Sukoon Insurance PJSC - Basic Plan
Yearly Cover
AED 150,000.00
Deductible
20% co-pay for some in-patient treatments up to a maximum of AED 500 (annual cap of AED 1,000); 20% co-pay on out-patient treatment & 30% on prescriptions
Coverage
GCC
Chronic Conditions
Covered with a waiting period of 6 month for new members
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Covered for in-patient treatment with pre-authorization
Hospital Accomodation
Shared room with pre-authorization
Hospital Cash Benefit
Not Covered
Parent Accomodation
Up to AED 100 per night with pre-authorization
Out-Patient
Vaccination
Covered for children up to age of 6 years
Physiotherapy
Up to 6 sessions for out-patient treatment with 20% co-pay & pre-authorization
Scans
Covered; pre-authorization required for in-patient treatment & out-patient CT scans, MRI scans & endoscopies; 20% co-pay for 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
38 Hospitals
506 Clinics
27 Laboratories
1653 Pharmacies
6 Dentals
0 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
Elective treatment covered 100% at actual with pre-authorization, if treatment is not available within the network; emergency treatment covered 100% at actual on reimbursement basis
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity (8 visits to PHC, 3 ultra scans); up to AED 7,000 per normal delivery & AED 10,000 for C-section, abortion & complicated pregnancy with pre-authorization; 10% co-pay
Newborn Baby Cover
Covered up to AED 150,000 for 30 days from birth; preauthorization required for in-patient treatment
Natal Complications
Up to AED 10,000 with 10% co-pay & pre-authorization
Dental
Dental Coverage
Not Covered
Accidental Damage to Teeth
Not Covered