Adamjee Senior Citizen Health Insurance

Q: Q1. What is the visa requirement for the Adamjee health insurance plan?

Ans: The applicant must have a valid UAE resident visa to be considered eligible for the plans.

Q: Q2. Does Adamjee health insurance cover alternative medicine?

Ans: Yes, the plan provides coverage for alternative medicine including Osteopathy, Chiropractic, Ayurveda, Homeopathy, Chiropractic, Acupuncture, and Herbal Treatments. This cover has a maximum limit of AED 1,600 per person per year (available only on a reimbursement basis).

Q: Q3. Will I get vaccine cover with Adamjee health insurance?

Ans: Yes, the plan covers all the essential vaccinations in the UAE as per official guidelines.

Q: Q4. Are dental treatments covered under Adamjee health insurance, and what are the conditions?

Ans: Although dental treatments are covered under the policy with a sub-limit of AED 3,500, they require pre-authorisation and come with a 20% co-payment is applicable. Additionally, reimbursement is available but with an additional 20% co-payment. It’s worth noting that there is no reimbursement for the Silk Road Network within the UAE.

Q: Q5. What dental procedures are covered under Adamjee’s health insurance plan?

Ans: The plan covers various dental procedures such as dental consultations, tooth extraction (both surgical and simple), scaling and polishing, tooth filling (Amalgam, Glass Ionomer, and Composite), Root Canal Treatment (R.C.T), Crown if followed by Root Canal Treatment, X-Rays (Intra Oral and Extra Oral), and certain medications like antacids, antibiotics, enzyme preparations, analgesics, and vitamins when used with antibiotics.

Q: Q6. What dental treatments are excluded from coverage?

Ans: The insurance plan does not cover dental medications such as toothpaste, antiseptics, denture cleaning agents, mouthwash, and desensitising agents.

Q: Q7. How are elective treatments handled, and what is the reimbursement process?

Ans: Elective treatments are accessible through Free Access (Network) and covered outside the UAE up to 100% of the UAE applicable network rates. For reimbursement in Southeast Asia (SEA), 100% of the actual covered costs are subject to a maximum of 100% of the applicable UAE network rates. Reimbursement for elective treatments elsewhere within the territorial scope of cover is at 80% of the actual covered costs, subject to a maximum of the applicable 80% of UAE Network rates. It’s worth remembering that elective treatments are not reimbursed for the Silk Road Network inside the UAE.

Q: Q8. How is emergency treatment covered under the policy?

Ans: Emergency treatment can be accessed through Free Access (Network), where 100% of the actual covered costs are reimbursed. For reimbursement outside the network, the coverage is subject to the terms mentioned earlier.

In the realm of senior citizen health insurance, Adamjee Insurance, founded in 1960 in Pakistan, stands out as a beacon of trust and reliability. With a legacy of safeguarding the well-being of individuals through excellent insurance products, the company has earned a reputation as a trusted partner in securing your future, especially during your golden years.read more

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With Adamjee senior citizen health insurance plans, you can get a range of benefits at attractive rates. Furthermore, through the seamless claim process of the company, you can easily access financial assistance through your plan when you require it the most.

Let’s explore the ins and outs of the senior citizen health insurance plans of Adamjee Insurance.

Key Benefits of Adamjee Senior Citizen Health Insurance

Here is an overview of the salient features and benefits of the senior citizen health insurance plan by Adamjee -

Annual Aggregate Limit: AED 1,000,000 is the total limit applicable to all benefits and sub-limits within the insurance coverage.
Area of Coverage for Elective and Emergency Treatment: The coverage of the plan extends worldwide, ensuring that you have access to medical treatment and care regardless of your location.
Third-Party Administrator (TPA): MEDNET is the appointed TPA for managing and facilitating various aspects of insurance claims and services.
Terms and Conditions for Treatment Outside the UAE: Although treatment outside the UAE is covered, it's limited to a period of 90 days per treatment. This limitation also applies to single holidays or business trips to ensure continuous coverage within this timeframe.
Applicable Network: The insurance plan is associated with several networks such as Gold, Green, Silver Classic, Silver Premium, Pearl, Emerald, and Silk Road. This allows you to choose from a range of options as per your preferences.
Terms Applicable to Coverage for Pre-existing Conditions: It is essential to declare all pre-existing medical conditions in the medical application form. Declared pre-existing and chronic conditions are covered with a sub-limit of AED 150,000.

