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General
In-Hospital
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Waiting period | Six months for pre-exiting cases, unless Continuity is granted | Six months for pre-exiting cases, unless Continuity is granted | Six months for pre-exiting cases, unless Continuity is granted |
Medical / Surgical Treatment | Covered | Covered | Covered |
One-day Treatments / Endoscopic Procedure | Covered | Covered | Covered |
Intensive Care | Covered | Covered | Covered |
Chemotherapy, Radiotherapy | Covered | Covered | Covered |
Emergency Treatments | Covered | Covered | Covered |
Pre-operative Tests | Covered | Covered | Covered |
Physiotherapy / Rehabilitation following a covered hospitalization | Covered | Covered | Covered |
Prosthetic Implants following Sickness | Covered without limitation | Covered for USD 30,000- per year | Covered for USD 30,000- per year |
Prosthetic Implants following Accidents | Covered without limitation | Covered without limitation | Covered without limitation |
Reconstructive Surgery | Covered | Covered | Covered |
But only following a covered accident or a covered surgical procedure occurred after the Insured person enrolment to this Policy. | But only following a covered accident or a covered surgical procedure occurred after the Insured person enrolment to this Policy. | But only following a covered accident or a covered surgical procedure occurred after the Insured person enrolment to this Policy. | |
Sexually Transmitted Diseases
including HIV / AIDS | Covered with a limitation of USD 15,000- per Insured per year | Covered with a limitation of USD 10,000- per Insured per year | Covered with a limitation of USD 10,000- per Insured per year |
Congenital Cases | Covered | Covered | Covered |
But limited only for cases that were neither diagnosed nor treated previously, and the complications that occur therefrom, which arise during the effective period of the policy. | But limited only for cases that were neither diagnosed nor treated previously, and the complications that occur therefrom, which arise during the effective period of the policy. | But limited only for cases that were neither diagnosed nor treated previously, and the complications that occur therefrom, which arise during the effective period of the policy. | |
Mental or Psychiatric Treatments
including nervous breakdowns | Covered with a limitation of USD 15,000-per Insured per year and up to 30 days of hospitalization per year. | Excluded | Excluded |
Organ and Bone Marrow Transplantation | Covered with a limitation of USD 100,000-
per Insured per year | Covered with a limitation of USD 50,000-
per Insured per year | Covered with a limitation of USD 50,000-
per Insured per year |
Includes all kinds of transplantation, surgical procedures for the Insured receiver only (Excluding the cost of organs). | Includes all kinds of transplantation, surgical procedures for the Insured receiver only (Excluding the cost of organs). | Includes all kinds of transplantation, surgical procedures for the Insured receiver only (Excluding the cost of organs). | |
Bariatric surgeries | Covered subject to medical necessity | Covered subject to medical necessity | Covered subject to medical necessity |
Other Features and Benefits
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Lifetime Guaranteed Renewability | Included | Included | Included |
Homecare Services | Covered, excluding home nursing. | Covered, excluding home nursing. | Covered, excluding home nursing. |
Parental Accommodation | Covering an extra bed for a parent accompanying a confined child below 18. | Covering an extra bed for a parent accompanying a confined child below 18. | Covering an extra bed for a parent accompanying a confined child below 18. |
Work Related Accidents | Covered, unless covered simultaneously elsewhere. | Covered, unless covered simultaneously elsewhere. | Covered, unless covered simultaneously elsewhere. |
Local Ambulance (in Lebanon only) | Covered on reimbursement basis, for a maximum of USD 250- | Excluded | Excluded |
Passive War Risks / Terrorism | Covered in Lebanon only. | Covered in Lebanon only. | Covered in Lebanon only. |
Worldwide Emergency Treatments Cover | Covered up to USD 200,000- per person per year, up to age 70. | Excluded | Excluded |
Travel Assistance Plan | Included, up to age 70. | Excluded | Excluded |
Morgue and Burial expenses | Covered for up to USD 2,000- per person. | Covered for up to USD 500- per person. | Covered for up to USD 500- per person. |
Sleep Disorders | Polysomnography and surgery for the Sleep Apnea are covered subject to a special approval. | Polysomnography and surgery for the Sleep Apnea are covered subject to a special approval. | Polysomnography and surgery for the Sleep Apnea are covered subject to a special approval. |
Epidemics / Pandemics | Excluded | Excluded | Excluded |
Except for the Malaria that is covered without limitation and the Covid-19 that is covered up to USD 50,000- per year | Except for the Malaria that is covered without limitation and the Covid-19 that is covered up to USD 50,000- per year | Except for the Malaria that is covered without limitation and the Covid-19 that is covered up to USD 50,000- per year | |
Parkinson Disease | Only surgery is covered, up to USD 15,000- | Excluded | Excluded |
Maternity and related Benefits
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Maternity and Maternity Complications | Covered after a ten-month waiting period, unless continuity expressly granted. | Covered after a ten-month waiting period, unless continuity expressly granted. | Covered after a ten-month waiting period, unless continuity expressly granted. |
Newborns under a covered maternity | Covered as from birth whatever the state of health is, including Congenital Cases. | Covered as from birth whatever the state of health is, including Congenital Cases. | Covered as from birth whatever the state of health is, including Congenital Cases. |
