Sukoon Insurance PJSC - Oman Max - Plan 3
Yearly Cover
AED 500,000.00
Deductible
10% co-insurance on all out-patient treatment
Coverage
Worldwide ex-USA
Chronic Conditions
Covered
Pre-Existing Conditions
Not Covered
In-Patient
Ambulance Coverage
Covered; pre-authorization required for in-patient treatment
Hospital Accomodation
Private Room with pre-authorization
Hospital Cash Benefit
Up to AED 500 per day
Parent Accomodation
Up to AED 500 per day with pre-authorization
Out-Patient
Vaccination
Covered for children up to 6 years
Physiotherapy
Covered with pre-authorization; up to a maximum of 10 sessions for out-patient treatment with 10% co-pay
Scans
Covered; pre-authorization required for in-patient treatment; 10% co-insurance on out-patient treatment
Health Checks
Covered up to AED 500 with 10% co-pay
Psychiatric Treatment
Not Covered
Alternative Medicine
Covered up to AED 3,000
Prescription Drugs
Not Covered
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Network
Network Coverage
119 Hospitals
1041 Clinics
62 Laboratories
1888 Pharmacies
68 Dentals
158 Optics
Treatment Outside Area of Cover
Covered Worldwide for emergency treatment
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 with 10% co-pay on out-patient maternity treatment; up to AED 15,000 each for normal delivery, medically essential C-section & complications; preauthorization required for in-patient treatment
Newborn Baby Cover
Covered for 30 days from birth
Natal Complications
Up to AED 15,000
Dental
Dental Coverage
Covered up to AED 1,000 with 20% co-pay
Accidental Damage to Teeth
Not Covered