Cigna Global Health Options

CUSTOMER GUIDE
Everything you need to know about your plan
HELPING TO IMPROVE YOUR
HEALTH, WELLBEING AND
PEACE OF MIND.
 CONTENTS
04 Welcome to Cigna Global

Overview of Services
05 Our Whole Health Services
06 Our Customer Care
07 Our Global Expertise

Our Health Services

08 Clinical Case Management
09 Cigna WellbeingTM App

Practical Information
10 Your Guide to Getting Treatment
12 How to Submit Claims
13 Your Online Customer Area
14 How Deductible and Cost Share work

List of Benefits
16 International Medical Insurance
24 International Outpatient
30 International Evacuation & Crisis Assistance PlusTM
35 International Health & Wellbeing
38 International Vision & Dental

WANT TO GET IN TOUCH?

If you have any questions about your policy, need to get approval for treatment, or for any other reason, please
contact our Customer Care team 24 hours a day, 7 days a week, 365 days a year.

Use your Customer Area Call Us

› Live chat with us International: +44 (0) 1475 788 182
› Message us USA: 800 835 7677 (toll free)
› Arrange a callback Hong Kong: 2297 5210 (toll free)
Singapore: 800 186 5047 (toll free)

Alternatively, you can email us at: cignaglobal_customer.care@cigna.com

 WELCOME TO CIGNA GLOBAL
OUR MISSION
Thank you for choosing a Cigna Global Health Options plan to protect you and
your family. Our mission is to help improve your health, wellbeing and peace of
mind – and everything we do is designed to achieve this.

WHAT WE DO
At Cigna Global we specialise in supporting you and your family on your global
journey as a wellbeing partner enabling you access to top medical care. We are
experts with dedicated knowledge and capabilities to support you, and we will
offer you exceptional customer service by putting people at the heart of what
we do.

We put YOU at the centre of everything we do.

re your WHOL
ea EH
W
E
A
LT
H
PA
RTNER

SE
TI
R
PE
EX
GLOBAL
e have
W

S T
We F IR
put P E O PLE

Please read this Customer Guide, along with your Policy Rules and your Certificate of Insurance as they all
form part of your contract between you and us for this period of cover. If your policy is insured by Cigna
Worldwide General Insurance Company Limited or Cigna Europe Insurance Company S.A.-N.V. Singapore
Branch, your application also forms part of your contract between you and us.
You have chosen a plan to meet your unique needs so as you look through your Customer Guide and
discover the full extent of the cover we provide, please remember to take a look at your Certificate of
Insurance to remind yourself exactly what optional benefits you may have chosen to add to your core
cover – International Medical Insurance.
You may see some terms that are in italics. These terms are clearly defined in your Policy Rules so as to
avoid any confusion.
In the meantime, we hope you enjoy the peace of mind that comes from knowing you and your family have
quick access to the medical treatment you need, whenever and wherever you need it.

4 | www.cignaglobal.com
OUR WHOLE HEALTH SERVICES

We are your WHOLE HEALTH PARTNER and we’re

here to support you throughout your wellbeing journey.

Our Clinical Case Management

Access our Clinical Team
programme can be accessed by You have access to our Clinical Case Management
contacting our Customer Care team. programme that is carried out by our dedicated team of
doctors and nurses. They will provide support if you are
diagnosed with serious or complex health conditions to
bring you the full medical support you deserve.

The programme can support you through:

› coordinating your healthcare and treatment plan;
› accessing global medical experts for advice and support;
› providing second medical opinions or medical reports if
required.
Further details on our Clinical Case Management programme
can be found on page 8 of this Customer Guide.

Access our WellbeingTM App

You can download the
The Cigna WellbeingTM App gives you easy
App for free via Google
access to a suite of healthcare tools.
Play and the Apple Store.
Our interactive app enables you to: Get started today:
› Access Global Telehealth: Video and › Search “Cigna
phone consultations with medical Wellbeing” in your
practitioners and specialists; App Store
› Manage health: Health risk assessments › Download the App
and chronic condition management; › Select “Global
› Change behaviour: Track biometrics and Individual Plan
access online coaching programmes and (policyholder)”
a health library. › Log-in with your
Customer Area
Further details on the Wellbeing App can
TM
credentials.
be found on page 9 of this Customer Guide.

Life Management Assistance Programme

Offered as part of the International Health and Wellbeing optional module only.
This service offers confidential assistance with any work, life, personal or family issue that matters to you
through counselling, telephone support and online programmes.

Available if you
have selected the You will have access to:
International › Telephonic, face-to-face, or video short-term counselling;
Health and › Mindfulness coaching sessions;
Wellbeing optional › An online Cognitive Behavioural Therapy (CBT) programme;
module. If you
would like to use › Career support with life coaching sessions and assistance for
this service, please people managers;
call us and we will › Information about local resources and referrals.
transfer you to our Further details can be found on page 34 of this Customer Guide.
service provider.

www.cignaglobal.com | 5
OUR CUSTOMER CARE

We put PEOPLE FIRST and our teams are dedicated to

providing you with the highest level of service and care.

heart of ev
the er
at yt
› You can speak to our highly experienced Customer
U

hi
Care team 24 hours a day.
O

ng
tY

› Our multi-language service centres will aim to answer

we d
We pu

your call within 20 seconds.

› We aim to process your guarantee of payment within
o.

one hour after receiving all necessary documentation

to avoid any delay to your treatment.
› We aim to process claims you submit within
five working days after receiving all necessary
documentation.

You have access to easy online You have several ways of contacting
tools to manage your policy and OU in co us, to get the help you need in a
submit your claims. put Y nt manner that is convenient to you.
e ro
W
l.

Live chat Call us or Email us

arrange a
call back

Further details about your secure Further details about how to contact
online Customer Area can be found us can be found on page 3 of this
on page 13 of this Customer Guide. Customer Guide.

We strive to continuously ly improve

enhance our health plans uous ou
and services thanks to your tin r
n

feedback.
co

se
rvi

› We may invite you to let us

We strive to

ce to YOU.

know if we are meeting your

expectations through Net
Promoter Score surveys.
› We may invite you to join our
exclusive Online Community
to open a dialogue with you
on the things that matter
to you (subject to your
location).

6 | www.cignaglobal.com
OUR GLOBAL EXPERTISE

We have GLOBAL EXPERTISE and we understand the

challenges you might face as a globally mobile individual.

You can search for local healthcare Access our Global Network
facilities and professionals through your
secure online Customer Area or by We have an extensive medical network of over 1.65 million
contacting our Customer Care team. partnerships. Our network is comprised of trusted hospitals,
clinics and medical practitioners around the world.

Our global network of trusted hospitals, clinics, and

doctors includes:
› Over 1.65 million medical partnerships around the world;
› Over 175,000 mental and behavioural healthcare
providers;
› Over 14,000 facilities and clinics.

Globally Mobile Resources The Country Guides section of your

Customer Area provide useful travel
We understand that moving to a new country can be an advices including pandemic information.
exciting, but busy time and we have resources that can
assist you along your journey.

› Visit the Health Blog on our website for a host of

useful information such as country guides,
information on healthcare systems, and tips for making
the most of your relocation.
› Access up to date travel information and advice and real
time alerts through your secure online Customer Area.

Crisis Assistance PlusTM

Available if you have selected the International
Evacuation and Crisis Assistance PlusTM optional Offered as part of the International Evacuation
module. and Crisis Assistance PlusTM optional module only.
In the event of a crisis situation, please call us and To further support our globally mobile customers,
we will transfer you to FocusPoint International® Cigna proudly offers Crisis Assistance PlusTM
who provide worldwide assistance. (CAP), a worldwide comprehensive crisis
assistance programme, provided by FocusPoint
International®.

The CAP programme provides

time-sensitive advice and coordinated
in-country crisis assistance for risks that
could impact you when you’re travelling
ranging from natural disasters to political
threats.
Further details about this programme
can be found on page 32 of this
Customer Guide.

www.cignaglobal.com | 7
 CLINICAL CASE MANAGEMENT
We are dedicated to helping you and your family live happier, healthier lives thanks to our clinical expertise.
This programme provides all beneficiaries access to clinical services by contacting our Customer Care team.

ACCESS CARE, ANYTIME, ANYWHERE

Our Global Telehealth service gives you access to licensed doctors around
the world for non-emergency health issues. We can arrange a callback
appointment for you often on the same day, or you can arrange a telephone or
video consultation from the Cigna WellbeingTM app.
› You can receive a diagnosis for non-emergency health conditions;
› It can help prepare you for an upcoming consultation or hospitalisation;
› You can discuss a medication or treatment plan and potential side effects.

FEEL SUPPORTED ON YOUR MEDICAL JOURNEY

Our Case Management service Our Chronic Condition programme
assigns you a case manager when offers support if you are suffering
you are diagnosed with a complex from a chronic condition. If the
condition requiring special condition is a special exclusion
support. They will serve as your as detailed on your Certificate of
single point of contact, offering Insurance, we can still help you
support through coordinating your manage your condition although
healthcare and treatment plan. your exclusion will still apply to any
treatment.
› You will receive personalised
advice and support from your › A case manager will schedule
assigned case manager; regular calls to monitor and
evaluate your condition and
› We will create tailored
treatment plan;
treatment plans to best suit
your individual needs. › Your assigned case manager will
create specific and achievable
› We will aim to reduce the
goals with you to better help
number of unnecessary or
you manage and maintain your
additional hospital admissions.
condition.

FEEL REASSURED THANKS TO SECOND MEDICAL OPINIONS

Our Decision Support programme gives you access to leading

medical experts to provide advice and recommendations on your
individual diagnosis and treatment plan.
This service is provided through our independent partner
who work with global medical experts to provide advice and
recommendations on individual cases and treatment plans.
› You will receive contact from our partner within 48 hours of
them receiving your medical history;
› The medical report will contain the medical expert’s opinion on
your diagnosis and treatment plan;
› You can also submit your own questions on your diagnosis and
treatment plan to be answered in the report.

8 | www.cignaglobal.com
CIGNA WELLBEINGTM APP
Our Cigna WellbeingTM app provides you with a host of tools and features to help you manage your
health and wellbeing.

ACCESS CARE, ANYTIME, ANYWHERE

The Cigna WellbeingTM app is the easiest way to access Global Telehealth.

Request an
Speak with a doctor Feel better
appointment

Use the Cigna WellbeingTM app The initial consultation will be

Feel reassured you have
to make an appointment with with a General Practitioner
spoken to a doctor.
a doctor anytime, anywhere. (GP) - by phone or video.

Why use Global Telehealth?

› It’s convenient. There’s no need to leave the house or
workplace.
› It’s available 24/7. That’s around the clock access to
doctors, usually within 24 hours (depending on language
preference).
› It’s affordable. It’s an alternative to doctor office or clinic
visits - with no deductibles or cost share payments and no
limits to the number of consultations arranged.

