1 EXPLORER HEALTH PLAN Product Summary From 1 September 2013 bupa-intl.com Insured by Working with Brokered by
2 ABOUT BUPA AND JUBILEE ABOUT ABOUT BUPA BUPA, AND JUBILEE AND JUBILEE JUBILEE AND JWS GLOBAL ExPERTISE, LOCAL GLOBAL GLOBAL ExPERTISE, LOCAL LOCAL KNOWLEDGE KNOWLEDGE About Bupa About Jubilee About We commenced Bupa About Bupa operations in 1947 and 66 s later we About From humble Jubilee About beginnings Jubilee in 1937, Jubilee Insurance is We serve commenced 14.5 We million commenced operations customers operations in worldwide, 1947 and in providing s and later 66 access s we later From now we the humble largest From beginnings humble composite beginnings insurance 1937, Jubilee in company 1937, Insurance Jubilee in Kenya, Insurance is serve to over ,000 serve million 14.5 customers medical million customers providers worldwide, globally. worldwide, providing We providing access have access now Uganda, the Tanzania largest now the composite and largest overall composite insurance East Africa insurance company as well company in as Kenya, being in Ken to been over serving 650,000 to over our 650,000 medical members providers medical in Africa providers globally. for over globally. We 30 s have We Uganda, the have number Tanzania Uganda, one and medical Tanzania overall insurer and East overall in Africa East in East Africa, well Africa as having being as well as be been and have serving been thousands our serving members of our happy members in customers Africa in for Africa over in East 30 for Africa. s over 30 s the won number the Medical the one number Insurance medical one insurer Underwriter medical in insurer East Award Africa, in every East having Africa, hav and We have thousands no have shareholders, thousands of happy and of customers unlike happy other customers in East insurance Africa. in East Africa. won since the Medical won Jubilee the Insurance Medical also has Insurance Underwriter operations Underwriter Award in Burundi every Award and every y We companies, have We no we have shareholders, reinvest no shareholders, our profits and unlike to help and other provide unlike insurance other better insurance since Mauritius since It is Jubilee the only also Jubilee ISO has certified operations also has insurance operations Burundi group in listed and Burundi healthcare companies, companies, to we more reinvest people we our reinvest around profits our the to profits help world. provide to We help use better provide our better Mauritius. on the three Mauritius. It is East the only Africa It is ISO the stock certified only exchanges ISO insurance certified insurance group The Nairobi listed group lis healthcare global expertise healthcare to more to people design to more around world-class people the around world. health the We insurance world. use our We use on Stock our the Exchange three on the East three (NSE), Africa East Dar stock Africa es exchanges Salaam stock Stock exchanges The Exchange Nairobi The Nair global plans for expertise you global and expertise to your design family. to world-class design We are world-class proud health to insurance have health won insurance Stock and Uganda Exchange Stock Securities Exchange (NSE), Exchange. Dar (NSE), es Salaam Dar es Stock Salaam Exchange Stock Excha plans the Best for International you plans and for your Private family. and your Medical We family. are proud Insurance We are to have proud Provider won to have and won Uganda and Securities Uganda Securities Exchange. Exchange. the nine Best times International the since Best International Private Medical Private Insurance Medical Insurance Provider Provider Together we bring you Bupa s global expertise and nine times nine since times since Together capabilities, Together we with bring Jubilee s we you bring local Bupa s you knowledge global Bupa s expertise and global legacy, expertise and to capabilities, ensure you capabilities, get with the Jubilee s best with of local both Jubilee s knowledge worlds local global knowledge and expertise, legacy, and to legacy ensure local knowledge. you ensure get the you best get of the both best worlds of both global worlds expertise, global expert local knowledge. local knowledge. About JWSeagon & Company We are an independent international insurance broker established in the United Kingdom in 1983 and 10 s later opened an office in Kenya. We have a long reputation as one of Kenya s leading international intermediaries in the region. With over 25 s experience, we support more than 8,000 clients across 12 countries in Africa through our extensive international network with some of the world s leading service providers, and have been one of the leading brokers of Bupa s Health Plans. JWSeagon & Company has a dedicated customer service team, offering immediate 24-hour emergency assistance through dedicated numbers and a seamless Claims Administration team that handles members needs throughout the African continent.
