Insurance Agreements · La Bene San Luis

Our agreements

Partner insurers and companies

Our team can guide you through available options and provide information about our services and current agreements. Contact us for personalized assistance.

MetLife

PAN AMERICAN

Plan Seguro

Prevem

Primero Seguros

Qualitas

Seguros Atlas

Seguros BX+

Seguros El Águila

Seguros MTY

Seguros SURA

Sofía Seguros

Somme Santé

VitaMédica

Zurich

We couldn't find that insurer. Call us and we'll help you.

Important information

Major Medical Expense Insurance

Dear Patient:

It is essential that both you and your family are well informed about the process and procedures related to your major medical expense insurance.

By purchasing a Major Medical Expense Policy, you will be securing coverage for hospitalization costs, surgical procedures, medical treatments, laboratory studies, radiology and imaging studies, medications, and medical fees.

We understand that the terms associated with major medical expense insurance can be confusing or unfamiliar. Below is a list of the most common concepts you will find in your policy, along with their definitions, to help you better understand their meaning.

COVERAGE LIMIT: ▼

This is the maximum amount your insurer will cover each time you need medical assistance, and it depends on the plan you have contracted. This value is specified on the cover page of your policy.

DEDUCTIBLE: ▼

This is the amount you are responsible for paying when an accident or illness occurs. You can find this amount on the cover page of your policy.

DEDUCTIBLE FOR MULTIPLE CONDITIONS: ▼

If your hospitalization covers more than one covered condition, a deductible may be applied for each one.

COINSURANCE: ▼

This is the percentage you must pay on the total hospitalization costs covered by the insurer, after the deductible has been deducted. This percentage is also detailed on the cover page of your policy.

MEDICAL COINSURANCE: ▼

This is the percentage of the total physician fees you must pay based on what is covered by your insurer. This percentage varies according to the specific conditions of your policy.

NON-COVERED EXPENSES: ▼

These are charges that your insurer does not cover and will appear on your private account.

PRE-EXISTING CONDITIONS: ▼

These are illnesses or conditions that began before you purchased your major medical expense insurance and are therefore not covered by the policy.

ACCIDENT: ▼

An event caused by an external, unforeseen, fortuitous, violent, and involuntary cause that injures the insured.

ILLNESS: ▼

Signs and symptoms presented by the patient that require medical attention.

EXCLUSIONS: ▼

Illnesses or treatments that are not covered by the insurer.

What are the most common reasons for insurer claim denial?

Hospital expenses below the deductible amount.
Policy conditions (exclusions, waiting periods, etc.)
Administrative policy issues (non-payment, exhausted coverage limit, etc.)

What happens if the insurer denies coverage for your account? Your account will need to be paid as a private patient.

We hope this information is helpful to you.

If you have any questions about your policy, we recommend contacting your Insurance Agent.

If you have any questions about discharge administrative procedures, please visit the Agreements area located on the ground floor or call extensions: 184, 185 or 229 Monday through Friday 07:00–21:00, Saturday and Sunday 09:00–19:00.

Explore our available agreements

Partner insurers and companies

Can't find your insurer or company?

Major Medical Expense Insurance

What are the most common reasons for insurer claim denial?