MANAGE YOUR HEALTH

Health Assessments Chronic Condition Management

The confidential online Health Risk This programme, led by our highly experienced nurses, will
Assessment allows you to create your help you take control of your chronic condition, including
own unique report. The 360° view of but not limited to:
your health will provide you with:
› Diabetes
› Your health score › High blood pressure
› Your positive habits › Heart problems
› The areas for improvement
Please complete the Wellbeing Assessment and let us know
› Any risk areas if you would like to be contacted by us.

CHANGE BEHAVIOURS

Track Biometrics Health Content & Coaching Programmes

The Cigna WellbeingTM App allows you Discover articles, online coaching
to continuously track: programmes, and videos designed to help
you make better decisions relating to sleep,
› Sleep
stress, nutrition and exercise.
› Height/Weight
› Lifestyle
› Blood sugar
› General health
› Blood pressure
› Nutrition / weight
› Cholesterol
› Healthy recipes
› Your health notes
› Physical activity
› Stress
www.cignaglobal.com | 9
 YOUR GUIDE TO GETTING TREATMENT
We want to make sure that getting treatment is as stress free as possible for you or your family.

BEFORE TREATMENT

Contact our Customer Care team prior to treatment. You can contact us 24 hours a day via live chat on
your secure online Customer Area, phone or email (See page 3 for details).
› We can help you arrange › We can liaise directly with your › We can liaise directly
your treatment plan, and treatment provider to ensure with your treatment
point you in the right the treatment that you are provider to arrange
direction, saving you the time about to undertake is covered direct billing by issuing
and hassle of looking for a under your policy and issue a a guarantee of payment.
hospital, clinic or medical prior authorisation.
practitioner yourself.

If it’s an emergency and you can’t

call us before, contact us within
the next 48 hours.

RECEIVING TREATMENT

› Please remember to take your Cigna ID card with you. A copy of your Cigna ID card is available in
your secure online Customer Area.

AFTER TREATMENT
In most cases we will pay your hospital, clinic or If you’ve paid your hospital, clinic or medical
medical practitioner directly. practitioner yourself.
› We will only pay the parts of the treatment › Submit your invoice and claims to us:
costs incurred which are covered.
- Online via your secure online Customer Area;
› All beneficiaries are responsible for paying - Or via email, fax, or post (See page 12).
any deductible or cost share directly to
› We will reimburse you (less your applicable
the hospital, clinic, medical practitioner or
deductible and/or cost share option).
pharmacy at the time of treatment.
› We aim to process your claim within 5
working days after receiving all necessary
documentation.

A list of Cigna network hospitals, clinics

You can download your claims
and medical practitioners is available in
forms from your secure online
your secure online Customer Area or you
Customer Area or at
can contact our Customer Care team for
www.cignaglobal.com/help/claims
more information.

Please note there may be certain countries where we are unable to pay a provider directly. In this instance,
you will be responsible for paying any treatment costs to your provider and Cigna will reimburse you.
Please note, we may, at our sole discretion and without notification, make changes to the Cigna network
from time to time by adding and/or removing hospitals, clinics, medical practitioners and pharmacies.

10 | www.cignaglobal.com
Before getting treatment, please read the following information regarding prior authorisation,
emergency treatment, and getting treatment in the USA.

PRIOR AUTHORISATION

Please call us as soon as possible before you receive treatment under the International Medical
Insurance plan, and any of the additional modules you have selected (if applicable).
Prior authorisation is required for all Inpatient and Daypatient treatments. It is not required for
Outpatient treatments with the exception of the treatments listed on page 24.
We may ask for further information, such as a medical report in order for us to approve treatment.
We will confirm authorisation, and where applicable, the number of treatments approved.
If you do not get prior authorisation from us, there may be delays in processing claims, or we may
decline to pay all or part of the claim. We will reduce the amount which we will pay by:
› 50% if you did not call us for prior authorisation when it was required for treatment inside the USA;
› 20% if you did not obtain prior authorisation for treatment outside the USA.
In most circumstances, we will give a beneficiary or a hospital, medical practitioner or clinic a
guarantee of payment. This means that we agree in advance to pay some or all of the cost of a
particular treatment. Where we have given a guarantee of payment we will pay the beneficiary or
hospital, medical practitioner or clinic the agreed amount on receipt of an appropriate request and
a copy of the relevant invoice, after the treatment has been provided.

EMERGENCY TREATMENT

We appreciate that there will be times when it will not be practical or possible to contact us
prior to treatment in an emergency and the priority is to get treatment as soon as possible. In
circumstances like these, we ask that you or the affected beneficiary get in touch with us within
48 hours of receiving the treatment. This will allow us to confirm whether your treatment is
covered and arrange settlement with your treatment provider.
We may ask for further information, such as a medical report in order for us to approve treatment.
We will confirm approval, and where applicable, the number of treatments approved.
If a beneficiary has been taken to a hospital, medical practitioner or clinic which is not part of
our network, then we may make arrangements (with the beneficiary’s consent) to move the
beneficiary to a Cigna network hospital, medical practitioner or clinic to continue treatment, once
it is medically appropriate to do so.

GETTING TREATMENT IN THE USA

If a beneficiary decides to receive treatment at a hospital, medical practitioner, clinic or pharmacy

which is not part of the Cigna network, we will reduce any amount which we will pay by 20%.
We realise that there may be occasions when it is not reasonably possible for treatment to be
provided by a Cigna network hospital, medical practitioner, clinic or pharmacy. In these cases, we
will not apply any reduction to the payments we will make. Examples include, but are not limited
to:
› when there is no Cigna network hospital, medical practitioner, clinic or pharmacy within 30
miles/50 kilometres of the beneficiary’s home address; or
› when the treatment the beneficiary needs is not available from a local Cigna network hospital,
medical practitioner, clinic or pharmacy; or
› when the treatment is emergency treatment.
For customers residing in the USA, we offer a home delivery pharmacy if you have a mailing address
in the USA. This service may be a convenient option if you develop a condition that requires to take
regular medication. Terms and conditions apply.

www.cignaglobal.com | 11
 HOW TO SUBMIT CLAIMS
If you have paid for your treatment yourself, you can send your invoice and claim form to us. The easiest way to
do this is via your secure online Customer Area.

YOU WILL NEED:

The Invoice from your The Receipt from
A completed Claims Form
medical provider your payment

Please clearly state your policy number on any documentation you submit to us.

You can download your claims forms from your secure online Customer Area
or at www.cignaglobal.com/help/claim.

YOU CAN SUBMIT YOUR CLAIMS THROUGH:

› Your secure online Customer Area (see page 13) › Fax: +44 (0) 1475 492 113 (Outside the USA);
› Email: cghoclaims@cigna.com 855 358 6457 (Inside the USA)
› Post: For Treatment Incurred:

Outside of the USA,

In the USA In Hong Kong In Singapore
Hong Kong, or Singapore

Cigna Global Cigna International Cigna Worldwide General Business Services Team
Health Options PO Box 15964 Insurance Company Ltd Cigna Europe Insurance
Customer Service Wilmington Cigna Global Company S.A.-N.V. -
1 Knowe Road Delaware 19850 Health Options Singapore Branch
Greenock USA Customer Service Cigna Global
Scotland PA15 4RJ 16/F, International Health Singapore
Trade Tower 152 Beach Road
348 Kwun Tong Road #33-05/06
Kwun Tong The Gateway East
Kowloon Singapore 189721
Hong Kong SAR

IMPORTANT INFORMATION
› You and all beneficiaries must comply with the claims procedures set out in this Customer Guide.
› We can reimburse you using bank wire transfer or cheque.
› We may need to ask for extra information to help us process a claim, for example: medical reports
or other information about the beneficiary’s condition or the results of any independent medical
examination that we may ask and pay for.
› Beneficiaries should submit claims forms and invoices as soon as possible after any treatment. If the
claim and invoice is not submitted to us within 12 months of the date of treatment, the claim will not
qualify for payment or reimbursement by us.
Subject to the terms of this policy, we will pay for the following costs related to your claim:
› Costs as described in the list of benefits section of this Customer Guide as applicable on the date(s) of
the beneficiary’s treatment.
› Costs for treatment which have taken place, however, we will not cover future treatment costs that
require payment deposits or payment in advance.
› Treatment which is medically necessary and clinically appropriate for the beneficiary.
› Reasonable and customary costs for treatment, and services related to treatments which are shown in
the list of benefits. We will pay for such treatment costs in line with the appropriate fees in the location
of treatment and according to established clinical and medical practice.
› If you exceed any individual benefit sub limit, or the overall annual benefit limit, we will seek
reimbursement from you to cover the costs where you have exceeded your limit.

12 | www.cignaglobal.com
YOUR ONLINE CUSTOMER AREA
As a Cigna Global Health Options customer, you have access to a wealth of information wherever you are
in the world through your secure online Customer Area.

To access your secure online Customer Area, please go to www.cignaglobal.com then:

Click on the ‘Member Select ‘Global Individual Enter the email address
Login’ button at the Policy’ from the list and that you provided us with
top right of the page. click ‘Login’ button. and then your password.

If you have any problems accessing the Customer Area, please contact our Customer Care team.

MANAGE YOUR POLICY

Your secure online Customer Area is the easiest way for you to
manage your policy and access all information relating to your
plan. Here you can:
› View your policy documents, including your Certificate of
Insurance and Cigna ID cards for all beneficiaries;
› View any special exclusions that are applied to your policy;
› View the benefits your plan includes;
› View a summary of your premium payments;
› View all correspondence with us;
› Easily submit and track the status of your claims;
› Update your details if required.

ACCESS CARE
Our search tool provides you with an easy way to find medical providers in your location. You can refine
your search by medical speciality, type of facility, or healthcare professional.

A clear map
A clear list of
showing where you
providers with
are in relation to
direct billing.
the providers.

CONTACT US
Your secure online Customer Area also provides you with convenient methods to contact us that include live
chat, sending us a direct message, or by letting us know a convenient time for you in which we will call you back.

Live chat Request a call back Message us

www.cignaglobal.com | 13
 HOW DEDUCTIBLE AND COST SHARE WORK
Our wide range of deductible and cost share options allow you to tailor your plan to suit your budget. You
can choose to have a deductible and/or cost share on the International Medical Insurance and/or on the
International Outpatient optional module.
If you chose a deductible and/or cost share, your premium will be lower than it otherwise would be.
› Deductible - this is the amount you must pay towards your cost of treatment until the deductible for the
period of cover is reached.
› Cost Share - this is the cost share percentage you must pay towards your cost of treatment. This applies
once the deductible amount (if selected) has been calculated.
› Out-of-Pocket Maximum - this is the maximum amount of cost share you have to pay per period of
cover. Only the amounts you pay related to the cost share are subject to the capping effect of the out of
pocket maximum.
If you have selected a deductible and/or cost share, the examples below demonstrate how it works.

Example 1:
Once the deductible amount
HOW THE DEDUCTIBLE WORKS has been reached, we pay for all
subsequent treatment costs for
Claim value: $1,200 that period of cover.
Deductible: $375 In this example, the deductible
amount has now been reached
for this period of cover.

