Yearly Cover
AED 250,000.00
Deductible
20% co-insurance with a maximum of AED 50 per OP consultation & 10% on prescriptions; (20% co-insurance on all out-patient Services at Saudi German Hospital Group & Al Zahra Hospital Sharjah)
Coverage
GCC
Chronic Conditions
Covered up to AED 150,000 (with pre-existing conditions), with a waiting period of 6 months for new members
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Covered
Hospital Accomodation
Semi-Private Room with pre-authorization
Hospital Cash Benefit
Up to AED 200
Parent Accomodation
Covered with pre-authorization
Out-Patient
Vaccination
Covered for children up to 6 years
Physiotherapy
Covered with pre-authorization; up to 20 sessions for out-patient treatment
Scans
Covered; Non-emergency out-patient MRI, CT scans and endoscopies are covered with pre-authorization
Health Checks
Diabetes screening covered once every year for members over 18 years
Psychiatric Treatment
Not Covered
Alternative Medicine
Covered for chiropractic, osteopathy, homeopathy and ayurvedic treatment up to AED 2,500 on reimbursement basis; 20% co-pay with a maximum of AED 50 per consultation
Prescription Drugs
Not Covered
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Network
Network Coverage
112 Hospitals
892 Clinics
62 Laboratories
1655 Pharmacies
70 Dentals
98 Optics
Treatment Outside Area of Cover
Covered worldwide (excluding USA & Canada) only in case of emergency treatment
Treatment Outside Network
Covered 80% of the Reasonable & Customary charges as per UAE Network rates on reimbursement basis
Maternity
Pregnancy Cover
Covered up to AED 10,000 for normal delivery and up to AED 10,000 for medically essential C-section & complications; preauthorization required; 9 months waiting period is applicable for non-working married females
Newborn Baby Cover
Covered for 30 days from birth
Natal Complications
Covered up to AED 10,000
Dental
Dental Coverage
Not Covered
Accidental Damage to Teeth
Covered only if required as a result of accidental injury to natural teeth or gum taken within 48 Hours of accident with 20% Co- insurance