NETWORK LIST

Effective 8 March 2018

Listed below are the facilities where you are provided usual benefits in respect of any eligible admission and direct settlement arrangements, if you have selected an International Global Health Network B option. Please read this in conjunction with your International Global Health Plan Membership Guide.

Please note that we retain the right to modify this list at any time, and note that co-insurance might apply in the event you are admitted into at any other Facility having chosen the Network B option.

To obtain a current Network List please contact [email protected] or call +62 361 737317.

Network B Country State Facility Name Telephone Address Website Plot No. 1A, Bhat GIDC Estate, Dist. Gandhinagar, Ahmedabad Apollo Hospital +91 79 8501900 www.apollohospitals.com Ahmedabad-382428, Gujarat Wockhardt Hospital & 14 Cunningham Road, India Bangalore +91 03 4633318 www.whhi.com Heart Insitute 560052 Bangalore, India 154 Poonamallee High Apollo First Med India Chennai +91 44 28211111 Road, Kilpauk 10 Chennai, www.apollohospitals.com Hospital India Apollo Hospital 21, Greams Lane, Off Gream India Chennai (Chennai Main +91 44 2829 0200 Road Chennai-600006, www.apollohospitals.com Hospital) Tamilnadu Apollo Specialty 319 Mount Road, 35 India Chennai +91 44 2433 6119 www.apollohospitals.com Hospital Chennai, India Jubilee Hills, Hyderabad India Hyderabad Apollo Hospital +91 40 23607777 www.apollohyderabad.com 500033, Andhra Pradesh No. 58, Canal Circular Road, Apollo Gleneagles India Kolkata +91 33 2358 5218 Kolkata-700054, West www.apollohospitals.com Hospital Bengal

Wockhardt Hospital & 111A, Rash Behari Avenue, India Kolkata +91 22 55994444 www.wockhardthospitals.com Heart Institute 700029 Kolkata India

Wani House, Near Wadala Wockhardt Hospital India Mumbai +91 22 55994444 Naka, Mumbai-Agra Road, www.wockhardthospitals.com Ltd Nashik - 422001 27 Corporation Colony, Wockhardt Heart India Nagpur +91 7122244844 North Ambazari Road, www.wockhardthospitals.com Hospital 440033 Nagpur, India Sarita Vihar, Mathura Road, India New Delhi Apollo Hospital +91 11 2682 5573 www.apollohospitals.com New Delhi, India +62 361 222588 Jl. Letda Tantular No.6 Bali Bali Royal www.baliroyalhospital.co.id +62 361 247499 Renon Denpasar - Bali Jl. Teuku Umar No.120, Indonesia Bali Kasih Ibu Hospital +62 361 3003030 Desa Dauh Puri Kauh www.kasihibuhospital.com Denpasar Barat, Denpasar Jl. Pulau Serangan No.9x, Prima Medika Indonesia Bali +62 361 236225 Denpasar, Bali Indonesia www.primamedika.com Hospital 20114 Jl. MH Thamrin Blok B3 Indonesia Jakarta RS Premier Bintaro +62 21 27625500 No.1, Sector VII Bintaro Jaya www.rs-premierbintaro.com 15224 Tangerang Jl. Raya Jatinegara Timur No.85-87, Jatinegara, Indonesia Jakarta RS Premier Jatinegara +62 21 1500908 www.rs-premierjatinegara.com Jakarta Timur, Indonesia 13310 Columbia Taman Kesihatan Afiat Johor +60 7 233 9999 www.columbiaasia.com Hospital-Nusajaya 79250 Nusajaya, Johor 9S Jalan Bintang Satu Taman Pantai Hospital Batu Malaysia Johor +60 7 4338 811 Koperasi Bahagia 83000 www.pantai.com.my Pahat Batu Pahat, Johor