Claim: $1,200

$375 $825
You pay the We pay
$375 deductible $825

Example 2: The amount of cost share is

HOW THE COST SHARE WORKS subject to the capping effect of
the out of pocket maximum.
Claim value: $5,000 In this example, $1,000 has been
Deductible: $0 paid towards the $2,000 out of
Cost share: 20% = $1,000 pocket maximum for this period
Out of Pocket Maximum: $2,000 of cover.

Claim: $5,000

$1,000 $4,000
You pay the We pay
$1,000 cost share $4,000

20% of $5,000 is $1,000

14 | www.cignaglobal.com
 Example 3:
HOW THE COST SHARE AND OUT OF POCKET MAXIMUM WORKS
Claim value: $20,000
The out of pocket maximum protects
Deductible: $0 you from large cost share amounts.
Cost Share: 20% = $4,000 In this example, you have satisfied your
Out of Pocket Maximum: $2,000 out of pocket maximum and we will
cover the rest for this period of cover.

Claim: $20,000

$2,000 $18,000
You pay the $2,000 We pay
cost share $18,000

20% of $20,000 is $4,000, however

the out of pocket maximum limits
your costs to $2,000

Example 4:
HOW THE DEDUCTIBLE AND COST SHARE WORK IF YOU HAVE SELECTED BOTH

Claim value: $20,000

The deductible is due before the cost share is
Deductible: $375 calculated.
Cost Share: 20% = $3,925 In this example, your deductible of $375 is taken off
Out of Pocket Maximum: $5,000 the cost of treatment first and then the 20% cost share
is calculated. $3,925 has been paid towards the $5,000
out of pocket maximum for this period of cover.

Claim: $20,000

$375 $3,925 $15,700

You pay the $375
We pay
deductible and
$15,700
$3,925 cost share
20% of $19,625 is $3,925

IMPORTANT INFORMATION
› You will be responsible for paying the amount of any deductible and cost share directly to the hospital,
clinic, medical practitioner or pharmacy.
› The deductible, cost share, and out of pocket maximum is determined separately for each beneficiary and
each period of cover.
› If you select both a deductible and a cost share, the amount you will need to pay due to the deductible is
calculated before the amount you will need to pay due to the cost share.
› You can request a change to the deductible and/or cost share and out of pocket maximum with effect
from your annual renewal date each year. If you wish to remove or reduce your deductible, cost share
or reduce your out of pocket maximum on your coverage, we may require you to provide us with more
detailed medical information (including medical information of any beneficiaries if relevant) and we may
apply new special restrictions or exclusions based on the information you provide us with.
› You can remind yourself of any deductible or cost shares you may have selected by checking your
Certificate of Insurance which is available in your secure online Customer Area.

www.cignaglobal.com | 15
 INTERNATIONAL MEDICAL INSURANCE
Our plans comprise of 3 distinct levels of cover: Silver, Gold and Platinum.
International Medical Insurance is your essential cover for inpatient, daypatient and
accommodation costs, as well as cover for cancer, mental health care and much more.

Annual overall benefit maximum - Silver Gold Platinum

per beneficiary per period of cover
$1,000,000 $2,000,000
This includes claims paid across all sections of International €800,000 €1,600,000 Paid in full
Medical Insurance. £650,000 £1,300,000

Silver Gold Platinum

Hospital charges
Up to the annual overall benefit maximum for your selected plan Paid in full Paid in full Paid in full
per beneficiary per period of cover.
Private room Private room Private room

› Nursing & accommodation for inpatient & daypatient treatment, and recovery room
› Operating theatre
› Prescribed medicines, drugs and dressings for inpatient or daypatient treatment only
› Pathology, radiology and diagnostic tests (excluding Advanced Medical Imaging)
› Treatment room and nursing fees for outpatient surgery (we will only provide the nursing fees whilst a beneficiary is
undergoing surgery)
› Intensive care: intensive therapy, coronary care and high dependency unit
› Surgeons’ and anaesthetists’ fees
› Inpatient and daypatient specialists’ consultation fees
› Emergency inpatient dental treatment.
We will partner with you and your medical practitioner to ensure you receive the appropriate care and treatment in the
right medical facility.
Important note:
› We will only pay for outpatient treatments received before or after inpatient and daypatient treatments and
surgery if the beneficiary has cover under the International Outpatient option (unless the treatment is given as
part of cancer treatment).

Hospital accommodation for a parent or Silver Gold Platinum

guardian
Up to the total limit shown for your selected plan per beneficiary $1,000 $1,000
per period of cover or, where “paid in full” is shown, this is up to €740 €740 Paid in full
the annual overall benefit maximum for your selected plan per £665 £665
beneficiary per period of cover.

If a beneficiary who is under the age of 18 years old needs and requires inpatient treatment and has to stay in hospital
overnight, we will also pay for hospital accommodation for a parent or legal guardian, if accommodation is available in
the same hospital and the cost is reasonable.
We will only pay for hospital accommodation for a parent or legal guardian if the treatment which the beneficiary is
receiving during their stay in hospital is covered under this policy.

16 | www.cignaglobal.com
Pandemics, epidemics and outbreaks of Silver Gold Platinum
infectious illnesses
Up to the annual overall benefit maximum for your selected plan Paid in full Paid in full Paid in full
per beneficiary per period of cover.

We will pay for medically necessary treatment for disease or illness resulting from a pandemic, epidemic or outbreak
of infectious illness, as defined by the World Health Organisation (WHO).
The medically necessary treatment and related medical conditions will be covered on an inpatient and daypatient
basis. We will only pay for outpatient treatments if the beneficiary has cover under the International Outpatient
option.
Important note:
We will cover medically necessary testing for pandemic, epidemic or outbreak of infectious illness, according to the
World Health Organisation (WHO) guidelines, on an outpatient basis under the pathology, radiology and diagnostic
tests outpatient benefit in line with policy coverage for diagnostics for other illnesses.

Silver Gold Platinum

Inpatient cash benefit
$100 $100 $200
Per night up to 30 days per beneficiary per period of cover. €75 €75 €150
£65 £65 £130

We will make a cash payment directly to a beneficiary when they:

› receive treatment in hospital which is covered under this plan;
› stay in a hospital overnight; and
› the hospital does not charge any fees for the room, board and treatment costs to either the beneficiary, any
Insurance company and/or any applicable local state or governmental authority.

Silver Gold Platinum

Accident and Emergency Room treatment
Up to the total limit shown for your selected plan per beneficiary $500 $1,000 $1,200
per period of cover. €370 €740 €1,000
£335 £665 £800

We will pay for necessary emergency treatment on an outpatient basis at an Accident and Emergency department in
a hospital following an accident, sudden illness, and/or life threatening situations, and where the beneficiary does not
occupy a bed overnight for medical reasons.
Important notes:
› If you have selected the International Outpatient option; this benefit and the limits are satisfied first and then the
applicable International Outpatient benefits can be used thereafter.
› The applicable International Outpatient deductible and cost share (if selected) will apply to this benefit.

Silver Gold Platinum

Transplant services
Up to the annual overall benefit maximum for your selected plan
per beneficiary per period of cover. Paid in full Paid in full Paid in full

We will pay for inpatient and daypatient treatment directly associated with an organ transplant for a beneficiary if
a transplant is medically necessary, and the organ to be transplanted has been donated by a verified and legitimate
source. We will also pay for any anti-rejection medicines following a transplant.
If a beneficiary requires an organ transplant (regardless of whether or not the donor is covered for this policy) we will
pay for:
› the harvesting of the organ or bone marrow;
› any medically necessary tissue matching tests or procedures;
› the donor’s hospital costs; and
› any costs which are incurred if the donor experiences complications, for a period of 30 days after their procedure.

www.cignaglobal.com | 17
 Advanced Medical Imaging (MRI, CT and PET Silver Gold Platinum
scans)
Up to the total limit shown for your selected plan per beneficiary $10,000 $15,000
per period of cover or, where “paid in full” is shown, this is up to €7,400 €12,000 Paid in full
the annual overall benefit maximum for your selected plan per £6,650 £9,650
beneficiary per period of cover.

We will pay for advanced medical imaging if it is recommended by a medical practitioner as a part of a beneficiary’s
inpatient, daypatient or outpatient treatment.

Rehabilitation Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary $5,000 $10,000
per period of cover or, where “paid in full” is shown, this is up to €3,700 €7,400 Paid in full
the annual overall benefit maximum for your selected plan per £3,325 £6,650
beneficiary per period of cover. Up to 30 days Up to 60 days Up to 90 days

We will pay for rehabilitation treatments including physical physiotherapy, occupational, cardiac, pulmonary, cognitive
and speech therapies.
We will only pay for rehabilitation treatment immediately after surgery and/or a traumatic event. If the rehabilitation
treatment is required in a residential rehabilitation centre, we will pay for accommodation and board.
In determining when the per day limit has been reached, we count each overnight stay during which a beneficiary
receives inpatient and/or daypatient treatment as one day.
Subject to prior approval being obtained, prior to the commencement of any treatment, we will pay for rehabilitation
treatment for more than the number of days specified, if further treatment is medically necessary and is
recommended by the treating specialist.
Important note:
We will only approve rehabilitation treatment if the treating specialist provides us with a report, explaining how long
the beneficiary will need to stay in hospital, the diagnosis and the treatment which the beneficiary has received, or
needs to receive.

Home nursing Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary $2,500 $5,000
per period of cover or, where “paid in full” is shown, this is up to €1,850 €3,700 Paid in full
the annual overall benefit maximum for your selected plan per £1,650 £3,325
beneficiary per period of cover. Up to 30 days Up to 60 days Up to 120 days

We will only pay for home nursing if it is provided in the beneficiary’s home by a qualified nurse and it comprises
medically necessary care that would normally be provided in a hospital. We will not pay for home nursing which only
provides non-medical care or personal assistance.
We will pay for a beneficiary to have home nursing if:
› it is recommended by a specialist following inpatient or daypatient treatment which is covered by this policy;
› it starts immediately after the beneficiary leaves hospital; and
› it reduces the length of time for which the beneficiary needs to stay in hospital.

Acupuncture and Chinese medicine Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $1,500 $2,500
the annual overall benefit maximum for your selected plan per €1,100 €1,850 Paid in full
beneficiary per period of cover. £1,000 £1,650

We will only pay for acupuncture and Chinese medicine if it is not the primary treatment which the beneficiary is in
hospital to receive.
The acupuncturist and the practitioner of Chinese medicine must be a properly qualified practitioner who holds the
appropriate licence in the country where the treatment is received.

18 | www.cignaglobal.com
Palliative care Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $35,000 $60,000
the annual overall benefit maximum for your selected plan per €25,900 €44,400 Paid in full
beneficiary per period of cover. £23,275 £38,400

We will pay for palliative care if a beneficiary is given a terminal diagnosis and their life expectancy is less than six
months, and there is no available treatment which will be effective in aiding recovery.
We will pay for:
› Home care;
› Inpatient and daypatient hospital or hospice care and accommodation;
› Prescribed medicines; and
› Physical and psychological care.

