SMG Trading Limited – Summary of Benefits
Guardian Health · Effective September 1, 2026 · Exodus Insurance Brokers
| Benefit | Plan pays |
|---|---|
| Doctor's visits | |
| Office visit (unlimited visits per disability) | $2,600 |
| Home visit – emergency only (unlimited) | $2,600 |
| Specialist consultation on referral (unlimited) | $3,500 |
| Specialist consultation, no referral (unlimited) | $2,800 |
| Direct access paediatric visit, to age 13 (unlimited) | $3,500 |
| Direct access gynaecologist/urologist (unlimited) | $3,500 |
| Routine medical (1 per policy year) | $2,600 |
| Wellness/preventative – PAP smears, mammograms, PSA (1 per year) | $6,000 |
| Psychiatric care/clinical psychologist (combined) – first 3 visits | $3,500 |
| Psychiatric care/clinical psychologist – next 17 visits | $2,500 |
| Psychological disorders (20 visits per year) | $3,500 |
| Ophthalmologist (1 per year) | $3,500 |
| Dietician – on referral/reimbursement only (2 per disability) | $3,500 |
| Podiatrist – on referral/reimbursement only (2 per disability) | $3,500 |
| Chiropractor – on referral/reimbursement only (2 per disability) | $3,500 |
| Diagnostic procedures | |
| Laboratory, X-ray, ultrasound – annual limit per member | 80% of cost |
| CT scan, MRI & other specialised tests | 80% of cost |
| Prescription drugs | |
| Annual limit per member | 80% of cost |
| Hospitalisation | |
| Hospital room & board, semi-private (unlimited days per disability) | 80% up to $6,000 |
| Public hospital ward | 100% up to $1,000 |
| Hospital miscellaneous | 80% up to $60,000 + MM |
| Emergency accident and outpatient | 80% up to $30,000 + MM |
| In-hospital doctor's visit, non-surgical (unlimited days per disability) | 80% of UCR |
| Private nursing, per 8-hour shift | 80% of UCR |
| Intensive care, per day (30 days per annum) | 80% of UCR |
| Surgery | |
| Maximum surgeon's fee | 80% of UCR |
| Maximum assistant surgeon's fee | 30% of surgeon's limit |
| Maximum anaesthetist's fee | 40% of surgeon's limit |
| Root canal | 80% of UCR |
| Permanent crowning as a result of root canal | 2 per year @ 80% of UCR |
| Maternity – in lieu of all other benefits | |
| Normal delivery – in-hospital expenses | $25,000 |
| Normal delivery – other expenses incl. pre & post natal care | $25,000 |
| Caesarean section – in-hospital expenses | $25,000 |
| Caesarean section – other expenses incl. pre & post natal care | $75,000 |
| Miscarriage | $25,000 |
| Miscellaneous | |
| Physiotherapy/speech therapy (unlimited per disability) | $3,500 |
| Occupational therapy – reimbursement only (10 per year) | $3,500 |
| Autism & developmental disorders, per contract year | $250,000 |
| Immunization to age 13, per contract year | 80% of cost up to $20,000 |
| HPV vaccine, ages 12–26 – reimbursement only | 80% of cost up to $5,000 per vaccine |
| Tubal ligation/vasectomy | 80% of UCR up to $10,000 |
| Radiotherapy | 80% of cost |
| Chemotherapy | 80% of cost |
| Renal dialysis | 80% of cost |
| Hearing aid, each ear, once every 3 years | 80% of cost up to $24,000 |
| Local ambulance | 80% of UCR |
| Annual school medicals, dependents under 18 only (1 per year) | $3,500 |
| Major medical | |
| Local deductible | $10,000 |
| Room & board – local | N/A |
| Overseas emergency | US$100,000 |
| If NPPs render the medical services – 50%. Emergency dental services – US$2,000. Return of deceased to country of issue – US$10,000. Emergency evacuation – US$10,000. Transportation of close relative to hospitalized insured – US$5,000. Other services at 100% of cost to the limit shown above. | |
| Annual major medical maximum | $5,500,000 |
| All MM payments are subject to UCR limits except where stated otherwise. | |
| Overseas non-emergency care (pre-authorisation required) | |
| Deductible – overseas (non-emergency) | US$1,000 |
| Daily room & board maximum | US$100 |
| Other medical expenses | 80% of UCR |
| Air transportation | N/A |
| Dental & optical | |
| Dental & optical combined | 80% of cost up to $30,000 |
Centric Care Membership
$10,000.00
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