No.1 Persiaraan Cempaka, Pantai Hospital Malaysia Kedah +60 4 442 8888 Bandar Amanjaya, 08000 www.pantai.com.my Sungai Petani Sungai Petani, Kedah No.3, Mahkota Melaka, Mahkota Medical Malaysia Melaka +60 6 285 2999 Jalan Merdeka, 75000 www.mahkotamedical.com Centre Malacca, Malaysia Pantai Hospital Ayer 2418-1, Km 8 Lebuh Air Malaysia Melaka +60 6 231 9999 www.pantai.com.my Keroh Keroh 75450 Melaka 292 Jalan Haruan 2 Oakland Columbia Asia Malaysia Negeri Sembilan +60 6 6033 988 Commercial Park 70300 www.columbiaasia.com Hospital-Seremban Seremban Negeri Sembilan Pt 13717, Jalan Bbn 2/1 Malaysia Negeri Sembilan Nilai Medical Centre +60 6 8500 999 Bandara Baru Nilai 71800 www.nilaimc.com Nilai, Negeri Sembilan

Pantai Hospital 82 Jalan Tengah Bayan Baru, Malaysia Penang +60 4 6396596 www.pantai.com.my Penang 11900 Bayan Lepas Penang

Columbia Asia Jalan Perwira, 34000 Malaysia Perak +60 5 820 8888 www.columbiaasia.com Hospital-Taiping Taiping, Perak

Lot 3582, Blok 26, Jalan Tan Columbia Asia Sri Ikhwan Kemena Land Malaysia Sarawak +60 86 251 888 www.columbiaasia.com Hospital-Bintulu District, Tanjung Kidurong, 97000 Bintulu, Sarawak

Lot 1035-1039 Jalan Bulan Columbia Asia Malaysia Sarawak +60 85 437 755 Sabit Cdt 155 98009 Miri, www.columbiaasia.com Hospital - Miri Sarawak

3, Persiaran Anggerik Eria, Columbia Asia Malaysia +60 3 5125 9999 Bukit Rimau, Seksyen 32, www.columbiaasia.com Hospital - Bukit Rimau 40460 , Selangor

No.1 Lebuh Puteri, Bandar Columbia Asia Malaysia Selangor +60 3 8064 8688 Puteri 47100 Pucong www.columbiaasia.com Hospital-Puchong Selangor Lot 5921, Persiaran Raja Malaysia Selangor Pantai Hospital +60 3 3372 5222 Muda Muda 41200 Klang, www.pantai.com.my Selangor 5 Jalan Lagoon Selatan Sunway Medical Malaysia Selangor +60 3 7491 9191 Badar Sunway 46150 www.sunwaymedical.com Centre , Selangor 11, Jalan Teknologi, Pju 5, Tropicana Medical Malaysia Selangor +60 3 6287 1111 47810, www.tropicanamedicalcentre.com Centre Petaling Jaya, Selangor

Columbia Asia Lot 33107, Jln Suakasih, Malaysia Wilayah Persekutuan +60 3 9086 9999 www.columbiaasia.com Hospital - Cheras 43200 Cheras, Kuala Lumpur

Jalan Danau Saujana Off Columbia Asia Malaysia Wilayah Persekutuan +60 3 4145 9999 Jalan Genting Klang, 53300 www.columbiaasia.com Hospital - Setapak Kuala Lumpur Global Doctors 18, Jalan Kiara 3, Mont Malaysia Wilayah Persekutuan +60 3 6203 0999 www.globaldoctorshospital.com Specialist Centre Kiara, 50480 Kuala Lumpur KPJ Tawakkal No.1 Jalan Pahang Barat Malaysia Wilayah Persekutuan +60 3 4026 7777 www.pkjtawakkal.com Specialist Hospital 53000 Kuala Lumpur National Heart 145, Jalan Tun Razak, 50400 Malaysia Wilayah Persekutuan +60 3 2617 8200 www.ijn.com.my Institute Kuala Lumpur

Pantai Hospital Jalan Perubatan 1, Pandaan Malaysia Wilayah Persekutuan +60 3 4289 2828 www.pantai.com.my Ampang Indah, 55100 Kuala Lumpur