Silver Gold Platinum

Prosthetic devices
Up to the annual overall benefit maximum for your selected plan
per beneficiary per period of cover. Paid in full Paid in full Paid in full

We will pay for internal and external prosthetic devices which are necessary as part of a beneficiary’s treatment,
subject to the limitations explained below.
We will pay for:
› a prosthetic device which is a necessary part of the treatment immediately following surgery for as long as is
required by medical necessity and/or is part of the recuperation process on a short-term basis;
› an initial external prosthetic device (but not any replacement devices) for beneficiaries aged 18 years old and over
per period of cover.

We will pay for an initial external prosthetic device and up to two replacements for beneficiaries aged 17 years old or
younger per period of cover.
If a beneficiary requires a replacement prosthetic device during the period of over, we will require an appropriate
medical report.

Silver Gold Platinum

Local ambulance & air ambulance services
Up to the annual overall benefit maximum for your selected plan
per beneficiary per period of cover. Paid in full Paid in full Paid in full

Where it is medically necessary and related to a covered condition, we will pay for a local or air ambulance to
transport a beneficiary:
› from the scene of an accident or injury to a hospital;
› from one hospital to another; or
› from their home to a hospital.

Important notes:

› We will only pay for a local air ambulance when appropriate, such as a helicopter, to transport a beneficiary for
distances up to 100 miles (160 kilometres) when medically appropriate.
› This policy does not provide cover for mountain rescue services.
› Cover for medical evacuation or repatriation is only available if you have cover under the International Evacuation
& Crisis Assistance Plus™ option. Please refer to page 30 of this Customer Guide for details of that option.

www.cignaglobal.com | 19
 Silver Gold Platinum

Mental and Behavioural Health Care $5,000 $10,000

€3,700 €7,400 Paid in full
Up to the total limit shown for your selected plan per beneficiary £3,325 £6,650
per period of cover or, where “paid in full” is shown, this is up to
the annual overall benefit maximum for your selected plan per Up to 30 days* Up to 60 days* Up to 90 days*
beneficiary per period of cover. (Inpatient and (Inpatient and (Inpatient and
Daypatient Daypatient Daypatient
treatment) treatment) treatment)

We will pay for:

› Evidence-based and medically necessary treatment which is recommended by a medical practitioner.
› Inpatient, daypatient or outpatient treatment carried out by a psychologist and/or psychiatrist who is licensed as
such under the laws of that country.
Autism and Attention Deficit Hyperactivity Disorder (ADHD)
We will pay for:
› Medical costs, including doctor and paediatrician visits related to Autism and Attention Deficit Hyperactivity
Disorder (ADHD) on an outpatient basis only which are evidence-based treatment and medically necessary.
› Assessment and diagnostic testing for Autism and Attention Deficit Hyperactivity Disorder (ADHD) when
symptoms are present.
› Behavioural therapy when medically necessary according to evidence-based treatment.
Important notes:
We will not pay for:
› Educational intervention, speech therapy and any devices to aid speech.
› Prescription drugs or medication prescribed on an outpatient basis for any of these conditions, unless you have
purchased the International Outpatient option.
Prior authorisation is required for all inpatient, daypatient and outpatient treatment.
*Day limit only applies to inpatient and daypatient treatments.

Silver Gold Platinum

Treatment for Obesity
Up to the total limit shown for your selected plan per beneficiary 70% refund 80% refund
per period of cover. up to: up to:
No coverage $20,000 $25,000
Available after the beneficiary has been covered for 24 months
€14,800 €18,500
or more.
£13,300 £16,500

We will pay for obesity surgery for beneficiaries over the age of 18 years in circumstances where there is documented
evidence that all other methods of weight loss, including but not limited to slimming classes, nutrition programmes,
aids and drugs have been tried over the past 24 months.
Important notes:
› The beneficiary must have a body mass index (BMI) of 40 or over and have been diagnosed as being morbidly
obese and;
› Can provide documented evidence of other methods of weight loss which have been tried over the past 24
months and;
› Has been through a psychological assessment which has confirmed that it is appropriate for them to undergo the
procedure.

Silver Gold Platinum

Cancer preventative surgery 70% refund 80% refund 90% refund

Up to the total limit shown for your selected plan per beneficiary up to: up to: up to:
per period of cover. $10,000 $18,000 $18,000
€7,400 €13,300 €13,300
£6,650 £12,000 £12,000

We will pay for preventative surgery when a beneficiary has a significant family history of a disease which is part of a
hereditary cancer syndrome (such as ovarian cancer), and has undergone genetic testing which has established the
presence of a hereditary cancer syndrome.
We will only pay for the genetic test if the beneficiary has cover under the Gold or Platinum International Outpatient
option.

20 | www.cignaglobal.com
Cancer care Silver Gold Platinum

Up to the annual overall benefit maximum for your selected plan

per beneficiary per period of cover. Paid in full Paid in full Paid in full

Following a diagnosis of cancer, we will pay for costs for the treatment of cancer if the treatment is considered by us
to be active treatment and evidence-based treatment, whether the beneficiary is staying in a hospital overnight or
receiving treatment as a daypatient or outpatient.
We will only pay for the genetic test if the beneficiary has cover under the Gold or Platinum International Outpatient
option.

Silver Gold Platinum

Cancer related appliances
Up to the total limit shown per beneficiary per lifetime per $125 $125 $125
cancer related appliance. €100 €100 €100
£85 £85 £85

If a beneficiary receives a cancer diagnosis, we will pay for the purchase of:
› Wigs / headbands for cancer patients
› Mastectomy bras for cancer patients

Silver Gold Platinum

Congenital conditions
Up to the total limit shown for your selected plan per beneficiary $5,000 $20,000 $39,000
per period of cover. €3,700 €14,800 €30,500
£3,325 £13,300 £25,000

We will pay for treatment of congenital conditions on an inpatient or daypatient basis that have manifested prior to a
beneficiary’s 18th birthday, regardless of the beneficiary’s age at the time of the treatment.

Important notes:
› We will not pay for treatment of congenital conditions under any of the other benefits within the list of benefits,
except in the instance where;
› A congenital condition is diagnosed after a beneficiary’s 18th birthday. Treatment will be subject to the applicable
inpatient and daypatient benefit limits.

Out of Area Emergency Hospitalisation Cover Silver Gold Platinum

For beneficiaries who do not have Worldwide including USA $100,000 $250,000
coverage. €75,000 €200,000 Paid in full
£65,000 £162,500
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to (Inpatient and (Inpatient and (Inpatient and
the annual overall benefit maximum for your selected plan per Daypatient Daypatient Daypatient
beneficiary per period of cover. treatment) treatment) treatment)

Emergency treatment for inpatient and daypatient treatment during temporary short term business or leisure trips
outside your area of coverage, under life threatening circumstances.
Important notes:
The beneficiary must have been treatment free, symptom and advice free of the medical condition requiring
emergency treatment, prior to initiating the travel.
Coverage is limited to:
• a duration not exceeding 21 days per trip; and
• a maximum of 60 days in aggregate per period of cover for all trips combined.
› If the International Outpatient option has been purchased under your policy, beneficiaries will only be covered
for emergency outpatient treatment. Cover will be subject to the overall annual benefit limit and the individual
International Outpatient benefit limits.
› Charges relating to maternity, pregnancy, childbirth or any complications of pregnancy or childbirth are excluded
from this Out of Area Emergency Hospitalisation Cover.
› This benefit is not applicable if you have selected the Worldwide including USA coverage option.
› We will require evidence of your entry and exit to the USA.
› This option is not available if your country of habitual residence is the USA.
› Receiving medical treatment must not have been one of the objectives of the trip.
› Emergency treatment is only applicable if you are not able to benefit from free state-provided healthcare in that
country.

www.cignaglobal.com | 21
 GLOBAL TELEHEALTH

Silver Gold Platinum

Global Telehealth with Teladoc

Up to the total limit shown per beneficiary per period of cover. Unlimited Unlimited Unlimited
consultations consultations consultations

You have access to unlimited video and phone doctor consultations via the Cigna WellbeingTM App, or via a referral
from our Customer Care team for non-emergency health issues. This includes but is not limited to:
› A diagnosis for non-emergency health issues ranging from acute conditions to complex chronic conditions
› Treating medical conditions like fever, rash, and pain
› Non-emergency paediatric care
› Making preparations for an upcoming consultation
› Discussing a medication plan and potential side effects
› Prescriptions for common health concerns, when medically necessary and permitted
If required, in-app referrals can be made to available Teladoc Global Telehealth specialists. This includes but is not
limited to:
› Dermatology, Psychiatry, Internal Medicine, Gastroenterology, Gynaecology, Paediatrics, Orthopaedics
GPs can schedule these Global Telehealth Specialist appointments within five days of the initial consultation.
Important notes
› The initial doctor appointments can typically be scheduled for the same day, dependent on language availability.
› Prescribing medication is permissible only when the doctor is licensed to prescribe medication in the state or
country of where the policy is underwritten. You must have purchased the optional International Outpatient
module to receive coverage under the outpatient prescribed drugs and dressing benefit.
› If you have selected a deductible or cost share for outpatient treatment, you will be required to pay this if you are
prescribed medication.

PARENT AND BABY CARE

Silver Gold Platinum
Routine maternity care
(Gold and Platinum plans only)
Up to the total limit shown for your selected plan per beneficiary $7,000 $14,000
per period of cover. No coverage €5,500 €11,000
Available once the mother has been covered by the policy for 12 £4,500 £9,000
months or more.*

We will pay for the following treatment, on an inpatient or daypatient basis as appropriate, if the mother has been a
beneficiary under this policy for a continuous period of at least 12 months or more*:
› hospital, obstetricians’ and midwives’ fees for routine childbirth; and
› any fees as a result of post-natal care required by the mother immediately following routine childbirth.
We will not pay for surrogacy or any related treatment. We will not pay for maternity care or treatment for a
beneficiary acting as a surrogate, or anyone acting as a surrogate for a beneficiary.

Important note:
* For treatment incurred in either Hong Kong or Singapore, this benefit is only available once the mother has been a
beneficiary under this policy for a continuous period of at least 24 months or more.

22 | www.cignaglobal.com
 Silver Gold Platinum
Complications from maternity
(Gold and Platinum plans only)
Up to the total limit shown for your selected plan per beneficiary $14,000 $28,000
per period of cover. No coverage €11,000 €22,000
Available once the mother has been covered by the policy for 12 £9,000 £18,000
months or more.*

We will pay for inpatient or outpatient treatment relating to complications resulting from pregnancy or childbirth if the
mother has been a beneficiary under this policy for a continuous period of at least 12 months or more.* This is limited
to conditions which can only arise as a direct result of pregnancy or childbirth, including miscarriage and ectopic
pregnancy.
› This part of the policy does not provide cover for home births.
› We will only pay for a Caesarean section, where it is medically necessary. If we cannot confirm that it was
medically necessary, we will only pay up to the limit of the mother’s routine maternity benefit care cover.
We will not pay for surrogacy or any related treatment. We will not pay for maternity benefit care or treatment for a
beneficiary acting as a surrogate or anyone acting as a surrogate for a beneficiary.

