Orient Insurance P.J.S.C - Healthplus Plan 2 AUH Nextcare GN
Yearly Cover
AED 750,000.00
Deductible
AED 50 per out-patient consultation; 15% co-insurance on prescriptions
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
Up to AED 300 per night for a max of 10 nights
Parent Accomodation
Up to AED 400 per day
Out-Patient
Vaccination
Covered for children up to age of 6 years as per MOH
Physiotherapy
Covered for out-patient treatment with pre-authorization
Scans
Covered
Health Checks
Not Covered
Psychiatric Treatment
Up to AED 10,000 for in-patient treatment; up to AED 3,000 for out-patient treatment
Alternative Medicine
Up to AED 2,000 for chiropractic, osteopathy, homeopathy and ayurvedic treatment
Prescription Drugs
Not Covered
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Network
Network Coverage
167 Hospitals
1268 Clinics
75 Laboratories
1741 Pharmacies
157 Dentals
130 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
80% of the reasonable actual costs or 80% of the reasonable & customary costs of the medical network, whichever is less on, reimbursement basis
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity treatment with AED 50 per consultation; covered 100% for in-patient treatment & in case of an emergency (within Abu Dhabi); up to AED 10,000 for normal delivery & up to AED 12,000 for C-section and complications (outside the Emirate of Abu Dhabi); AED 500 deductible per delivery within Abh Dhabi
Natal Complications
Covered; up to AED 12,000 (combined limit with medically necessary C-section) outside Abu Dhabi
Dental
Dental Coverage
Up to AED 3,000 with 20% co-pay