| Plan | A | B1 | B2 | 
|---|---|---|---|
| Room, board and medical-related services including meals, prescriptions, professional charges, investigations, procedures and miscellaneous charges (per day) | $500 | $400 | $150 | 
| Intensive care unit and medical-related services including meals, prescriptions, professional charges, investigations, procedures and miscellaneous charges (per day) | $1,000 | $800 | $300 | 
| Surgery limits table: | |||
| 1 | $500 | $400 | $150 | 
| 2 | $1,000 | $800 | $300 | 
| 3 | $1,500 | $1,200 | $450 | 
| 4 | $2,500 | $2,000 | $750 | 
| 5 | $3,500 | $2,800 | $750 | 
| 6 | $5,000 | $4,000 | $750 | 
| 7 | $6,500 | $5,200 | $750 | 
| Surgical implants (per year) | $2,000 | $1,600 | $1,000 | 
| Other outpatient hospital treatment: - Renal dialysis (per month) - Erythropoietin (per month) - Cyclosporin (per month) - Radiotherapy for cancer (per year) - Chemotherapy for cancer (per year) - Immunotherapy for cancer (per year)  | 
$2,000 $500 $500 $4,000 $4,000 $4,000  | 
$1,600 $400 $400 $3,200 $3,200 $3,200  | 
$600 $200 $200 $1,600 $1,600 $1,600  | 
| Limit per policy year | $80,000 | $60,000 | $20,000 | 
| Limit per life time | $240,000 | $180,000 | $70,000 |