” as option 003.
• routine check-ups of cover. Policy exclusions are shown on pages 6 to
• managing drugs and dressings 7 of the policy wording under the section
• hospital accommodation entitled “Exclusions”.
• nursing
• surgery
Not subject to the policy Excess.
Additional options All additional options have the same Full details of the general exclusions
exclusions and limitations as those noted, and the other policy exclusions
shown under the inpatient, day patient are shown on pages 6 to 7 of the policy
and outpatient sections above unless wording under the section entitled
specifically stated. “Exclusions
USA elective treatment Special limitations Full details of this product option are shown
Extends cover to provide for choosing to Any inpatient or day patient treatment in the policy wording under the “Product
have treatment in the USA which is not only which is not undertaken within our provider Options” section on page 9 as option 005.
due to an accident or emergency. network, is subject to a 50% co-insurance
and an annual limit of £625,000,
€/US$1,000,000.
Semi-private room restriction Special limitations Full details of this product option are shown
(Available to residents of Hong Kong only). Hospital accommodation is restricted to a in the policy wording under the “Product
semi-private room and corresponding rates Options” section on page 9 as option 006.
when receiving treatment as an inpatient/
day patient.
China private room restriction Special limitations Full details of this product option are shown
(Available to residents of mainland Hospital accommodation is restricted to a in the policy wording under the “Product
China only). semi-private room and corresponding rates Options” section on page 9 as option 007.
when receiving treatment as an inpatient/
day patient outside of mainland China.
Direct settlement network Special limitations Full details of this product option are shown
Allows for nil excess to be paid should Restricted to clinics in selected countries in the policy wording under the “Product
outpatient treatment be undertaken in one only. treatment not undertaken in one of Options” section on page 9 as option 008.
of our direct settlement network clinics. the listed clinics is subject to an excess of
£65, €/US$100.

9
Lifestyle Plus
This document provides a summary of the cover provided. Full details can be found in the policy wording. Where you have purchased
cover you should refer to your own benefit schedule, policy wording and policy schedule including any endorsements which apply for
full details of your cover.
Your insurer is Aetna Health Insurance Company of Europe Limited.
Type of Insurance: International Private Medical Insurance
Period of Insurance: The policy will last for one year and will be renewable on an annual basis.

policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Cover under this policy is up to a maximum General exclusions Full details of the general exclusions noted,
of £1,000,000, €/US$1,600,000 per insured Cover is not provided for any medical and the other policy exclusions are shown
person per period of cover. condition in existence at the date of entry on pages 6 to 7 of the policy wording under
to the policy until it has been treatment, the section entitled “Exclusions”.
symptom and advice free for two consecutive
years following the date of entry.
General exclusions also include:
• chronic medical conditions which
pre-date your original date of entry
• infertility/sterilisation
• cosmetic treatment
• alcohol, drug or solvent abuse
• sexually transmitted diseases
• non-emergency treatment in the USA
• elective medical check-ups, vaccinations
General limitations
Costs are subject to a reasonable and
customary level based on the average
treatment costs applicable to the region
in which the treatment was received, as
determined by us.
The policy provides payment for treatment Below are noted the exclusions and
of an eligible medical condition including: limitations applied to each section.
Inpatient and day patient treatment Special limitations Full details of the benefits are shown in the
• accommodation charges Inpatient (including day patient) psychiatric benefit schedule and in the policy wording on
• drugs and dressings treatment is restricted to a maximum of 30 pages 4 to 5 in the section entitled “Cover”.
• theatre charges days per person, per period of cover and
• specialist fees must be pre-authorised.
• diagnostic tests Reconstructive surgery must be undertaken
• oncology, radiotherapy and chemotherapy within 12 months of an accident or injury
• scans and x-rays which has caused disfigurement.
• anaesthetist fees
Rehabilitation cover is limited 120 days per
• nursing
medical condition.
• intensive care unit costs
• psychiatric treatment
• reconstructive surgery
• organ transplant
• rehabilitation
Outpatient treatment Special limitations Full details of the benefits are shown in the
• medical practitioner visits Psychiatric treatment must be pre-authorised, benefit schedule and in the policy wording on
• diagnostic procedures limited to £3,125, US$/€5,000 per period pages 4 to 5 in the section entitled “Cover”.
• specialist consultations of cover.
• drugs and dressings Acupuncture, homeopathic, osteopathic,
• physiotherapy chiropractic treatment limited to 10 sessions
• CT/MRI scans in aggregate per person per period of cover.
• outpatient surgery
Traditional Chinese medicine cover is
• oncology treatment
limited to £20,€/US$30 per session and to
• psychiatric treatment
a maximum of 10 sessions.
• acupuncture, homeopathic, osteopathic,
podiatry, chiropractic treatment Ancillary charge up to £625, US$/€1,000 per
• traditional Chinese medicine medical condition.
• ancillary charges