3 ExPLORER HEALTH PLAN - PRODUCT OVERVIEW Whether you are at home in Kenya, or spending time abroad on a regular basis, it is important that you have the right health insurance to cover all of your needs. Explorer is our regional plan for East Africa which provides cover for those living in, and travelling around Africa, as well as including treatment options at facilities in India, Pakistan and Sri Lanka. This plan offers great value for money by providing you access to world class healthcare, without the cost of worldwide cover. Explorer includes comprehensive in-patient cover, which can be extended to include immediate family members. We also offer a wide range of out-patient benefits on each plan, including optical and dental, so you can select the level of cover that is right for you. FAST FAcTS JuST SOmE OF OuR EXPLORER PROducT FEATuRES No lifetime limits for chronic diseases, such as heart disease, stroke, cancer and diabetes, ensuring continued access to treatment for as long as you are on the plan. Full range of health screening available, providing valuable early detection of conditions such as cancer. Treatment for AIDS and HIV, including related conditions and drug therapy (available after one s membership). Eligible cancer treatment paid in full, ensuring you are supported at every stage of treatment. Comprehensive cover for new born babies with all treatment covered for the first 90 days from birth. Cover available for congenital conditions such as heart defects.
4 ExPLORER SUMMARY OF BENEFITS ExPLORER ESSENTIAL PLUS ExPLORER GOLD OVERALL ANNUAL MAXIMUM PER MEMBER PER MEMBERSHIP YEAR USD 500,000/EUR 370,000/GBP 300,000 USD 1,500,000/EUR 1,103,000/GBP 900,000 CORE BENEFITS AND LIMITATIONS COVERAGE Hospital accommodation 100% 100% Surgical operations, including pre- and post-operative 100% 100% Post-hospitalisation services (for a maximum of 90 days after discharge) USD 2,000, EUR 1,500, GBP 1,200 per membership Paid from out-patient benefit Nursing care, drugs and surgical dressings 100% 100% Physicians fees 100% 100% Theatre charges 100% 100% Intensive care 100% 100% Pathology, X-rays, diagnostic tests and therapies 100% 100% Prosthetic implants and appliances 100% 100% Parent accommodation 100% 100% Psychiatric treatment (after two s membership, lifetime maximum of 90 days) 100% 100% Advanced imaging 100% 100% Cancer treatment 100% 100% HIV/AIDS treatment (related conditions + drug therapy including ART) after 1 s membership Home nursing after in-patient treatment Hospice and palliative care Maternity (after 10 months membership) Newborn care USD 5,000, EUR 3,750, GBP 2,950 per membership USD 200, EUR 150, GBP 120 each day for a maximum of 15 days per membership USD 20,000, EUR 14,800, GBP 11,800 lifetime maximum Not covered USD 50,000, EUR 36,900, GBP 29,500 for a maximum of 90 days following birth USD 10,000, EUR 7,400, GBP 5,900 per membership USD 200, EUR 150, GBP 120 each day for a maximum of 30 days per membership USD 20,000, EUR 14,800, GBP 11,800 lifetime maximum USD 8,000, EUR 6,000, GBP 4,700 per membership USD 100,000, EUR 73,750, GBP 58,800 for a maximum of 90 days following birth Prosthetic devices USD 4,000, EUR 3,000, GBP 2,350 for each device USD 4,000, EUR 3,000, GBP 2,350 for each device Rehabilitation 100% for a maximum of 30 days per membership 100% for a maximum of 30 days per membership Transplant services 100% 100% Air ambulance 100% 100% Road ambulance 100% 100% Assistance cover 100% 100% Emergency out of area cover Treatment for congenital and hereditary conditions USD 50,000, EUR 36,900, GBP 29,500 for a maximum of 30 days per membership Not covered USD 50,000, EUR 36,900, GBP 29,500 for a maximum of 30 days per membership USD 100,000, EUR 73,750, GBP 58,800 per membership
5 ExPLORER SUMMARY OF BENEFITS ExPLORER ESSENTIAL PLUS ExPLORER GOLD OVERALL ANNUAL MAXIMUM PER MEMBER PER MEMBERSHIP YEAR USD 500,000/EUR 370,000/GBP 300,000 USD 1,500,000/EUR 1,103,000/GBP 900,000 OUT-PATIENT BENEFITS AND LIMITATIONS COVERAGE Out-patient surgical operations 100% 100% Accident-related dental treatment USD 500, EUR 375, GBP 300 per membership USD 1,000, EUR 750, GBP 600 per membership Consultants fees for consultations 100% Costs for treatment by a family doctor 100% Costs for treatment by therapists and complementary medicine practitioners Consultants fees and psychologists fees for psychiatric treatment (after two s membership) Paid from post-hospitalisation services 100% for a maximum of 30 visits per membership Pathology, X-rays and diagnostic tests 100% Prescribed drugs