No. 1 Jalan 1/96A Taman Pantai Hospital Malaysia Wilayah Persekutuan +60 3 9145 2888 Cheras Makmur 56100 www.pantai.com.my Cheras Kuala Lumpur Pantai Hospital Kuala 8 Jalan Bukit Pantai 59100 Malaysia Wilayah Persekutuan +60 3 2296 0888 www.pantai.com.my Lumpur Kuala Lumpur 820 Thompson Road, Singapore Mount Alvernia +65 6347 6688 www.mtalvernia-hospital.org Singapore 574623 National University 5 Lower Kent Ridge Road, Singapore +65 67795 555 www.nuh.com.sg Hospital Singapore 119074 11 Jalan Tan Tock Seng Singapore Tan Tock Seng +65 6357 8898/9 www.ttsh.com.sg Singapore 308433 Bangkok Hospital 2 Soi Soonvijai 7 New Thailand Bangkok +66 2231 03000 www.bangkokhospital.com (BHQ) Petchburi Road Bangkok Hospital 624 Yaowarat Rd, Thailand Bangkok 66 2118 7888 www.bangkokhospitalchinatown.com China Town (BCT) Samphanthawong Bangkok Hospital 25/14 Thaluang Road Thailand Chanthaburi +66 3931 9888 www.chanthaburihospital.com Chanthaburi (BCH) Watnai, Mueang

88/8 Moo 6, Nong Pa Bangkok Hospital Thailand Chiang Mai +66 5208 9888 Khrang Sub District, Mueang www.bangkokhospital-chiangmai.com Chiangmai (BCM) Chiangmai District

301 Moo , Sukhumvit Road Bangkok Hospital Thailand Chonburi +66 3825 9999 301 (km 143) Naklua, www.bangkokpattayahospital.com Pattaya (BPH) Banglamung 888 Moo 16, Naumuang Sub Bangkok Hospital Thailand Khon Kaen +66 4304 2888 District, Muang Khon Kaen www.bangkokhospitalkhonkaen.com Khon Kaen (BKN) district

Bangkok Hospital Trat 376 Moo 2 Sukhumwit Road Thailand Muangtrat +66 39552777 www.bangkoktrathospital.com (BTH) Wangkrajae Bangkok Hospital 1308/9 Mitrapap Road nai Thailand Nakhon Ratchasima +66 44429999 www.bkh.co.th Ratchasima (BKH) Muang Bangkok Hospital 5/1 Mitraparp Road A. Thailand Nakonratchasima +66 4431 6611 www.bkh.co.th Pakchong (BHP) Pakchong

Bangkok Hospital 1194 Petchkasem Road, Thailand Nakorn Pathom 66 34219600 www.bangkokhospital.com Sanamchan (BSN) Sanamchan Amphur Muang

Bangkok Hospital 138 Phra Ong Dam Rd., Nai Thailand Phitsanulok +66 5521 2222 www.bangkokhospitalphitsanulok.com Phitsanulok (BPL) Muang

Bangkok Hospital Hua 888 Petchkasem Road Thailand Prachuapakhirikhan +66 3261 6800 www.bangkokhospital.com/huahin Hin Huahin Bangkok Hospital 8 Moo 2, Soi, Saengchan Thailand Rayong +66 38921999 www.bangkokrayong.com Rayong (BRH) Nerami Nernpra 288 Moo 1, Suksawas Rd., Bangkok Hospital Thailand Samutprakarn +66 28189000 Pakklongbangplakod www.bangkokphrapradaeng.com Prapadaeng (BPD) Phrasamutjadee 57 Moo 3, Thweerat Bangkok Hospital Thailand Suratthani +66 77429500 Phakdee Road Bophut, www.bangkokhospitalsamui.com Samui (BSH) Kohsamui Bangkok Hospital 111 Thongyai RD, Thailand Udonthani +66 42343111 www.bangkokhospital.com Udon (BUD) Markkaeng, Muang, District

We will consider adding quality, cost effective healthcare providers to our network in locations where facilities are not already provided. If you have such a request, please email us at [email protected] with the details.

Condition to be note that should you receive treatment outside your chosen network, additional coinsurance will be applied to eligible benefits as follow:  Out of network coinsurance ○ Out of network B with preauthorization coinsurance 35%

 BIMC Providers in Bali, Indonesia ○ with preauthorization coinsurance 45%