Important note:
* For treatment incurred in either Hong Kong or Singapore, this benefit is only available once the mother has been a
beneficiary under this policy for a continuous period of at least 24 months or more.

Silver Gold Platinum

Homebirths
(Gold and Platinum plans only)
Up to the total limit shown for your selected plan per beneficiary $500 $1,100
per period of cover. No coverage €370 €850
Available once the mother has been covered by the policy for 12 £335 £700
months or more.*

We will pay midwives’ and specialists’ fees relating to routine home births if the mother has been a beneficiary under
this policy for a continuous period of 12 months or more.*
› Please note that the Complications from maternity cover explained above does not include cover for home
childbirth. This means that any costs relating to complications which arise in relation to home childbirth will only
be paid in accordance with the home childbirth limits, as explained in the list of benefits.
Important note:
* For treatment incurred in either Hong Kong or Singapore, this benefit is only available once the mother has been a
beneficiary under this policy for a continuous period of at least 24 months or more.

www.cignaglobal.com | 23
 Silver Gold Platinum
Newborn Care
Up to the total limit shown for your selected plan per period of
cover within the first 90 days following birth. $25,000 $75,000 $156,000
€18,500 €55,500 €122,000
Available once either parent has been covered by the policy for
£16,500 £48,000 £100,000
12 months or more.*

Provided the newborn is added to the policy, we will pay for:

› up to 10 days routine care for the baby following birth; and
› all treatment required for the baby during the first 90 days after birth instead of any other benefit.
Important notes:
Adding the newborn to the policy:
› If at least one (1) parent has been covered by the policy for a continuous period of twelve (12) months or more*
prior to the newborns birth, we will not require information about the newborn’s health or a medical examination
if an application is received by us to add the newborn to the policy within thirty (30) days of the newborn’s date
of birth. However, if an application is received by us more than thirty (30) days after the newborn’s date of birth,
the newborn will be subject to medical underwriting.
› If neither parent has been covered by the policy for a period of twelve (12) consecutive months or more* prior to
the newborn’s birth, the newborn will be subject to medical underwriting, and you can submit an application to
add the newborn. If medical underwriting is required for the newborn, we will then tell you whether we will offer
cover to the newborn and, if so, any special conditions and exclusions which would apply. Cover will begin no
sooner than the date you accept our offered terms.
› Children who are born to a surrogate or have been adopted can be covered under this benefit but will be
subject to medical underwriting, regardless of the length of cover under this policy by either of the parents. On
completion of a medical health questionnaire, we will tell you whether we will offer cover to the newborn and, if
so, any special conditions and exclusions which would apply. Cover will begin no sooner than the date you accept
our offered terms.
› *For treatment incurred in either Hong Kong or Singapore, this benefit is only available once either parent has
been a beneficiary under this policy for a continuous period of at least 24 months or more.
Any treatment required for congenital conditions for a newborn is covered under the ‘Congenital conditions’ benefit,
on page 21, and is subject to the terms of adding the newborn to the policy as detailed above.

YOUR DEDUCTIBLE AND COST SHARE OPTIONS

$0 €0 £0
$375 €275 £250
Deductible $750 €550 £500
A deductible is the amount which you must pay before any $1,500 €1,100 £1,000
claims are covered by your plan. $3,000 €2,200 £2,000
$7,500 €5,500 £5,000
$10,000 €7,400 £6,650

Cost share after deductible

First choose your cost share percentage:
Cost share is the percentage of each claim not covered by your 0% / 10% / 20% / 30%
plan.

Out of Pocket Maximum

Next, choose your out of pocket maximum:
The out of pocket maximum is the maximum amount of cost
share you would have to pay in a period of cover. $2,000 $5,000
€1,480 or €3,700
The cost share amount is calculated after the deductible is
£1,330 £3,325
taken into account. Only amounts you pay related to cost share
contribute to the out of pocket maximum.

24 | www.cignaglobal.com
THE FOLLOWING PAGES DETAIL THE OPTIONAL
BENEFITS YOU MAY HAVE CHOSEN TO ADD TO YOUR
CORE COVER – INTERNATIONAL MEDICAL INSURANCE.

TAKE A LOOK AT YOUR

CERTIFICATE OF INSURANCE
TO REMIND YOURSELF EXACTLY
WHAT COVER YOU HAVE.

INTERNATIONAL OUTPATIENT
The International Outpatient optional module provides more comprehensive outpatient care
where a hospital admission as a daypatient or inpatient is not required, including consultations
with specialists, prescribed outpatient drugs and dressings, rehabilitation, genetic cancer testing
and much more.
You do not need to request prior authorisation for outpatient treatment with the exception of the
following:
› Genetic Cancer tests
› Mental and Behavioural Health (on an outpatient basis)
› Infertility investigations and treatment
› Prescribed drugs and dressings for more than 3 months
› Physiotherapy, chiropractic and osteopathy treatments when you have exceeded 10 sessions.
For any other treatment under the International Outpatient module, you do not need to contact
us for prior authorisation.

Silver Gold Platinum

Annual overall benefit maximum -
per beneficiary per period of cover
$15,000 $35,000
This includes claims paid across all sections of International €12,000 €25,900 Paid in full
Outpatient. £9,650 £23,275

Consultations with medical practitioners and Silver Gold Platinum

specialists
Up to the total limit shown for your selected plan per beneficiary $2,500 $5,000
per period of cover or, where “paid in full” is shown, this is up to €1,850 €3,700 Paid in full
the annual overall benefit maximum for your selected plan per £1,650 £3,325
beneficiary per period of cover.

› We will pay for consultations or meetings with a medical practitioner which are necessary to diagnose an illness,
or to arrange or receive treatment.
› We will pay for non-surgical treatment on an outpatient basis, which is recommended by a specialist as being
medically necessary.

www.cignaglobal.com | 25
 Silver Gold Platinum
Telehealth consultations
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $2,500 $5,000
the annual overall benefit maximum for your selected plan per €1,850 €3,700 Paid in full
beneficiary per period of cover. £1,650 £3,325

Where possible, telehealth consultations should be accessed through the Cigna WellbeingTM app or via Customer
Care with Teladoc. Where virtual consultations are not available through Teladoc, we will pay for video and phone
consultations with a medical practitioner or specialist intended to facilitate the assessment, diagnosis, treatment,
education and care management of a beneficiary by a healthcare provider.
Telehealth consultations with a healthcare provider are limited to:
› 1 initial session; and
› 2 follow-up sessions
Any further sessions are subject to prior-approval and require a medical report to be provided by the treating medical
practitioner. The medical report should include:

› evolution of medical condition

› treatment goal
› treatment plan and estimated number of sessions still required.
Important notes
› Telehealth expenses should not exceed the cost of an equivalent face-to-face consultation. Expenses deemed to
be excessive, unreasonable or unusual will not be covered or the amount of the benefit paid will be reduced.
› This benefit is payable up to the combined benefit maximum of the consultations with medical practitioners and
specialists benefit.

Silver Gold Platinum

Prescribed drugs and dressings
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $1,500 $3,000
the annual overall benefit maximum for your selected plan per €1,100 €2,200 Paid in full
beneficiary per period of cover. £1,000 £2,000

We will pay for prescribed drugs and dressings which are prescribed by a medical practitioner on an outpatient basis.

Important note:
Medication prescribed by a medical practitioner in the USA and/or delivered by a pharmacy in the USA are subject to
our formulary drugs list.

Pathology, Radiology and diagnostic tests Silver Gold Platinum

(excluding Advanced Medical Imaging)
Up to the total limit shown for your selected plan per beneficiary $2,500 $5,000
per period of cover or, where “paid in full” is shown, this is up to €1,850 €3,700 Paid in full
the annual overall benefit maximum for your selected plan per £1,650 £3,325
beneficiary per period of cover.

We will pay for the following tests where they are medically necessary and are recommended by a specialist as part of a
beneficiary’s outpatient treatment:
› Blood and urine tests;
› X-rays;
› Ultrasound scans;
› Electrocardiograms (ECG); and
› Other diagnostic tests (excluding advanced medical imaging).
Important note:
› We will pay for medically necessary testing for pandemic, epidemic or outbreak of infectious illnesses in line with
the World Health Organisation (WHO) guidelines.

26 | www.cignaglobal.com
 Silver Gold Platinum
Outpatient Rehabilitation
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $5,000 $10,000
the annual overall benefit maximum for your selected plan per €3,700 €7,400 Paid in full
beneficiary per period of cover. £3,325 £6,650

We will pay for:

› Outpatient Physiotherapy;
› Outpatient Occupational therapy;
› Osteopathy and Chiropractic treatment;
› Speech therapy; and
› Cardiac and pulmonary rehabilitation.
Important notes:
Outpatient Physiotherapy, Osteopathy and Chiropractic treatment:
We will pay for this treatment if it is medically necessary and restorative in nature to help you to carry out your
normal activities of daily living. The treatment must be carried out by a properly qualified practitioner who holds the
appropriate license to practice in the country where the treatment is received. This excludes any sports medicine
treatment.
Speech therapy treatment:
We will pay for restorative speech therapy if it is required immediately following treatment which is covered under this
policy (for example, as part of a beneficiary’s follow-up care after they have suffered a stroke) and it is confirmed by a
specialist to be medically necessary on a short-term basis.

Pre-natal and post-natal care Silver Gold Platinum

(Gold and Platinum plans only)
Up to the total limit shown for your selected plan per beneficiary
per period of cover. $3,500 $7,000
No coverage €2,750 €5,500
£2,250 £4,500
Available once the mother has been covered by the policy for 12
months or more.*

› We will pay for medically necessary pre-natal and post-natal care on an outpatient basis if the mother has been a
beneficiary under the International Outpatient option for a continuous period of 12 months or more.*
› Examples of pre-natal treatment and tests include:
• Routine obstetricians’ and midwives’ fees;
• All scheduled ultrasounds and examinations;
• Prescribed medicines, drugs and dressings;
• Routine pre-natal blood tests, if required;
• Amniocentesis procedure (also referred to as amniotic fluid test or AFT) or chorionic villous sampling (also
referred to as CVS); and
• Non-invasive pre-natal testing (NIPT) for high risk individuals.
Post-natal care:
• Any fees, including prescribed drugs and dressings, as a result of post-natal care required by the mother
immediately following routine childbirth.
Important note:
* For beneficiaries whose country of habitual residence is either Hong Kong or Singapore, this benefit is only available
once the mother has been a beneficiary under this policy for a continuous period of at least 24 months or more.

www.cignaglobal.com | 27
 Infertility Investigations and treatment Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per lifetime. $10,000
No coverage No coverage €7,400
Available once the beneficiary has been covered by this option
£6,650
for 24 months or more.

