Plan A/B - Product Benefits & Premium Table - AXA Life Insurance ...

GlobalCare Health PlanPlan A product benefitsBENEFITSPlease note: benefit values are per person each year unless otherwise specified and are reduced each time you claim only by the net amount (less any deductible,excess or co-insurance) we have actually paid.Area of coverYearly maximum up toOutside area of coverLevel of reimbursementWorldwide/Worldwide excluding USASG$4,000,000/US$2,900,000Emergency treatment onlyReasonable and customary (R&C) chargesIN-PATIENT AND DAYCARE TREATMENT (including surgery, consultations, organ transplants, consumables, surgical implants etc.)Daily accommodation chargesStandard Single RoomParent accommodation up toSG$200/US$160 per nightCash benefitSG$300/US$230 per nightPre-/post-hospitalizationOutpatient treatmentIn-patient direct billingApplicable in-patient direct billing networkIncluded - within 90 days prior to hospital admissionand 90 days following discharge from hospitalIncludedGlobal directory of hospitalsOUT-PATIENT (OP) TREATMENTDeductible per visitRadiotherapy and chemotherapy (OP deductible does not apply)Kidney dialysis treatment (OP deductible does not apply)Surgical procedures received as an outpatient (OP deductible does not apply)Consultation and prescriptions | Diagnostic scansLabs investigations, X-Ray and Ultrasound | Courses of PhysiotherapyAlternative treatments: Courses of chiropractic treatment, acupuncture,homeopathy, osteopathy and Traditional Chinese medicine up toNILIncludedIncludedIncludedIncludedSG$1,600/US$1,200OTHER BENEFITSAmbulance transportInternational Emergency Medical AssistanceConcierge servicesAccidental damage to teethPre- and post-natal complicationsDeath benefitNewborn accommodationHealth screen up toPsychiatric treatment up toPre-existing conditions up toVaccination up toHospice and palliative care up toPregnancy and delivery up toRoutine dental care up toRoutine optical care up toIncludedIncludedIncludedIncludedIncluded *SG$5,000/US$4,000IncludedSG$1,350/US$1,000 *SG$10,000/US$7,500Years 1 # & 2: SG$3,000/US$2,300. Subsequent years: SG$6,000/US$4,600SG$2,000/US$1,600SG$52,000/US$38,000 in a member’s lifetime *SG$19,000/US$13,800 *80% eligible expenses incurred up to SG$1,600/US$1,200SG$380/US$280*Available only after 12 months of cover# Available only after 9 months of coverwww.axa.com.sg

GlobalCare Health PlanPlan B product benefitsBENEFITSPlease note: benefit values are per person each year unless otherwise specified and are reduced each time you claim only by the net amount (less any deductible,excess or co-insurance) we have actually paid.Area of coverYearly maximum up toOutside area of coverLevel of reimbursementWorldwide/Worldwide excluding USASG$3,000,000/US$2,300,000Emergency treatment onlyReasonable and customary (R&C) chargesIN-PATIENT AND DAYCARE TREATMENT (including surgery, consultations, organ transplants, consumables, surgical implants etc.)Daily accommodation chargesStandard Single RoomParent accommodation up toSG$200/US$160 per nightCash benefitSG$200/US$160 per nightPre-/post-hospitalizationOutpatient treatmentIn-patient direct billingApplicable in-patient direct billing networkIncluded - within 90 days prior to hospital admissionand 90 days following discharge from hospitalIncludedGlobal directory of hospitalsOUT-PATIENT (OP) TREATMENTDeductible per visitRadiotherapy and chemotherapy (OP deductible does not apply)Kidney dialysis treatment (OP deductible does not apply)Surgical procedures received as an outpatient (OP deductible does not apply)Consultation and prescriptions | Diagnostic scansLabs investigations, X-Ray and Ultrasound | Courses of PhysiotherapyAlternative treatments: Courses of chiropractic treatment, acupuncture,homeopathy, osteopathy and Traditional Chinese medicine up toNILIncludedIncludedIncludedIncludedSG$1,600/US$1,200OTHER BENEFITSAmbulance transportInternational Emergency Medical AssistanceConcierge servicesAccidental damage to teethPre- and post-natal complicationsDeath benefitNewborn accommodationHealth screen up toPsychiatric treatment up toPre-existing conditions up toVaccination up toHospice and palliative care up toPregnancy and delivery up toRoutine dental care up toRoutine optical care up toIncludedIncludedIncludedIncludedIncluded *SG$5,000/US$4,000IncludedSG$200/US$160 *SG$6,000/US$4,600Years 1 # & 2: SG$3,000/US$2,300. Subsequent years: SG$6,000/US$4,600SG$1,600/US$1,200SG$40,000/US$30,000 in a member’s lifetime *Not applicableNot applicableNot applicable*Available only after 12 months of cover# Available only after 9 months of coverwww.axa.com.sg

