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As specified under The Health Insurance Act 1970 and its regulations, orders and rules |
| Ancillary Hospital Services 100%, Bermuda Hospitals Board Fee Schedule |
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| Surgical, Obstetrical, Anaesthetic, Diagnostic and Medical Care 100%, Bermuda Fee Schedule |
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| Ground Ambulance to Home As specified under The Health Insurance Act |
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| Chronic Disease Management Programme 80% | $2,880 maximum per policy year |
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| Medical Alarm Device 80% | $200 maximum per policy year |
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| $10,000 Combined annual maximum per policy year |
Medical Nutritional Therapy (Provider must be a registered Dietitian):
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Diabetes Prevention Programme (Programme & provider must be pre-approved by Argus):
Diabetes Rewind Programme (Programme & provider must be pre-approved by Argus):
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Annual Foot Exam: $150, maximum 1 exam per policy year For persons with type I or II diabetes or diabetic neuropathy |
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| Allergy testing: $600 per lifetime |
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| Allergy Injections: $20 per injection and serum combined |
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| Annual Health Exam: Maximum 1 exam per policy year
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Annual Specialist / Gynaecologist Exam (all ages): $225, maximum 1 exam per policy year |
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| Routine Diagnostic Testing in conjunction with Annual Exams: 100%, Bermuda Fee Schedule |
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| Well-Baby Routine Health exam (under 2 years): $107, maximum 6 exams per policy year |
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| Annual Eye Exam: $115, maximum 1 exam per policy year Routine Diagnostic Testing in conjunction with Annual Eye Exam (Provider must be approved by the Bermuda Health Council): $200 per policy year |
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| Immunisations and Injections: $30 per injection |
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| Laboratory & Diagnostic Services in Private Testing Facilities: Includes Genetic Testing and Sleep Studies (Must be pre-approved by Argus): covered by approved fee schedule. COVID-19 Testing (Approved Tests at Approved Facilities) 100%, Bermuda Fee Schedule |
General Practitioner
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Specialist
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Telemedicine
(Services & providers must be pre-certified/approved by Argus; refer to FAQ’s) |
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In Office Medical / Surgical Treatment 100%,Bermuda Fee Schedule |
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| In-Office COVID-19 Sample Collection (and associated charges relating to evaluation and management, PPE and handling) 50%, Bermuda Fee Schedule or as otherwise directed by the Bermuda Health Council guidelines |
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Physical & Occupational Therapy/TENS:
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| Chiropractic: $75, maximum 6 visits per policy year |
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| Chiropody / Podiatry: $75, maximum 6 visits per policy year |
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| Behavioural Therapies for Autism Spectrum & Attention Deficit Disorders (Services must be pre-approved by Argus): Individual and family applied behavioural therapies 100% of billed charges, $10,000 maximum per policy year |
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| Psychiatrist: $190, maximum 6 visits per policy year Psychologist/Group Therapy Session: $140, maximum 6 sessions per policy year Counselling Services (Includes Addiction, Art, Play & Equestrian Therapies):
Smoking Cessation Counselling:
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| Neuropsychological Testing (Services must be pre-approved by Argus): 100%, Bermuda Fee Schedule. Maximum 1 test every 2 policy years |
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| Sclerotherapy: 100%, Bermuda Fee Schedule $1,000 per policy year |
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| Lymphedema Treatment: $110, 28 visits policy year |
| Prescription Benefits are applicable Worldwide. Prescription Drugs, Birth Control, Medicines and Sera available only by prescription: 80% for brand name drugs 100% for generic drugs $7,500 maximum per policy year |
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