10
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Home nursing Exclusions Full details of the benefits are shown in the
The services only of a qualified nurse Nursing for domestic reasons or benefit schedule and in the policy wording on
immediately after a period of inpatient convenience. pages 4 to 5 in the section entitled “Cover”.
treatment and on the recommendation Special limitations Policy exclusions are shown on pages 6 to
of a specialist. Costs are limited to 28 weeks of nursing 7 of the policy wording under the section
care provided per condition and subject to entitled “Exclusions”.
pre-authorisation.
Additional hospital accommodation costs Special limitations Full details of the benefits and specific
• parental accommodation • limited to an adult staying with a child limitations are shown in the benefit schedule
• new born accommodation under the age of 18. and in the policy wording on pages 4 to 5 in
• limited to a new born, which is defined the section entitled “Cover”.
as under the age of 16 weeks.
AIDS cover Exclusions Full details of the benefits are shown in the
Covers treatment for HIV/AIDS/ARC Does not cover sexually transmitted benefit schedule and in the policy wording on
HIV/AIDS. pages 4 to 5 in the section entitled “Cover”.
Special limitations Policy exclusions are shown on pages 6 to
Cover limited to £6,250, €/US$10,000 per 7 of the policy wording under the section
period of cover. entitled “Exclusions”.
Accidental damage to teeth Special limitations Full details of the benefits are shown in the
Limited to treatment undertaken in an benefit schedule and in the policy wording on
emergency room in a hospital within seven pages 4 to 5 in the section entitled “Cover”.
days of the accident. Must be damage
caused to sound, natural teeth.
Complications of pregnancy Exclusions Full details of the benefits are shown in the
Treatment in the antenatal stages of Any complications of pregnancy where benefit schedule and in the policy wording on
pregnancy that requires a recognised the date of conception is within the first pages 4 to 5 in the section entitled “Cover”.
obstetric procedure, including medically 12 months from the date of entry. Policy exclusions are shown on pages 6 to
necessary caesarean sections. Special limitations 7 of the policy wording under the section
Caesarean sections are not classed as entitled “Exclusions”.
medically necessary if they are as a result
of a previous elective caesarean section.
New born care Special limitations Full details of the benefits are shown in the
Inpatient treatment of an acute medical Benefit limited to 30 days hospital stay and benefit schedule and in the policy wording on
condition given to a new born baby within to a maximum of £62,500, €/US$100,000. pages 4 to 5 in the section entitled “Cover”.
30 days of its birth. Policy exclusions are shown on pages 6 to
7 of the policy wording under the section
entitled “Exclusions”.
Emergency transportation Exclusions Full details of the benefits are shown in the
To and from hospital where medically Does not include the costs of car hire. benefit schedule and in the policy wording on
necessary. Special limitations pages 4 to 5 in the section entitled “Cover”.
Limited to inpatient/day patient treatment Full details of the specific exclusions noted,
only and must be pre-authorised. and the other policy exclusions are shown
on pages 6 to 7 of the policy wording under
section 3 entitled “Exclusions”.
Extended evacuation Exclusions Full details of the benefits are shown in the
Where appropriate inpatient/day patient Does not include treatment as a result benefits Schedule and in the policy wording
emergency treatment is not available at the of complications of pregnancy. Excludes on page 8, in the section entitled “Product
place of incident, the costs of evacuation outpatient treatment. Options” as option 003.
transport to the nearest appropriate medical Special limitations Full details of the specific exclusions noted,
facility, or to your country of choice. Must be pre-authorised by us and under and the other policy exclusions are shown
Covers one other person to act as escort. our supervision. on pages 6 to 7 of the policy wording under
Where choosing your country of choice, this section 3 entitled “Exclusions”
is limited to appropriate medical facilities
being in place and where it is medically
suitable at our discretion.