We will pay for investigations into the cause of infertility if a specialist rules out any medical cause and the beneficiary
was unaware of the existence of any infertility problem, and had not suffered any symptoms, when their cover under
this policy commenced.
If necessary, we will pay a maximum of 4 attempts for Infertility treatment up to the total limit shown in aggregate,
per lifetime of the policy. This benefit is available for beneficiaries up to 41 years old.
Prior authorisation is required for all infertility investigations and treatment.
We will not pay for infertility investigations or treatment for anyone acting as a surrogate for a beneficiary.

Silver Gold Platinum

Sleep Apnoea
Up to the total limit shown for your selected plan per beneficiary $1,500 $2,000
per period of cover. No coverage €1,100 €1,480
£1,000 £1,330

Following a referral from your medical practitioner, we will pay for one sleep study or home sleep test to diagnose if
you have sleep apnoea.
If it has been determined a beneficiary has sleep apnoea we will pay for the hire of a Continuous Positive Airway
Pressure (CPAP) machine, or other appropriate oral appliances.
Once the beneficiary has been covered by this option for a continuous period of 12 months or more and if the hire of
a CPAP machine is not available to the beneficiary, we will pay, when medically necessary, for the purchase of a CPAP
machine up to the total limit of this benefit for your selected plan.
If it is medically appropriate, we will pay for surgery.

Genetic Cancer test Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per lifetime. $2,000 $4,000
No coverage €1,480 €2,950
Available once the beneficiary has been covered by this option
£1,330 £2,650
for 12 months or more.

We will pay for one genetic test for beneficiaries with an increased risk of cancer, when medically necessary and in
accordance with medical evidence.

Silver Gold Platinum

Acupuncture and Chinese medicine
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $2,500 $5,000
the annual overall benefit maximum for your selected plan per €1,850 €3,700 Paid in full
beneficiary per period of cover. £1,650 £3,325

We will pay for a combined maximum total of 15 consultations with an acupuncturist and practitioner of Chinese
medicine, if those treatments are recommended by a medical practitioner. The treatment must be carried out by a
properly qualified practitioner who holds the appropriate licence to practice in the country where the treatment is
received.

28 | www.cignaglobal.com
 Silver Gold Platinum
Durable medical equipment
Up to the annual overall benefit maximum for your selected plan
per beneficiary per period of cover. Paid in full Paid in full Paid in full

We will pay for the use of durable medical equipment if the use of that equipment is recommended by a specialist in
order to support the beneficiary’s treatment which is covered under this policy.
We will only pay for one type of medical equipment per period of cover which:
› is not disposable, and is capable of being used more than once;
› serves a medical purpose;
› is fit for use in the home; and
› is of a type only normally used by a person who is suffering from the effect of a disease, illness or injury.

Adult vaccinations Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $250
the annual overall benefit maximum for your selected plan per €185 Paid in full Paid in full
beneficiary per period of cover. £165

We will pay for certain vaccinations and immunisations that are clinically appropriate.

Silver Gold Platinum

Dental accidents
Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to $1,000
the annual overall benefit maximum for your selected plan per €740 Paid in full Paid in full
beneficiary per period of cover. £665

If a beneficiary needs dental treatment as a result of injuries which they have suffered in an accident, we will pay for
outpatient dental treatment for any sound natural tooth/teeth damaged or affected by the accident, provided the
treatment commences immediately after the accident and is completed within 30 days of the date of the accident.
In order to approve this treatment, we will require confirmation from the beneficiary’s treating dentist of:
› the date of the accident; and
› the fact that the tooth/teeth which are the subject of the proposed treatment are sound natural tooth/teeth.
We will pay for this treatment instead of any other dental treatment the beneficiary may be entitled to under this
policy, when they need treatment following accidental damage to a tooth or teeth.
We will not pay for the repair or provision of dental implants, crowns or dentures under this part of this policy.

www.cignaglobal.com | 29
 Silver Gold Platinum
Child and Adolescence Wellbeing Health
Up to the annual overall benefit maximum for your selected plan
beneficiary per period of cover. Paid in full Paid in full Paid in full

We will pay for child and adolescence wellbeing health at appropriate age intervals, carried out by a medical
practitioner for the following preventative care services:
› evaluating medical history;
› physical examinations;
› development assessment;
› anticipatory guidance; and
› appropriate immunisations, vaccinations and laboratory tests.

Important notes:
Mental health consultations with a psychiatrist or psychologist are covered under the Mental Health and Behavioural
Care benefit under International Medical Insurance.
In addition, we will pay for:
› One school entry health check, to assess growth, hearing and vision, for each child at the first school entry date.
› Diabetic retinopathy screening for children who have diabetes.

Silver Gold Platinum

60+ Care
Up to the total limit shown for your selected plan per beneficiary $1,000 $2,000
per period of cover. No coverage €740 €1,480
£665 £1,330

If a beneficiary is aged 60 years old and above, or turning 60 years old within the period of cover, and has one of
the following conditions as declared on their medical questionnaire (and is a special exclusion as detailed on your
Certificate of Insurance), we will pay for the medically necessary outpatient treatment costs associated with the
maintenance of this condition: Hypertension, Type 2 Diabetes, Glaucoma, Arthritis, joint or back pain, Osteoporosis/
Osteopenia.
Important notes:

› If, during the application stage you have selected the option to have one of the above conditions covered at an
additional premium, whereby the condition is covered comprehensively on an inpatient and outpatient basis (if
the International Outpatient option has been selected); this benefit will not be applicable.
› Examples of medically necessary treatment and tests include but are not limited to: consultations with medical
practitioners, prescribed drugs and dressings, pathology and radiology, outpatient rehabilitation and acupuncture
and Chinese medicine. Please note, this benefit excludes Advanced Medical Imaging.
› You are eligible to have the condition(s) covered (but not conditions, symptoms or complications arising from
those conditions) on an outpatient basis, up to the total limits shown per period of cover.
› The benefit is subject to any cost shares or deductibles elected on your policy.

YOUR DEDUCTIBLE AND COST SHARE OPTIONS

$0 €0 £0
Deductible $150 €110 £100
A deductible is the amount which you must pay before any $500 €370 £335
claims are covered by your plan. $1,000 €700 £600
$1,500 €1,100 £1,000

Cost share after deductible

First choose your cost share percentage:
Cost share is the percentage of each claim not covered by your 0% / 10% / 20% / 30%
plan.

Out of Pocket Maximum

Next, choose your out of pocket maximum:
The out of pocket maximum is the maximum amount of cost
share you would have to pay in a period of cover. $3,000
The cost share amount is calculated after the deductible is €2,200
taken into account. Only amounts you pay related to cost share £2,000
contribute to the out of pocket maximum.

30 | www.cignaglobal.com
INTERNATIONAL EVACUATION &
CRISIS ASSISTANCE PLUS™
International Medical Evacuation provides coverage for reasonable transportation costs to the
nearest centre of medical excellence in the event that the treatment is not available locally in an
emergency. This option also includes medical repatriation coverage as a result of a serious illness
or after a traumatic event or surgery, and compassionate visits for a parent, spouse, partner,
sibling or child to visit a beneficiary after an accident or sudden illness and the beneficiary has not
been evacuated or repatriated.
Peace of mind for you and your family, particularly while travelling globally, is very important to us.
As well as providing coverage for medical evacuation events, this option also includes the Crisis
Assistance Plus™ programme providing 24/7 time-sensitive advice and coordinated in-country
crisis response services in the event of a travel or security risk that may occur while you and your
family are travelling globally.

INTERNATIONAL MEDICAL EVACUATION

Silver Gold Platinum

International Medical Evacuation
Annual overall benefit maximum -
per beneficiary per period of cover Paid in full Paid in full Paid in full

Silver Gold Platinum

Medical Evacuation
Paid in full Paid in full Paid in full

Transfer to the nearest centre of medical excellence if the treatment the beneficiary needs is not available locally in an
emergency.
If a beneficiary requires emergency treatment, we will pay for medical evacuation for them:
› to be taken to the nearest hospital where the necessary treatment is available (even if this is in another part of the
country, or in another country); and
› to return to the place they were taken from, provided the return journey takes place not more than 14 days after
the treatment is completed.
As regards to the return journey, we will pay:
› the price of an economy class air ticket; or
› the reasonable cost of travel by land or sea; whichever is lesser.
We will only pay for taxi fares if:
› It is medically preferable for the beneficiary to travel to the airport by taxi, rather than by ambulance; and
› Approval is obtained in advance from the medical assistance service.
We will pay for evacuation (but not repatriation) if the beneficiary needs diagnostic tests or cancer treatment (such as
chemotherapy) if, in the opinion of our medical assistance service, evacuation is appropriate and medically necessary
in the circumstances.
We will not pay any other costs related to an evacuation (such as accommodation costs).
Important notes:

› If you require to return to the hospital where you were evacuated for follow up treatment, we will not pay for
travel costs or living allowance costs.
› In the event that evacuation services are not organised by us, we reserve the right to decline the costs.

www.cignaglobal.com | 31
 Silver Gold Platinum

Medical Repatriation
Paid in full Paid in full Paid in full

If a beneficiary requires a medical repatriation as a result of a serious illness or after a traumatic event or surgery, we
will pay:
› for them to be returned to their country of habitual residence or country of nationality; and
› to return them to the place they were taken from, provided the return journey takes place not more than 14 days
after the treatment is completed.
The above journey must be approved in advance by our medical assistance service and to avoid doubt all
transportation costs are required to be reasonable and customary.
As regards to the return journey, we will pay:
› the price of an economy class air ticket; or
› the reasonable cost of travel by land or sea; whichever is lesser.
We will only pay for taxi fares if:
› it is medically preferable for the beneficiary to travel to the airport by taxi, rather than by ambulance; and
› approval is obtained in advance from the medical assistance service.
We will not pay any other costs related to a repatriation (such as accommodation costs).
Important notes:

› If you require to return to the hospital where you were repatriated for follow up treatment, we will not pay for
travel costs or living allowance costs.
› If a beneficiary contacts the medical assistance service to ask for prior approval for repatriation, but the medical
assistance service does not consider repatriation to be medically appropriate, we may instead arrange for the
beneficiary to be evacuated to the nearest hospital where the necessary treatment is available. We will then
repatriate the beneficiary to his or her specified country of nationality or country of habitual residence when his or
her condition is stable, and it is medically appropriate to do so.
› In the event that repatriation services are not organised by us, we reserve the right to decline the costs.

Silver Gold Platinum

Repatriation of mortal remains

Paid in full Paid in full Paid in full

If a beneficiary dies outside their country of habitual residence during the period of cover, the medical assistance
service will arrange for their mortal remains to be returned to their country of habitual residence or country of
nationality as soon as reasonably practicable, subject to airlines requirements and restrictions.
We will not pay any costs associated with burial or cremation or the transport costs for someone to collect or
accompany the beneficiary’s mortal remains.
Important note:

› In the event that repatriation services are not organised by us, we reserve the right to decline the costs.