Addition of Insured Free of Charge | The newborns from a covered maternity will be covered free of charge until the expiry of the mother's policy and under her same covers. | The newborns from a covered maternity will be covered free of charge until the expiry of the mother's policy and under her same covers. | The newborns from a covered maternity will be covered free of charge until the expiry of the mother's policy and under her same covers. |
Incubators | Covered | Covered | Covered |
Infertility | Excluded, except for laparoscopic surgery and hysteroscopy, as well as specific surgeries (E.g. Varicocele) | Excluded, except for laparoscopic surgery and hysteroscopy, as well as specific surgeries (E.g. Varicocele) | Excluded, except for laparoscopic surgery and hysteroscopy, as well as specific surgeries (E.g. Varicocele) |
Ambulatory Plan
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Financial Limitation | Unlimited | Unlimited | Unlimited |
Waiting period | Two months for pre-exiting cases, unless Continuity is granted | Two months for pre-exiting cases, unless Continuity is granted | Two months for pre-exiting cases, unless Continuity is granted |
Co-payment and Excess Deductibles | Plan available at 85% (15% co-payment) and at 100% (0% co-payment) | Plan available at 85% (15% co-payment) and at 100% (0% co-payment) | Plan available at 85% (15% co-payment) and at 100% (0% co-payment) |
Diagnostic Tests 1/2 | Radiology, C.T. Scans, MRI, Ultrasounds, Laboratory Tests, Nuclear Medicine Tests, Electroencephalogram, Electrocardiogram, Electromyogram, Audiogram, Stress Test, Evoked Response, Ocular Angiography | Radiology, C.T. Scans, MRI, Ultrasounds, Laboratory Tests, Nuclear Medicine Tests, Electroencephalogram, Electrocardiogram, Electromyogram, Audiogram, Stress Test, Evoked Response, Ocular Angiography | Radiology, C.T. Scans, MRI, Ultrasounds, Laboratory Tests, Nuclear Medicine Tests, Electroencephalogram, Electrocardiogram, Electromyogram, Audiogram, Stress Test, Evoked Response, Ocular Angiography |
Diagnostic Tests 2/2 | Thallium Myocardial Scintigraphy, Echocardiography, Holter Monitoring, VCT 64, PET Scan (Limited to cancer cases only), Ocular Coherence Tomography (OCT), Serum Free Light Chains (SFLC), Glaucoma Diagnosis Ophthalmology Test (GDX) and Video Capsule Test. | Thallium Myocardial Scintigraphy, Echocardiography, Holter Monitoring, VCT 64, PET Scan (Limited to cancer cases only), Ocular Coherence Tomography (OCT), Serum Free Light Chains (SFLC), Glaucoma Diagnosis Ophthalmology Test (GDX) and Video Capsule Test. | Thallium Myocardial Scintigraphy, Echocardiography, Holter Monitoring, VCT 64, PET Scan (Limited to cancer cases only), Ocular Coherence Tomography (OCT), Serum Free Light Chains (SFLC), Glaucoma Diagnosis Ophthalmology Test (GDX) and Video Capsule Test. |
Osteodensitometry | Covered if age more than 55 years or on prior approval if medical necessity | Covered if age more than 55 years or on prior approval if medical necessity | Covered if age more than 55 years or on prior approval if medical necessity |
Treatments | Laser therapy, Physiotherapy, Kinesitherapy and Deflux Medicine. | Laser therapy, Physiotherapy, Kinesitherapy and Deflux Medicine. | Laser therapy, Physiotherapy, Kinesitherapy and Deflux Medicine. |
Covid-19 PCR testing | Covered only if results is positive and on reimbursement basis. | Covered only if results is positive and on reimbursement basis. | Covered only if results is positive and on reimbursement basis. |
Morphological Ultrasound | Covered once per covered maternity | Covered once per covered maternity | Covered once per covered maternity |
Routine Check-ups | Not covered | Not covered | Not covered |
All tests related to infertility | Not covered | Not covered | Not covered |
Amniocentesis | Covered for pregnant women aged 35 years and above | Covered for pregnant women aged 35 years and above | Covered for pregnant women aged 35 years and above |
Genetic Testing | Covered up to USD 250-
subject to medical necessity | Excluded | Excluded |
CT Calcium Score | Not covered | Not covered | Not covered |
Doctors Visits Plan
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Financial Limitation | Plan covered up to USD 80- per visit | Plan covered up to USD 80- per visit | Plan covered up to USD 80- per visit |
Co-payment and Excess Deductibles | Not applicable | Not applicable | Not applicable |
Number of transactions per year | 10 per person | 10 per person | 10 per person |
Exclusions | All exclusions to the In-hospital Plan apply also to the Doctors Visits Plan | All exclusions to the In-hospital Plan apply also to the Doctors Visits Plan | All exclusions to the In-hospital Plan apply also to the Doctors Visits Plan |
Routine Eye & Ear examination | Routine Eye & Ear examination | Routine Eye & Ear examination | |
Examination related to errors of refraction, sight correction surgery, lasik, treatment for near-sightedness (myopia), farsightedness and astigmatism. | Examination related to errors of refraction, sight correction surgery, lasik, treatment for near-sightedness (myopia), farsightedness and astigmatism. | Examination related to errors of refraction, sight correction surgery, lasik, treatment for near-sightedness (myopia), farsightedness and astigmatism. | |
Dentists and psychiatrics consultations | Dentists and psychiatrics consultations | Dentists and psychiatrics consultations |
The above is provided as a general overview of our ILA products and should not be taken as exhaustive. You should refer to the General Conditions of the insurance policy for full details on each benefit, feature, limitation and exclusion.
ILA ULTIMA Plan | ILA PREMIUM Plan | ILA HDF-Santé Plan | |
|---|---|---|---|
Financial Limitation | Unlimited per insured per year | Unlimited per insured per year | Unlimited per insured per year |
Applicable Network in Lebanon | Full Network for Classes A & B
excluding AUBMC & CMC for Class S | Full Network excluding AUBMC & CMC for all classes | Limited to USJ Network of hospitals (Hotel Dieu de France and 5 other hospitals) |
Applicable Network outside Lebanon | Africa & the Middle East | Africa | Africa |
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