11
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Additional travel expenses Special limitations Full details of the benefits are shown in the
• to and from medical appointments Covers costs only following an evacuation. benefit schedule and in the policy wording on
• costs of accompanying person to and from Pre- and post-hospitalisation pages 4 to 5 in the section entitled “Cover”.
the hospital to visit the insured person accommodation costs limited to £95,
• immediate pre and post-hospitalisation €/US$150 per person per day to a total of
accommodation costs £3,000, €/US$5,000 per evacuation.
Economy class ticket to return insured person
and escort back to their country of residence
or to where the evacuation occurred.
Mortal remains Special limitations Full details of the benefits are shown in the
In the event of death, the cost of Cover limited to £5,300, €/US$8,500 benefit schedule and in the policy wording on
transportation of the body or ashes of per person. pages 4 to 5 in the section entitled “Cover”.
an insured person to his/her country of
residence or country of nationality, or the
costs of a burial or cremation at the place
of death.
Hospital cash benefit Special limitations Full details of the benefits are shown in the
Where inpatient treatment of an eligible Cash Benefit is limited to £75, €/US$125 benefit schedule and in the policy wording on
medical condition is received and where per night for a maximum of 20 nights pages 4 to 5 in the section entitled “Cover”.
accommodation and treatment is free of hospital stay
charge. Not applicable to accident and emergency
admissions.
Routine treatment of chronic conditions Exclusions Full details of the benefits are shown in the
Routine management and palliative Does not cover chronic medical conditions benefits Schedule and in the policy wording
treatment in respect of a chronic medical which pre-date your original date of entry. on page 8, in the section entitled “Product
condition to include: Special limitations Options” as option 003.
• routine check-ups Limited to £9,375, €/US$15,000 per period policy exclusions are shown on pages 6 to
• managing drugs and dressings of cover. 7 of the policy wording under the section
• hospital accommodation entitled “Exclusions”.
• nursing
• surgery
Not subject to the policy Excess.
Routine dental treatment Special limitations Full details of the benefits are shown in the
Fees of a dental practitioner to cover: Cover is limited to £435, €/US$700 per benefits Schedule and in the policy wording
• examinations insured person per period of cover, with the on page 8, in the section entitled “Product
• tooth cleaning insured person being responsible for 25% of Options” as option 004.
• normal compound fillings the total value of any claim.
• simple or non-surgical extractions Benefits are subject to a six month wait
Not subject to the policy excess. period from your date of entry.
Major restorative dental treatment Special limitations Full details of the benefits are shown in the
Fees of a dental practitioner to cover: Cover is limited to £945, €/US$1500 per benefits Schedule and in the policy wording
• removal of impacted, buried or insured person per period of cover in on page 8, in the section entitled “Product
unerupted teeth aggregate to Routine Dental, with the Options” as option 004.
• removal of roots, removal of solid insured person being responsible for 25%
odontomes of the total value of the claim.
• apicectomy, new or repair of bridge work, Benefits are subject to a nine month wait
new or repair of crowns period from your date of entry.
• root canal treatment, new or repair of
upper or lower dentures
Not subject to the policy excess.
Routine pregnancy and childbirth Special limitations Full details of the benefits are shown in the
Not subject to the policy excess. Benefit is limited to £6,250, €/US$10,000 benefits Schedule and in the policy wording
for each pregnancy, with the insured person on page 8, in the section entitled “Product
being responsible for 20% of the total value Options” as option 004.
of the claim.
Benefits are subject to a 12 month wait
period from your date of entry to the date
of conception.