32 | www.cignaglobal.com
 Silver Gold Platinum

Travel cost for an accompanying person

Paid in full Paid in full Paid in full

If a beneficiary needs a parent, sibling, child, spouse or partner, to travel with them on their journey in conjunction
with a medical evacuation or repatriation, because they:
› need help getting on or off an aeroplane or other vehicle;
› are travelling 1000 miles (or 1600km) or further;
› are severely anxious or distressed, and are not being accompanied by a nurse, paramedic or other medical escort;
or
› are very seriously ill or injured;
we will pay for a relative or partner to accompany them. The journeys (for the avoidance of doubt shall mean one
outbound and one return) must be approved in advance by the medical assistance service and the return journey
must take place not more than 14 days after the treatment is completed.

We will pay:
› the price of an economy class air ticket; or
› the reasonable cost of travel by land or sea;
whichever is the lesser.
If it is appropriate, considering the beneficiary’s medical requirements, the family member or partner who is
accompanying them may travel in a different class.
If it is medically necessary for a beneficiary to be evacuated or repatriated, and they are going to be accompanied by
their spouse or partner, we will also pay the reasonable travel costs of any children aged 17 or under, if those children
would otherwise be left without a parent or guardian.
Important notes:
› We will not pay for a third party to accompany a beneficiary if the original purpose of the evacuation was to
enable the beneficiary to receive outpatient treatment.
› We will not pay for any other costs relating to third party travel costs, such as accommodation or local
transportation.

If you have purchased this option, we will also make available the provision below for compassionate visits to
you by immediate family members.

Silver Gold Platinum

Compassionate visit - travel costs
Up to a maximum of 5 trips per lifetime up to the total limit $1,200 $1,200 $1,200
shown for your selected plan per beneficiary. €1,000 €1,000 €1,000
£800 £800 £800

Silver Gold Platinum

Compassionate visit - living allowance costs
Up to the total limit shown per day for each visit with a $155 $155 $155
maximum of 10 days per visit. €125 €125 €125
£100 £100 £100

For each beneficiary we will pay for up to 5 compassionate visits over the lifetime of the cover. Compassionate visits
must be approved in advance by our medical assistance service.
We will pay the cost of economy class return travel for a parent, spouse, partner, sibling or child to visit a beneficiary
after an accident or sudden illness, if the beneficiary is in a different country and is anticipated to be hospitalised for 5
days or more, or has been given a short-term terminal prognosis.
We will also pay for living expenses incurred by a family member during a compassionate visit, for up to 10 days per
visit while they are away from their country of habitual residence up to the limits shown in the list of benefits (subject
to being provided with receipts in respect of the costs incurred).
Important note:
› We will not pay for a compassionate visit when the beneficiary has been evacuated or repatriated. If an
evacuation or repatriation takes place during a compassionate visit, we will not pay any further third party
transportation costs.

www.cignaglobal.com | 33
 CRISIS ASSISTANCE PLUS™ PROGRAMME
This programme is provided by global crisis response experts, FocusPoint International®, who support global travellers
with 24/7 multilingual response centres and resources in over 100 countries.

Crisis Assistance Plus™ (CAP) provides time-sensitive advice and coordinated in-country crisis assistance for ten
different risks that have the potential to impact beneficiaries when traveling:
› Terrorism › Violent crimes
› Pandemic › Disappearances of persons
› Political threats › Hijacks
› Natural disasters › Kidnaps for ransom
› Blackmail or extortion › Wrongful detentions
The programme provides beneficiaries with 24/7 on-demand access to FocusPoint International’s global assistance
centres for advice and coordinated in-country crisis response services, when necessary.

Depending on the situation, the programme offers:

› Rapid-response teams and dedicated CAP managers deployed globally within 24 hours;
› Experienced security personnel for field rescue, shelter in place and ground evacuations;
› Nationally recognized crisis communications teams;
› Highly experienced kidnap-for-ransom and extortion- response specialists;
› Emergency-message relay to family members or employers;
› Point-in-time geographic threat information; and
› Access to private aviation fleet, with aircraft launched in as little as 60 minutes.

Important notes:

› FocusPoint International® will provide crisis response services for a maximum of two physical incidents per
beneficiary per period of cover. The programme provides access to unlimited crisis consultations during the
period of cover.
› The eligible physical incident response is limited to forty five (45) calendar days of assistance.
› The Crisis Assistance PlusTM Programme is not an insurance policy. Focuspoint does not and will not reimburse or
indemnify beneficiaries for any expenses incurred directly by a beneficiary and/or on behalf of a beneficiary. All
additional expenses are incurred and paid directly by and at the sole discretion of Focuspoint.

We have no involvement in, nor are we liable for, any decisions and/or outcomes that are made or determined by
FocusPoint International®. FocusPoint International® will not provide crisis response services:
› With respect to kidnapping or violent crime by a relative;
› To any person who has had kidnap insurance cancelled or declined;
› To any person who has been kidnapped in the past;
› To any kidnapping of a protected person within their country of residence;
› Where such service would be prohibited under United Nations’ resolutions or any laws of the European Union,
United Kingdom or the United States;
› For the payment of any ransom;
› If the beneficiary elects to travel to location(s) with an issued and active advisory against all travel to said
location(s);
› For a business dispute;
› For extra expenses caused by a non-covered travel delay;
› For suicide or attempted suicide;
› For war, whether declared or not, between China, France, the United Kingdom, the Russian Federation and the
United States, or war in Europe other than civil war;
› For any enforcement action by or on behalf of the United Nations in which countries stated above or any armed
forces are engaged; and
› For loss or destruction to any property arising from any consequential loss or any legal liability caused from
radioactivity.

In the event of one of the crisis situations as detailed above, please contact our Customer Care Team. We will
transfer you to a FocusPoint crisis consultant who can provide advice and coordinate immediate worldwide
assistance. In order to use this service we are required to pass your name and contact information to FocusPoint
International®.

Silver Gold Platinum

FocusPoint International® will pay for crisis consulting expenses and other additional expenses per covered response (up to a
maximum of two physical incidents per beneficiary per period of cover) and included but not limited to:

› Emergency political or natural disaster evacuation costs;

› Legal referrals and fees;
› Fees and expenses of an independent interpreter;
› Costs of relocations, travel and accommodations;
› Fees and expenses of security personnel temporarily deployed solely and directly for the purposes of protecting a
beneficiary and located in a country where a crisis event has occurred.

34 | www.cignaglobal.com
The following important notes and general conditions apply to all of the cover which is provided
under the International Medical Evacuation option.

Important notes
The services described in this section are provided or arranged by the medical assistance service under this policy.

The following conditions apply to both emergency medical evacuations and repatriations:

› all evacuations and repatriations must be approved in advance by the medical assistance service, which is contactable
through the Customer Care Team;
› the treatment for which, or following which, the evacuation or repatriation is required must be recommended by a
qualified nurse or medical practitioner;
› evacuation and repatriation services are only available under this policy if the beneficiary is being treated (or needs to
be treated) on an inpatient or daypatient basis;
› the treatment because of which the evacuation or repatriation service is required must:
• be treatment for which the beneficiary is covered under this policy; and
• not be available in the location from which the beneficiary is to be evacuated or repatriated;
• the beneficiary must already have cover under the International Medical Evacuation option, before they need the
evacuation or repatriation service;
• the beneficiary must have cover in the selected area of coverage which includes the country where the treatment
will be provided after the evacuation or repatriation (treatment in the USA is excluded unless the beneficiary has
purchased Worldwide including USA cover).

› We will only pay for evacuation or repatriation services if all arrangements are approved in advance by our medical
assistance service. Before that approval will be given, we must be provided with any information or proof that we may
reasonably request;
› We will not approve or pay for an evacuation or repatriation if, in our reasonable opinion, it is not appropriate, or if it is
against medical advice. In coming to a decision as to whether an evacuation or repatriation is appropriate, we will refer
to established clinical and medical practice;
› From time to time we may carry out a review of this cover and reserve the right to contact you to obtain further
information when it is reasonable for us to do so.

General conditions
› Where local conditions make it impossible, impractical, or unreasonably dangerous to enter an area, for example
because of political instability or war, we may not be able to arrange evacuation or repatriation services. This policy
does not guarantee that evacuation or repatriation services will always be available when requested, even if they are
medically appropriate.
› We will only pay for hospital accommodation for as long as the beneficiary is being treated. We will not pay for
hospital accommodation if a beneficiary is no longer being treated but is waiting for a return flight.
› Any medical treatment which a beneficiary receives before or after an evacuation or repatriation will be paid from the
International Medical Insurance plan (or under another coverage option if appropriate) provided that the treatment is
covered under this policy and you have purchased the relevant cover.
› We cannot be held liable for any delays or lack of availability of evacuation or repatriation services which result
from adverse weather conditions, technical or mechanical problems, conditions or restrictions imposed by public
authorities, or any other factor which is beyond our reasonable control.
› We will only pay for evacuation, repatriation and third party transportation if the treatment for which, or because of
which, the evacuation or repatriation is necessary is covered under this policy.
› All decisions as to:
• the medical necessity of evacuation or repatriation;
• the means and timing of any evacuation or repatriation;
• the medical equipment and medical personnel to be used; and
• the destination to which the beneficiary should be transported;
will be made by our medical team, after consultation with the medical practitioners who are treating the beneficiary,
taking into account all of the relevant medical factors and considerations.

www.cignaglobal.com | 35
 INTERNATIONAL HEALTH & WELLBEING
We understand the importance of your overall wellbeing and living a balanced life. In addition to
health screenings, tests and examinations; this module also empowers you and your family with the
services and support to manage your own individual day-to-day health and wellbeing. Your Wellness
companion, comprising of the Life Management Assistance programme and the Telephonic Wellness
Coaching, is available to help you and your family stay healthy and well, both physically and mentally.

Silver Gold Platinum

Life Management Assistance Programme
Paid in full Paid in full Paid in full

Our Life Management Assistance programme is available 24 hours a day, 7 days a week, 365 days a year meaning
you can contact the service for access to free, confidential assistance with any work, life, personal or family issue that
matters to you at a time that is suitable for you.
You will have access to the following services and tools:
Short-term counselling:
› Up to 6 counselling sessions via telephone, video, or face-to-face, per issue per period of cover. Common use cases
include: managing anxiety and depression, couples’ and family relationship support, bereavement, and more.
Behavioural health:
› Up to 6 sessions with a mindfulness coach via telephone per period of cover. Beneficial for individuals
experiencing stress, and challenges with focus and concentration.
› An online self-help Cognitive Behavioural Therapy (CBT) programme to address mild to moderate anxiety, stress,
and depression, with unlimited access to the programme for 6 months.
Career and workplace support:
› Life coaching telephonic sessions to assist with personal growth and career development at work.
› Telephonic sessions with a counsellor for managers to develop their people management skills.
Practical needs:
› Unlimited in the moment telephonic support for live assistance.
› Pre-qualified referrals and information to assist with your day to day demands, such as relocation logistics, child
or eldercare, legal or financial services.
Please contact the Customer Service team if you wish to use this service. This service is provided by our chosen
counselling provider.

