National Life & General Insurance (NLGI) - Plan 5 Emerald - 20% Max AED 50 deductible & 20% co-pay on pharmacy & diagnostics
Yearly Cover
AED 100,000.00
Deductible
20% co-pay with a maximum of AED 50 per OP consultation & 20% on Pharmacy & diagnostics
Coverage
Worldwide
Chronic Conditions
Covered up to AED 150,000 (with pre-existing conditions); 6 month waiting period for new members except those who are under continuous cover
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Covered
Hospital Accomodation
Private Room
Hospital Cash Benefit
Not Covered
Parent Accomodation
Up to AED 100 per day
Out-Patient
Vaccination
Covered for children up to age of 6 years as per MOH
Physiotherapy
Covered up to a maximum of 15 out-patient visit with 10% co-insurance
Scans
Covered for X-ray, MRI, CT-Scan, Ultra Sound & Endoscopy with 20% co-pay
Health Checks
Not Covered
Psychiatric Treatment
Not Covered
Alternative Medicine
Up to AED 1,600 for Chiropractic, Osteopathy, Homeopathy and Ayurvedic treatment
Prescription Drugs
Not Covered
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Network
Network Coverage
41 Hospitals
470 Clinics
27 Laboratories
1403 Pharmacies
8 Dentals
0 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
80% of the reasonable & customary costs
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity treatment (12 visits to PHC, 6 ultra scans); up to AED 10,000 for in-patient treatment & covered 100% in case of an emergency; 10% co-pay
Newborn Baby Cover
Not Covered
Natal Complications
Up to AED 10,000 (combined limit with delivery, medically necessary C-section & termination) & 10% co-pay
Dental
Dental Coverage
Up to AED 3,500 with 20% co-pay
Accidental Damage to Teeth
Not Covered