12
policy SUMMARY
Significant features and benefits Significant exclusions and limitations Section of the policy that contains details
Additional options All additional options have the same Full details of the specific exclusions
exclusions and limitations as those noted, and the other policy exclusions
shown under the inpatient, day patient are shown on pages 6 to 7 of the policy
and outpatient sections above unless wording under the section entitled
specifically stated. “Exclusions”.
USA elective treatment Special limitations Full details of this product option are shown
Extends cover to provide for choosing to Any inpatient or day patient treatment in the policy wording under the “Product
have treatment in the USA which is not only which is not undertaken within our provider Options” section on page 9 as option 005.
due to an accident or emergency. network, is subject to a 50% co-insurance
and an annual limit of £625,000,
€/US$1,000,000.
Semi-private room restriction Special limitations Full details of this product option are shown
(Available to residents of Hong Kong only). Hospital accommodation is restricted to a in the policy wording under the “Product
semi-private room and corresponding rates Options” section on page 9 as option 006.
when receiving treatment as an inpatient/
day patient.
China private room restriction Special limitations Full details of this product option are shown
(Available to residents of mainland Hospital accommodation is restricted to a in the policy wording under the “Product
China only). semi-private room and corresponding rates Options” section on page 9 as option 007.
when receiving treatment as an inpatient/
day patient outside of mainland China.
Direct settlement network Special limitations Full details of this product option are shown
Allows for nil excess to be paid should Restricted to clinics in selected countries in the policy wording under the “Product
outpatient treatment be undertaken in one only. treatment not undertaken in one of Options” section on page 9 as option 008.
of our direct settlement network clinics. the listed clinics is subject to an excess of
£65, €/US$100.

Major Medical Foundation Lifestyle Lifestyle Plus


Excess
Policy excess level options - The excess level selected for this policy will be applicable to each new medical condition.
£0 / €0 / $0 Standard Optional
£30 / €40 / $50 N/A Optional
£65 / €80 / $100 N/A Standard
£155 / €200 / $250 N/A Optional
£300 / €360 / $500 N/A Optional N/A
£625 / €750 / $1,000 Optional N/A
£1,250 / €1,500 /$2,000 N/A Optional N/A
£3,000 / €3,600 / $5,000 Optional N/A

13
Medical underwriting How to submit a claim
Moratorium underwriting Upon inception, each member will receive a membership card.
Our standard approach to medical underwriting. This provides them with the contact information for the Aetna
International Member Service Centre and information they
At the member level, cover is not provided for any medical
need to register for the Aetna International secure member
condition in existence on the date your policy with Aetna
website. Members can use either resource to submit a claim.
Global Benefits (Europe) Ltd commences (date of inception)
until it has been treated such that the individual is symptom We reserve the right to deny any claim that is not submitted
and advice-free for two consecutive years following the within 180 days of the treatment date. Claims may only be
date of inception with regard to that medical condition. made for treatment given during a period of cover. The
This policy does not cover the treatment of pre-existing benefit will only be payable for expenditure incurred prior to
chronic conditions. expiry or termination.

Full medical underwriting Who regulates us?


Should we accept cover, we may apply additional terms and
exclusions, which will be shown on the member’s certificate We are authorised and regulated by the Financial Services
of insurance. Authority (FSA) in the United Kingdom. our FSA registered
number is 310030. our permitted business is arranging
Continuous transfer terms general insurance contracts.
For members wishing to transfer from other policies. You can check this on the FSA’s Register by visiting the FSA’s
This feature may incur additional premium. website at www.fsa.gov.uk/register or by contacting the FSA
The acceptance by us of the member’s original date of at 0845 606 1234.
inception as shown by the member’s current insurer will be
applied to the member’s policy with us. We will maintain Whose products do we offer?
the member’s existing underwriting or special acceptance
Aetna Global Benefits (Europe) Limited offers and
terms, as offered by the member’s existing insurer, such as
recommends Aetna International products. Insurance plans
any moratoria or specific exclusions, and the member’s policy
are underwritten by Aetna Health Insurance Company of
with us will be governed by the terms and conditions of our
Europe Limited. Aetna Health Insurance Company of Europe
policy. Any transfer will be subject to no enhanced benefits
Ltd are regulated by the Central Bank of Ireland (C47511).
being provided. We reserve the right at all times to decline
a continuous transfer terms request without giving any
reason or impose/include additional exclusions. Who are we owned by?
Aetna Global Benefits (Europe) Limited is a wholly owned
Plan currency subsidiary of Aetna Inc. and is an Aetna company.
The Sterling (£) currency is available to policyholders
registered in the United Kingdom. Demands and needs statement
The Euro (€) currency is available to policyholders registered At Aetna, we strive to ensure that all our policies are of real
in Europe. benefit to our individual customers. Therefore we ask each
customer to carefully consider which Aetna policy best meets
The US Dollar ($) currency is available to policyholders outside their own specific needs.
of the United Kingdom and Europe.
Aetna Global Benefits (Europe) Ltd is an execution-only
business. We do not provide advice regarding which plan
Policyholder’s right of termination
best suits your individual requirements. Therefore it is your
If, having examined the benefit schedule, policy wording and responsibility to determine which policy type is most suitable
policy schedule you decide not to proceed, you have 15 days for you.
from the commencement date of your cover, or the receipt
We also recommend that policyholders should frequently
of these details and your policy schedule (whichever is the
review their health insurance requirements to ensure their
later) to cancel your cover. To do this you should contact your
current policy continues to meet with those requirements.
Insurance Advisor or Aetna.
If the policy is terminated by the policyholder at any other time,
whatsoever the reason, there will be no return of premium.