and dressings USD 2,000, EUR 1,500, GBP 1,200 per membership Vaccinations Not covered USD 1,000, EUR 750, GBP 600 per membership Full Health Screening and Wellness (after one s membership) Not covered USD 500, EUR 375, GBP 300 per membership OPTIONAL BENEFITS AND LIMITATIONS Dental (after 6 months membership) Not covered Optical GENERAL ExCLUSIONS There are general exclusions which apply for all levels. Below are some of the treatments we do not pay for: COVERAGE 75% to a maximum of USD 1,000, EUR 750, GBP 600 per membership 75% to a maximum of USD 400, EUR 315, GBP 250 per membership SIGNIFICANT ExCLUSIONS OR LIMITATIONS WHAT IS NOT COVERED? Artificial life maintenance Developmental problems, including learning difficulties and behavioural and physical development problems, and developmental problems treated in an educational environment. Elective cosmetic surgery/treatment. Foetal surgery undertaken in the womb. Health hydros/nature cure clinics. Infertility treatment. Pre-existing conditions - i.e. any condition that you have when you join, or which you have suffered from in the past and which may recur. Self-inflicted injuries Sleep disorders. Temporomandibular joint (TMJ) disorders. The purchase of donor organs. Treatment of harmful or hazardous use of alcohol, drugs and/or medicines. The information contained in this product summary is for illustration purposes only. For full details of what is and what is not covered, please refer to the Membership Guide, contact a Bupa International representative or view online by visiting bupa-intl.com.
6 ADVANTAGES OF BUYING BUPA Complete freedom to choose any recognised hospital, clinic, doctor or specialist, with thousands to select from. Through an interpreter service, our advisors are able to communicate with you in the language of your choice and are available to offer help, advice and reassurance, 24 hours a day, 365 days a. An emergency assistance team is on standby to help with everything from locating the right medical facility to organising air ambulance evacuation at short notice. Speedy and safe evacuation, including air ambulances and scheduled flights to the right medical facility within the region*. Depending on the condition, we also appoint a dedicated case manager for all complex treatment or lengthy stays in hospital. Our medical concierge and hospitality program provides patients and their families with support and guidance during a hospital stay. *Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Democratic Republic of the Congo, Republic of the Congo, Djibouti, Egypt, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, India, Ivory Coast, Kenya, Lesotho, Liberia, Libya, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mayotte, Morocco, Mozambique, Namibia, Niger, Nigeria, Pakistan, Réunion, Rwanda, Saint Helena, São Tomé and Príncipe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, South Sudan, Sri Lanka, Sudan, Swaziland, Tanzania, Togo, Tunisia, Uganda, Western Sahara, Zambia, Zimbabwe.
7 SO, FANCY BEING WELL LOOKED AFTER? Call us today to find out more about Explorer or any of our other products and services that may be of interest to your company. After all, our purpose is all about longer, healthier, happier lives, so there is no better place to start. +44 (0) bupa-intl.com +254 (0) jwseagon.com/bupaafrica
8 General services: Inside Kenya: +254 JWSeagon&Company: (0) First Floor, Olibya Rest Plaza, of the Muthaiga world: P.O. Box (0) , Nairobi 563 Phone: +254 (20) Mobile: +254 (722) Medical / +254 related (734) enquiries: General services: Wireless:+254 (20) Inside /7/9 Kenya: Inside Kenya: Fax: (0)(20) (0) Rest of the world: Rest of the world: +44 (0) (0) Your calls may be recorded or Medical related enquiries: monitored. Inside Kenya: +254 (0) Bupa International Rest of the world: Victory House +44 (0) Trafalgar Place Brighton Your calls may be recorded or BN1 4FY monitored. United Kingdom Bupa International bupa-intl.com Victory House Trafalgar Place Brighton BN1 4FY United Kingdom bupa-intl.com The world of Bupa AFR-INHS-PDSM-13.3 Care homes Cash plans Dental insurance Health analytics Health assessments The world of Bupa Health at work services Health centres Care homes Health coaching Cash plans Health information Dental insurance Health insurance Health analytics Home healthcare Health assessments Hospitals Health at work services International health insurance Health centres Personal medical alarms Health coaching Retirement villages Health information Travel insurance Health insurance Home healthcare Hospitals