Yearly Cover
AED 150,000.00
Deductible
20% co-pay with a maximum of AED 50 per OP consultation; 10% on out-patient prescriptions
Coverage
Worldwide ex-North America
Chronic Conditions
Covered; up to AED 30,000 (with pre-existing conditions) for new members for first 6 months and up to AED 150,000 thereafter
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Covered
Hospital Accomodation
Semi-private Room
Hospital Cash Benefit
Up to AED 350 per night for a max of 60 days
Parent Accomodation
Up to AED 250 per day
Out-Patient
Vaccination
Covered for children up to age of 6 years as per MOH
Physiotherapy
Covered up to 10 out-patient sessions with 10% co-pay; pre-authorization required
Scans
Covered with 10% co-pay on out-patient treatment
Health Checks
Diabetes screening as per DHA
Psychiatric Treatment
Not Covered
Alternative Medicine
Not Covered
Prescription Drugs
Not Covered
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Network
Network Coverage
74 Hospitals
742 Clinics
75 Laboratories
1742 Pharmacies
24 Dentals
16 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
80% of the reasonable & customary costs of the medical network on reimbursement basis
Maternity
Pregnancy Cover
Up to AED 10,000 for normal delivery and up to AED 15,000 for medically necessary C-section & complications; up to AED 150,000 in case of an emergency; covered 100% for out-patient treatment; covered with 10% co-pay; preauthorization required for in-patient treatment
Newborn Baby Cover
Covered for 30 days from birth
Natal Complications
Up to AED 15,000 (combined limit with medically necessary C-section) with 10% co-pay
Dental
Dental Coverage
Up to AED 5,000 with 20% co-pay
Accidental Damage to Teeth
Covered