CosmetAssure

Maximum Limits

maximum-limits

The Company will pay Usual and Customary Medical Expenses incurred by the patient of a CosmetAssure Participating Surgeon, up to the Maximum Limit Amounts, if the patient develops a Covered Complication within 45 days of the original elective procedure and is admitted to an accredited facility, such as a hospital, ER, or surgical center. Covered expenses are the charges for Medically Necessary services, supplies, and treatments which may include, but are not limited to, OR and ER time and costs, anesthesia, blood, oxygen, diagnostic tests, radiological procedures,  prescription drugs, copays etc.  This is only a brief description of coverages available.  Certain exclusions do apply.  For complete details please contact CosmetAssure.

The following amounts apply during any one Liability Period for all Covered Complication(s) due to same Surgical Event and are payable until one of the following occurs:

  • The date the Covered Complication no longer requires further hospitalization or follow-up outpatient physician expense(s);
  • The date the Maximum Limits are paid; or
  • The expiration of the Liability Period (six months from the date of the original Covered Complication)

CosmetAssure

Medical Expense
Maximum Limits
Inpatient Hospital Expense
$5,000 per day up to a maximum of 45 days
Intensive Care / Trauma Expense
Additional $1,000 per day up to a maximum of 10 days
Outpatient / Emergency Medical Expense
$3,500
Ambulance Expense
$2,000
Follow Up Outpatient Physician Expense
$1,500
Outpatient Expense to Rule Out DVT‡
$750
Outpatient Expense to Rule Out Infection‡ 
$750
Capsular Contracture 
$2,500 (plus any remaining OEM** up to total maximum limit of $3,500)

CosmetAssure Plus

Medical Expense
Maximum Limits
Inpatient Hospital Expense
$10,000 per day up to a maximum of 45 days
Intensive Care / Trauma Expense
Additional $2,000 per day up to a maximum of 10 days
Outpatient / Emergency Medical Expense
$5,000
Ambulance Expense
$2,000
Follow Up Outpatient Physician Expense
$2,500
Outpatient Expense to Rule Out DVT‡
$1,000
Outpatient Expense to Rule Out Infection‡ 
$1,000
Capsular Contracture 
$2,500 (plus any remaining OEM** up to total maximum limit of $3,500)
‡Non-hospital procedure
**OEM – Outpatient/Emergency Medical
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