Inpatient pre-authorisation
All inpatient treatment is required to be pre-authorised prior
to a planned admission into a hospital. Members should
contact the Aetna International Member Service Centre to
determine whether treatment is covered under the policy.

14
Complaints procedure T: 0800 0 234 567
Free for people phoning from a UK “fixed line” (for example,
We intend to meet our customers’ expectations at all times.
a land line at home)
However, we understand that from time to time complaints
may arise. Our complaints handling procedures are based on 0300 123 9 123
the rules prescribed by the UK’s Financial Services Authority Free for UK mobile-phone users who pay a monthly charge
and our aim is to resolve any complaints that we receive both for calls to numbers starting with 01 or 02
fairly and promptly. +44 20 7964 1000
Who to contact with a complaint For calls from outside of the UK

Aetna Global Benefits (Europe) Limited www.financial-ombudsman.org.uk


2nd Floor complaint.info@financial-ombudsman.org.uk
8 Eastcheap
Where a complaint relates to the services provided by another
London EC3M 1AE
firm we shall advise the complainant of this and forward the
United Kingdom
complaint to the other firm for resolution. Where we and
TF: +1 866 320 4023*** another firm are jointly responsible for the complaint, we
Collect: +1 813 775 0244 shall ensure that the complainant is informed of this and
each company will contact them directly in relation to the
TF Fax: +1 866 320 4024*** complaint for which it is responsible.
EuropeServices@aetna.com
Financial Services Compensation Scheme****
Summary of our complaints handling procedures
Aetna Global Benefits (Europe) Limited is covered by the
Complaints will:
Financial Services Compensation Scheme (FSCS). This means
• Be acknowledged promptly, confirming who will be that you may be entitled to compensation from the scheme
responsible for investigating the complaint. if it cannot meet its obligations. This depends on the type
• Be investigated competently, efficiently and impartially, of business and the circumstances of the claim and would
ensuring that we provide updates on progress. provide cover for 90% of the claim without any upper limit.
• Be assessed fairly, consistently and promptly. Further information about compensation is available from the
FSCS at www.fscs.org.uk or telephone +44 (0) 020 7892 7300
Financial Ombudsman Service (United Kingdom): or +44 (0) 0800 678 1100.
The Financial Ombudsman Service If a policyholder takes any of the action mentioned above, it
South Quay Plaza will not affect any rights he/she may have to take legal action.
183 Marsh Wall
London
E14 9SR
United Kingdom
Open Monday through Friday from 8am until 6pm (GMT)

Stay connected to Aetna International


Visit www.aetnainternational.com
Follow www.twitter.com/AetnaGlobal
Like www.facebook.com/AetnaInternational

***International toll-free number requires an access code, which can be found by country at the website www.att.com/business_traveler.
****Applies only to plans purchased through Aetna Global Benefits (Europe) Limited.

Aetna® is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.
Policies issued in Europe are issued and underwritten or reinsured by Aetna Health Insurance Company of Europe Limited, regulated by the Central Bank Ireland
(CBI), and administered by Aetna Global Benefits (Europe) Limited, regulated by the Financial Services Authority (310030). Registered address: 400 Capability
Green Luton Bedfordshire LU1 3AE. Registered in England & Wales. Registered No. 04548434.
Aetna does not provide care or guarantee access to health services. Not all health services are covered. Health information programmes provide general health
information and are not a substitute for diagnosis or treatment by a health care professional. See plan documents for a complete description of benefits, exclusions,
limitations and conditions of cover. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about
Aetna International plans, refer to www.aetnainternational.com.

www.aetnainternational.com

©2012 Aetna Inc.


46.02.954.1-EU (6/12)

You might also like