Yearly Cover
AED 7,350,000.00
Deductible
10% Max AED 50 co-pay on all out-patient services
Coverage
Worldwide ex-USA
Chronic Conditions
Covered; pre-authorization required for in-patient treatment (insurer will reduce the amount by 20% if prior approval is not obtained)
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Local road & air ambulance covered with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained)
Hospital Accomodation
Standard Private Room with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained)
Hospital Cash Benefit
Up to AED 600 per night (maximum 30 nights) with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained)
Parent Accomodation
Up to AED 1,000 per night with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained)
Out-Patient
Vaccination
Covered 100% for children up to 17 years & up to AED 7,500 for adult vaccinations, with 10% (max AED 50) co-pay
Physiotherapy
Covered with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained); maximum 30 visits for out-patient treatment with 10% (max AED 50) co-pay
Scans
Covered with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained); 10% (max AED 50) co-pay on out-patient treatment; covered up to AED 5,500 for genetic cancer screening, allergy testing & bone dentistometry
Health Checks
Diabetes screening as per DHA; Covered 100% well child tests & annual routine tests (eye & hearing) for children up to 15 years; 10% (max AED 50) co-pay; up to AED 2,000 for enhanced adult physical examination & up to AED 1,100 for routine adult physical examination
Psychiatric Treatment
Covered 100% for emergency treatment & up to AED 7,500 for non-emergency treatment; 10% (max AED 50) co-insurance for out-patient treatment; pre-authorization required for in-patient non-emergency treatment (insurer will reduce the amount by 20% if prior approval is not obtained)
Alternative Medicine
Covered 100% for acupuncture, ayurveda, homeopathy, chinese medicine, osteopathy & chiropractic treatment (maximum 15 visits combined for osteopathy & chiropractic treatment); 10% (max AED 50) co-pay on out-patient treatment
Prescription Drugs
Not Covered
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Network
Network Coverage
145 Hospitals
1334 Clinics
81 Laboratories
1658 Pharmacies
167 Dentals
203 Optics
Treatment Outside Area of Cover
Covered for emergency treatment up to AED 280,000
Treatment Outside Network
100% of covered non-emergency costs (80% within the UAE) subject to network rates on reimbursement basis; 100% of emergency costs on reimbursement basis
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity (maximum 8 visits to obstetrician); up to AED 7,000 for normal delivery or medically necessary C-section; up to AED 10,000 for caeserean (non life-threatening); covered with 10% co-insurance; covered with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained); waiting period of 12 months for treatment outside the UAE
Newborn Baby Cover
Covered up to AED 150,000 for 30 days from birth (including congenital or other defects) with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained)
Natal Complications
Covered up to AED 10,000 (combined limit with caeserean) with pre-authorization (insurer will reduce the amount by 20% if prior approval is not obtained); waiting period of 12 months for treatment outside the UAE
Dental
Dental Coverage
Up to AED 11,000 for preventive, routine and major restorative treatment with pre-authorization; 20% co-insurance with waiting period of 12 months for major restorative dental treatment (50% co-insurance if treatment is taken before completion of waiting period); 20% co-insurance on orthodontic treatment with waiting period of 18 months
Accidental Damage to Teeth
Covered for emergency treatment