Keep in mind that undisclosed pre-existing conditions will not be covered during the policy period and will undergo underwriting at the time of renewal.

Other Adamjee Health Insurance Plans

Adamjee - Emerald

Adamjee - Emerald (AUH)

Adamjee - Gold

Adamjee - Gold - (AUH)

Adamjee - Green

Adamjee - Green (AUH)

Adamjee - Pearl

Adamjee - Pearl (AUH)

Adamjee - Silk Road

Adamjee - Silk Road (AUH)

Adamjee - Silver Classic

Adamjee - Silver Classic (AUH)

Adamjee - Silver Premium

Adamjee - Silver Premium (AUH)

Adamjee Senior Citizen Health Insurance Plans

Check out the table below to understand the variants of the Adamjee health insurance plan available for senior citizens -

Plan Name	Medical Cover (AED)	Pharmacy Limit (AED)
Silk Road (AUH)	1,000,000	Up to Medical Cover
Emerald (AUH)	1,000,000	Up to Medical Cover
Pearl (AUH)	1,000,000	Up to Medical Cover
Green (AUH)	1,000,000	Up to Medical Cover
Silver Classic (AUH)	1,000,000	Up to Medical Cover
Silver Premium (AUH)	1,000,000	Up to Medical Cover
Gold AUH (Mednet Gold)	1,000,000	Up to Medical Cover

Eligibility Criteria for Adamjee Senior Citizen Health Insurance

Listed below are the general eligibility criteria for Senior citizen health insurance plans in the UAE -

Categories	Eligibility Criteria
Minimum Entry Age	60 years
Maximum Age	99 years
Renewability	As Per the Upper Limit

Inclusions of Adamjee Senior Citizen Health Insurance

Although the specific inclusions of each variant of the Adamjee senior citizen health insurance plan vary, you can check out the general inclusions below -

In-patient services such as hospitalisation, ICUs, ambulances, and more
Out-patient services like lab tests, consultations, physiotherapy, and more
Emergency mental health treatments
Emergency dental treatment
Hearing and vision aids (in cases of emergency)
Medications

Exclusions of Adamjee Senior Citizen Health Insurance

Here are some general exclusions of the Adamjee senior citizen health insurance plan -

Orthodontics
Certain medications
General anaesthesia

Check out some frequently asked questions related to Adamjee senior citizen health insurance below -

FAQ's

Ans: The applicant must have a valid UAE resident visa to be considered eligible for the plans.

Ans: Yes, the plan provides coverage for alternative medicine including Osteopathy, Chiropractic, Ayurveda, Homeopathy, Chiropractic, Acupuncture, and Herbal Treatments. This cover has a maximum limit of AED 1,600 per person per year (available only on a reimbursement basis).

Ans: Yes, the plan covers all the essential vaccinations in the UAE as per official guidelines.

Ans: Although dental treatments are covered under the policy with a sub-limit of AED 3,500, they require pre-authorisation and come with a 20% co-payment is applicable. Additionally, reimbursement is available but with an additional 20% co-payment.

It’s worth noting that there is no reimbursement for the Silk Road Network within the UAE.

Ans: The plan covers various dental procedures such as dental consultations, tooth extraction (both surgical and simple), scaling and polishing, tooth filling (Amalgam, Glass Ionomer, and Composite), Root Canal Treatment (R.C.T), Crown if followed by Root Canal Treatment, X-Rays (Intra Oral and Extra Oral), and certain medications like antacids, antibiotics, enzyme preparations, analgesics, and vitamins when used with antibiotics.

Ans: The insurance plan does not cover dental medications such as toothpaste, antiseptics, denture cleaning agents, mouthwash, and desensitising agents.

Ans: Elective treatments are accessible through Free Access (Network) and covered outside the UAE up to 100% of the UAE applicable network rates. For reimbursement in Southeast Asia (SEA), 100% of the actual covered costs are subject to a maximum of 100% of the applicable UAE network rates.

Reimbursement for elective treatments elsewhere within the territorial scope of cover is at 80% of the actual covered costs, subject to a maximum of the applicable 80% of UAE Network rates. It’s worth remembering that elective treatments are not reimbursed for the Silk Road Network inside the UAE.

Ans: Emergency treatment can be accessed through Free Access (Network), where 100% of the actual covered costs are reimbursed. For reimbursement outside the network, the coverage is subject to the terms mentioned earlier.