Orient Insurance P.J.S.C - Healthplus Plan 2 Nextcare GN
Yearly Cover
AED 1,000,000.00
Deductible
10% per GP consultation up to a maximum of AED 35 & 20% per SP consultation up to a maximum of AED 75
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
Physiotherapy
Covered up to 20 sessions per condition for out-patient treatment with pre-authorization
Scans
Covered; 10% co-pay for out-patient treatment
Health Checks
Diabetes screening as per DHA
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
Prescription Drugs
Not Covered
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Network
Network Coverage
167 Hospitals
1261 Clinics
75 Laboratories
1739 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 (15 visits to PHC, 8 ultra scans); up to AED 20,000 for in-patient treatment & covered 100% in case of an emergency; 10% co-pay
Newborn Baby Cover
Covered for 30 days from birth; preauthorization required for in-patient treatment
Natal Complications
Up to AED 20,000 (combined limit with delivery, medically necessary C-section & termination) & 10% co-pay
Dental
Dental Coverage
Up to AED 3,000 with 20% co-pay