Benefits Comparision - Summary
Benefits Mutual Upgraded Plus Mutual Basic Plus

In-Hospital: General Conditions
Financial Limitation Unlimited $150,000 Per member per year
Network Full Network Excluding AUBMC and CMC
Burial Cost Covered up to $2,000 Not Covered

In-Hospital: Maternity and Congenital Cases
Coverage of New Born Covered with GR from day 0 Covered after 14 days subject to U/W
Baby Incubator Unlimited Covered for 6 days irrespective of the
mother's stay at the hospital
Congenital Cases Unlimited Covered up to $3,000
Additional Congenital Cases Covered

In-Hospital: Prothesis
Due to accident Unlimited Covered up to $5,000
Mesh Related to Hernia Surgeries Covered up to $30,000
Coronary Stent
Cardiac Valve
All kinds of Prothesis

In-Hospital: Cancer
Radiotherapy Unlimited Covered up to $100,000 Per member per year
Breast reconstruction

In-Hospital: Heart Procedures
Open Heart Covered - Unlimited Subject to 3 months waiting period up to
$50,000 Per member per year

In-Hospital: Organ Transfer and Transplantation
Surgery of Organ Transfer and/or Transplantation Covered up to $60,000 Not Covered
Surgery of Bone Marrow Transfer and/or Transplantation
Cornea Transplant Covered up to $2,000 Per admission

In-Hospital: Psychiatric Illnesses
Mental or Psychiatric Disorders, Nervous Breakdown and
Psychological Tests or Evaluations
Covered Not Covered

In-Hospital: Infertility and Birth Control
Varicocele Covered Not Covered

In-Hospital: Sleep Disorder
Sleep Disorder Treatments and Polysomnography Covered Not Covered

Ambulatory: General Conditions
Financial Limitation Unlimited Up to $2,500 Per member per year
Network Full Network Excluding AUBMC & CMC

Ambulatory: Diagnostic Tests
C.T Scan Covered Covered
MRI Covered Covered
Laboratory Tests Covered Covered
Stress Test Covered Covered
Obstetrical Ultrasound (Eg: Echography) Covered Covered twice per delivery
Coroscan (VCT 64) Covered Not Covered
PET Scan Covered Not Covered
Ocular Coherence Tomography (OCT) Covered Not Covered
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