Cigna (Zurich Insurance ME) - Healthguard International - Worldwide incl USA - 10% co-pay
Yearly Cover
AED 7,350,000.00
Deductible
10% co-pay on all out-patient services (maximum annual cap AED 3,500)
Coverage
Worldwide
Chronic Conditions
Up to AED 150,000 (with pre-existing conditions) within the UAE & up to AED 5,000 (with pre-existing conditions) outside the UAE; pre-authorization required for in-patient treatment (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained); 6 months waiting period (excluding emergency treatment); waiting period in the UAE waived for members who have been previously insured
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Local road & air ambulance covered with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained)
Hospital Accomodation
Standard Private Room with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) 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% (50% in the USA) 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% (50% in the USA) 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% co-pay (maximum annual co-pay of AED 3,500 for all OP benefits)
Physiotherapy
Covered with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained); maximum 30 visits for out-patient treatment with 10% co-pay (maximum annual co-pay of AED 3,500 for all OP benefits)
Scans
Covered with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained); 10% co-pay on out-patient treatment (maximum annual co-pay of AED 3,500 for all OP benefits)
Health Checks
Diabetes screening as per DHA; covered 100% for well child tests; annual routine tests (eye & hearing) for children up to 15 years covered 100%; 10% co-pay applicable (maximum annual co-pay of AED 3,500 for all OP benefits)
Psychiatric Treatment
Covered 100% for emergency treatment & up to AED 7,500 for non-emergency treatment; 10% co-insurance for out-patient treatment (maximum annual co-pay of AED 3,500 for all OP benefits); pre-authorization required for in-patient non-emergency treatment (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained)
Alternative Medicine
Covered 100% for acupuncture, osteopathy & chiropractic treatment (maximum 15 visits combined for osteopathy & chiropractic treatment); 10% co-pay applicable (maximum annual co-pay of AED 3,500 for all OP benefits)
Prescription Drugs
Not Covered
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Network
Network Coverage
144 Hospitals
1334 Clinics
81 Laboratories
1658 Pharmacies
167 Dentals
203 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
100% of covered non-emergency costs (80% within the UAE & the USA) subject to network rates on reimbursement basis; 100% of emergency costs on reimbursement basis
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity (maximum 12 visits to obstetrician); up to AED 25,500 for normal delivery or up to AED 36,500 for medically necessary C-section, with 10% co-insurance; covered with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained); waiting period of 12 months for treatment outside the UAE
Newborn Baby Cover
Covered for 30 days from birth (including congenital or other defects) with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained)
Natal Complications
Covered with pre-authorization (insurer will reduce the amount by 20% (50% in the USA) if prior approval is not obtained); waiting period of 12 months for treatment outside the UAE
Dental
Dental Coverage
Not Covered
Accidental Damage to Teeth
Covered for emergency treatment