GlobalCare Health PlanPlan B premium table (inclusive of GST)PLAN B1 – WorldwidePLAN B2 – Worldwide excluding USAAGESGDUSDAGESGDUSDAGESGDUSDAGESGDUSD0-10$6,119.33$4,895.2546$17,580.10$14,064.080-10$2,846.20$2,276.9646$8,616.71$6,892.9411$6,119.33$4,895.2547$18,060.53$14,448.2111$2,896.49$2,317.6247$8,863.88$7,090.8912$6,119.33$4,895.2548$18,538.82$14,831.2712$2,946.78$2,357.2148$9,112.12$7,289.9113$6,119.33$4,895.2549$19,034.23$15,227.1713$2,997.07$2,397.8749$9,360.36$7,487.8614$6,119.33$4,895.2550$19,514.66$15,611.3014$3,047.36$2,437.4650$9,608.60$7,686.8815$6,119.33$4,895.2551$20,050.73$16,040.3715$3,097.65$2,478.1251$9,856.84$7,885.9016$6,191.02$4,953.0352$20,619.97$16,496.1916$3,147.94$2,518.7852$10,106.15$8,084.9217$6,407.16$5,125.3053$21,446.01$17,156.3817$3,198.23$2,558.3753$10,259.16$8,206.9018$6,628.65$5,302.9254$22,321.27$17,857.2318$3,248.52$2,599.0354$10,413.24$8,331.0219$7,163.65$5,730.9255$23,240.40$18,592.3219$3,420.79$2,737.0655$10,627.24$8,502.2220$7,702.93$6,162.1356$24,213.03$19,370.2120$3,593.06$2,874.0256$11,063.80$8,851.0421$8,459.42$6,767.7557$25,214.55$20,171.6421$3,999.66$3,199.3057$11,513.20$9,210.5622$8,998.70$7,198.9658$26,729.67$21,383.9522$4,240.41$3,391.9058$12,191.58$9,753.0523$9,770.17$7,816.3559$28,255.49$22,604.8223$4,587.09$3,670.1059$12,876.38$10,300.8924$10,247.39$8,198.3460$29,856.21$23,884.5424$4,801.09$3,841.3060$13,594.35$10,875.4825$10,731.03$8,584.6161$31,588.54$25,271.2625$5,018.30$4,014.6461$14,371.17$11,497.1526$11,194.34$8,955.9062$33,477.09$26,782.1026$5,225.88$4,180.4962$15,217.54$12,174.4627$11,631.97$9,305.7963$36,079.33$28,863.2527$5,421.69$4,337.7863$16,384.91$13,107.5028$11,863.09$9,490.9064$38,861.33$31,088.8528$5,525.48$4,420.1764$17,632.53$14,105.8129$12,081.37$9,665.3165$43,835.76$35,068.1829$5,623.92$4,499.3565$19,863.48$15,890.5730$12,285.74$9,829.0266$46,768.63$37,414.6930$5,714.87$4,572.1166$21,178.51$16,942.3831$12,490.11$9,991.6667$49,593.43$39,674.5331$5,806.89$4,645.9467$22,354.44$17,883.9832$12,677.36$10,141.4668$51,686.35$41,349.0832$5,890.35$4,712.2868$24,018.29$19,215.0633$12,910.62$10,328.7169$53,658.36$42,926.2633$5,995.21$4,795.7469$25,799.84$20,640.3034$13,126.76$10,500.9870$55,506.25$44,405.0034$6,092.58$4,873.8570$27,188.70$21,750.9635$13,348.25$10,678.6071$57,384.10$45,907.2835$6,191.02$4,953.0371$28,648.18$22,918.3336$13,593.28$10,874.4172$59,263.02$47,410.6336$6,301.23$5,040.7772$30,184.70$24,147.7637$13,840.45$11,072.3673$61,278.90$49,023.1237$6,387.90$5,110.3273$31,805.75$25,444.6038$14,191.41$11,352.7074$63,296.92$50,637.7538$6,634.00$5,307.2074$33,513.47$26,810.9939$14,543.44$11,635.1875$65,340.62$52,272.7139$6,879.03$5,503.0175$35,304.65$28,243.7240$14,916.87$11,933.7176$67,387.53$53,909.8140$7,124.06$5,698.8276$37,181.43$29,744.9341$15,294.58$12,235.4577$69,420.53$55,536.2141$7,370.16$5,895.7077$39,150.23$31,319.9742$15,686.20$12,548.9678$71,372.21$57,097.3442$7,615.19$6,092.5878$41,216.40$32,973.1243$16,140.95$12,912.7679$73,329.24$58,663.8243$7,860.22$6,288.3979$43,386.36$34,708.6644$16,618.17$13,294.7580$75,267.01$60,213.1844$8,105.25$6,484.2080$45,656.90$36,525.5245$17,099.67$13,679.9581-99 $86,557.65 $69,246.12(applicable for renewals only)45$8,351.35$6,681.0881-99 $52,504.90 $42,003.92(applicable for renewals only)If the policyholder or the life assured is a Singapore citizen, Singapore permanent resident or valid work pass holder then premiums payable are subject to Goods & Services Tax (GST)in accordance with the Goods and Services Tax Act (Cap. 117A). Every such premium payment made must include GST, otherwise the premium will be deemed to be unpaid.AXA Life Insurance Singapore Private LimitedCompany Reg No. 199903512M8 Shenton Way #27-02 AXA Tower Singapore 068811AXA Customer Centre #B1-01 Tel: 1800-880 4888 Fax: 68805501