Silver Gold Platinum

Telephonic Wellness Coaching
Paid in full Paid in full Paid in full

We will match you with your own personal qualified wellness coach who is specifically trained in health behaviour
change. Your coach will partner with you to identify a specific wellness goal that is important to you, and will support
you in building a wellness plan around one of the following areas of focus: weight management, healthy eating,
physical activity, sleep, stress management and tobacco cessation.
› You will have access to 6 confidential telephonic coaching sessions per focus area per period of cover with your
dedicated coach to build your strategy and motivation to reach your wellbeing goal.
› You will be supported by your personal coach with advice and recommendations that can be implemented in
between your 6 coaching sessions to ensure lasting lifestyle changes.
The coaching sessions are delivered via telephone which means you can access it from the comfort of your own home
and can be scheduled at a convenient time for you, based on time zone and language preference. Please note, this is a
confidential service.

Please contact the Customer Service team if you wish to use this service. This service is provided by our chosen
coaching provider.

Silver Gold Platinum

Routine adult physical examinations
Up to the total limit shown for your selected plan per beneficiary $225 $450 $600
per period of cover. €165 €330 €440
£150 £300 £400

We will pay for routine adult physical examinations (including but not limited to: height, weight, bloods, urinalysis,
blood pressure, lung function etc.), for persons aged 18 years or older.

36 | www.cignaglobal.com
 Silver Gold Platinum
Cervical cancer screening
Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 Papanicolaou test (pap smear); and
› 1 HPV DNA test for female beneficiaries aged 30-65 years old.

Silver Gold Platinum

Prostate cancer screening
Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 prostate examination (prostate specific antigen (PSA) test) for men aged 50 years old or older; or
› 1 prostate examination (prostate specific antigen (PSA) test) for asymptomatic men 40 years old or older, when
medically necessary.

Silver Gold Platinum

Breast cancer screening
Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 screening mammogram for women aged 25-39 years old when medically necessary, if they have a prior history
of breast cancer
› 1 screening mammogram for asymptomatic women aged 40 years or older.

Bowel cancer screening Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 bowel cancer screening for beneficiaries aged 50 years old or older.

Silver Gold Platinum

Skin cancer screening
Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 skin cancer examination for men and women aged 18 or older.

www.cignaglobal.com | 37
 Silver Gold Platinum
Lung cancer screening
Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300

We will pay for:

› 1 lung cancer examination for men and women aged 45 or older who are current or past smokers.

Bone densitometry Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary $225 $450
per period of cover. €165 €330 Paid in full
£150 £300
We will pay for:
› 1 scan for women aged 65 years old or older;
› 1 scan for post-menopausal women younger than 65 years old when medically necessary; and
› 1 scan for men aged 50 years or older when medically necessary.

Dietetic consultations Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover. No coverage No coverage Paid in full

We will pay for up to 4 consultations with a dietician per period of cover, if the beneficiary requires dietary advice
relating to a diagnosed disease or illness such as diabetes.

38 | www.cignaglobal.com
INTERNATIONAL VISION & DENTAL
International Vision and Dental pays for the beneficiary’s routine eye examination and pays costs
for spectacles and lenses. It also covers a wide range of preventative, routine and major dental
treatments.

VISION CARE

Silver Gold Platinum

Eye Test
Up to the total limit shown for your selected plan per beneficiary $100 $200
per period of cover. €75 €150 Paid in full
£65 £130

We will pay for one routine eye examination per period of cover, to be carried out by either an ophthalmologist or
optometrist.
We will not pay for more than one eye examination in any one period of cover.

Silver Gold Platinum

Expenses for:
Up to the total limit shown for your selected plan per beneficiary $155 $155 $310
per period of cover. €125 €125 €245
£100 £100 £200

› Spectacle lenses.
› Contact lenses.
› Spectacle frames.
› Prescription sunglasses
when all are prescribed by an optometrist or ophthalmologist.
We will not pay for:
› sunglasses, unless medically prescribed, by an ophthalmologist or optometrist;
› glasses or lenses which are not medically necessary or not prescribed by an ophthalmologist or optometrist; or
› treatment or surgery, including treatment or surgery which aims to correct eyesight, such as laser eye surgery,
refractive keratotomy (RK) or photorefractive keratectomy (PRK).
A copy of a prescription or invoice for corrective lenses will need to be provided to us in support of any claim for
frames.

www.cignaglobal.com | 39
 DENTAL TREATMENT

Overall annual Dental treatment benefit Silver Gold Platinum

maximum
$1,250 $2,500 $5,500
Annual overall benefit maximum - €930 €1,850 €4,300
per beneficiary per period of cover £830 £1,650 £3,500

Preventative Silver Gold Platinum

Up to the overall annual Dental treatment benefit maximum for
your selected plan beneficiary per period of cover.
Available once the beneficiary has been covered by this option Paid in full Paid in full Paid in full
for 3 months.

We will pay for the following preventative dental treatment recommended by a dentist after a beneficiary has had
International Vision and Dental cover for at least 3 months:
› 2 dental check-ups per period of cover;
› X-rays, including bitewing, single view, and orthopantomogram (OPG);
› scaling and polishing including topical fluoride application when necessary (two per period of cover);
› 1 mouth guard per period of cover;
› 1 night guard per period of cover; and
› Fissure sealant.

Routine Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to
the annual overall benefit maximum for your selected plan per
beneficiary per period of cover. 80% refund 90% refund Paid in full
Available once the beneficiary has been covered by this option
for 3 months.

We will pay treatment costs for the following routine dental treatment after the beneficiary has had International
Vision and Dental cover for at least 3 months (if that treatment is necessary for continued oral health and is
recommended by a dentist):
› root canal treatment; › occasional treatment;
› extractions; › anaesthetics; and
› surgical procedures; › periodontal treatment.

Major restorative Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to
the annual overall benefit maximum for your selected plan per
beneficiary per period of cover. 70% refund 80% refund Paid in full
Available once the beneficiary has been covered by this option
for 12 months.

We will pay treatment costs for the following major restorative dental treatments after the beneficiary has had
International Vision and Dental cover for at least 12 months:
› dentures (acrylic/synthetic, metal and metal/acrylic);
› crowns;
› inlays; and
› placement of dental implants.
If a beneficiary needs major restorative dental treatment before they have had International Vision and Dental cover
for 12 months, we will pay 50% of the treatment costs.

40 | www.cignaglobal.com
 Orthodontic treatment Silver Gold Platinum

Up to the total limit shown for your selected plan per beneficiary
per period of cover or, where “paid in full” is shown, this is up to
the annual overall benefit maximum for your selected plan per
beneficiary per period of cover. 40% refund 50% refund 50% refund
Available for beneficiaries aged 18 or younger, once they have
been covered by this option for 18 months.

We will only pay for orthodontic treatment if:

› the dentist or orthodontist who is going to provide the treatment provides us, in advance, with a detailed
description of the proposed treatment (including X-rays and models), and an estimate of the cost of treatment;
and
› we have approved the treatment in advance.

Dental exclusions
The following exclusions apply to dental treatment, in addition to those set out elsewhere in this policy and in
your Certificate of Insurance.

› We will not pay for:

• Purely cosmetic treatments, or other treatments which are not necessary for continued or improved oral
health.
• The replacement of any dental appliance which is lost or stolen, or associated treatment.
• The replacement of a bridge, crown or denture which (in the reasonable opinion of a dentist of ordinary
competence and skill in the beneficiary’s country of habitual residence) is capable of being repaired and
made usable.
• The replacement of a bridge, crown or denture within five years of its original fitting unless:
• it has been damaged beyond repair, whilst in use, as a result of a dental injury suffered by the beneficiary
whilst they are covered under this policy; or
• the replacement is necessary because the beneficiary requires the extraction of a sound natural tooth/
teeth; or
• the replacement is necessary because of the placement of an original opposing full denture.
• Acrylic or porcelain veneers.
• Crowns or pontics on, or replacing, the upper and lower first, second and third molars unless:
• they are constructed of either porcelain; bonded-to-metal or metal alone (for example, a gold alloy
crown); or
• a temporary crown or pontic is necessary as part of routine or emergency dental treatment.
• Treatments, procedures and materials which are experimental or do not meet generally accepted dental
standards.
• Treatment for dental implants directly or indirectly related to:
• failure of the implant to integrate;
• breakdown of osseointegration;
• peri-implantitis;
• replacement of crowns, bridges or dentures; or
• any accident or emergency treatment including for any prosthetic device.
• Advice relating to plaque control, oral hygiene and diet.
• Services and supplies, including but not limited to mouthwash, toothbrush and toothpaste.
• Medical treatment carried out in hospital by an oral specialist may be covered under International Medical
Insurance plan and/or International Outpatient, if this option has been bought, except when dental
treatment is the reason for you being in hospital.
• Bite registration, precision or semi-precision attachments.
• Any treatment, procedure, appliance or restoration (except full dentures) if its main purpose is to:
• change vertical dimensions; or
• diagnose or treat conditions or dysfunction of the temporomandibular joint; or
• stabilise periodontally involved teeth; or
• restore occlusion.

www.cignaglobal.com | 41
 HELPING TO IMPROVE YOUR
HEALTH, WELLBEING AND
PEACE OF MIND.
42 | www.cignaglobal.com
 WANT TO GET IN TOUCH?
If you have any questions about your policy, need to get approval for treatment, or for any other reason, please
contact our Customer Care team 24 hours a day, 7 days a week, 365 days a year.

Use your Customer Area Call Us

Live chat with us International: +44 (0) 1475 788 182
Message us USA: 800 835 7677 (toll free)
Arrange a call back Hong Kong: 2297 5210 (toll free)
Singapore: 800 186 5047 (toll free)

Alternatively, you can email us at: cignaglobal_customer.care@cigna.com

Details of the Cigna company who provides the cover under your policy can be found in your Policy Rules and
on your Certificate of Insurance.
If your policy is insured by Cigna Europe Insurance Company S.A.-N.V. Singapore Branch, the following
statement applies:

Cigna Europe Insurance Company S.A.-N.V. Singapore Branch (Registration Number: T10FC0145E), is a foreign
branch of Cigna Europe Insurance Company S.A.-N.V., registered in Belgium with limited liability, with its
registered office at 152 Beach Road, #33-05/06 The Gateway East, Singapore 189721.
This policy is protected under the Policy Owners’ Protection Scheme which is administered by the Singapore
Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required
from you. For more information on the types of benefits that are covered under the scheme as well as the
limits of coverage, where applicable, please contact us or visit the General Insurance Association (GIA) or SDIC
websites (www.gia.org.sg or www.sdic.org.sg).

For policies arranged through our Dubai International Finance Centre office, under insurance license Cigna Global Insurance Company Limited, the underwriting agent is Cigna Insurance Management Services (DIFC) Limited which is
regulated by the Dubai Financial Services Authority.
“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating
subsidiaries, and not by Cigna Corporation. Such operating subsidiaries include Cigna Global Insurance Company Limited, Cigna Life Insurance Company of Europe S.A.–N.V., Cigna Europe Insurance Company S.A.-N.V. and Cigna
Worldwide General Insurance Company Limited. © 2022 Cigna
591048 CGHO Customer Guide EN 05/2022