Al Sagr Gold - Plan B : Choose Best Health Insurance Plan From Al Sagr

Plan Summary

Plan NameGold - Plan B

Cover AmountAED 250,000

Pharmacy LimitUpto AED 1,000,000

TPANextcare

Al Sagr - Gold - Plan B Details

Maternity Cover

Maximum benefit AED 7,000 per normal delivery, AED 10,000 for medically necessary C-section, complications and for medically necessary termination (All limits include co-payment).

Out-patient Maternity Services

Requires prior approval from the insurance company.Covered (9 months waiting period for non-working married females without continuity of coverage who are confirmed pregnant after time of enrollment o Nil waiting period for employees & non-working married females with continuity of coverage)10% coinsurance payable by the insured. 8 visits to PHC Visits to include reviews. (All Care provided by Primary Health care obstetrician for low risk or specialist obstetrician for high risk referrals.)

New Born Cover

Cover from 30 days from birth BCD, Hepatitis B and neo-natal screening test. (Cover for 30 days from birth.)

Waiting Period

Maternity Waiting Period

any pregnancy, which arises within forty calendar days from the date of policy issuance, shall not be covered under this policy under any condition

Chronic Condition Waiting Period

Treatment for chronic Or pre-existing conditions excluded for first 6 months of first membership (DXB). Pre-existing Conditions Covered after 1 year of continuous cover with ASNIC (NE)

Pre-existing diseases (PED)

Covered only if declared on additional payment

Hospital Access

Direct access to hospital

Coverage Type

Clinic + Hospital Access

In-Patient Services

Room Type

Private Room

Ambulance Service

Ground transportation services in the UAE provided by an authorized party for medical emergencies.

Companion Accomodation

Maximum AED 200 per night. (The cost of accomodating a person accompanying an insured child up to the age of 16 years.)Maximum AED 200 per night. (The cost of accommodation of a person accompanying an in-patient in the same room in case of medical necessity at the recommendation of the treating doctor and after the prior approval of the insurance company providing coverage.)

Territorial Scope Of Coverage

Coverage

UAE(except AUH& AAN)Insurance Coverage is only for Dubai visa holders.

Pre-Existing and Chronic Conditions

6 months waiting period is applicable for new entrants & members without continuity of coverage for the declared Pre-existing & the newly discovered Chronic conditions Nil waiting period for members with continuity of coverage for the declared Pre-existing & Chronic conditions.

Network

Nextcare - RN

Other Services

Radiology diagnostic

Covered in full

Test, diagnosis, treatments related to surgeries in hospitals

Prior approval required from the insurance company / TPA.

Emergency Treatment

Approval required from the insurance company within 24 hours of admission to the authorized hospital.

Healthcare services for emergency cases

Prior approval required from the insurance company (Prior approval required from the insurance company Where a pre-existing or chronic condition develops into an emergency within the 6-month exclusion preriod this must be covered up to the annual aggregate limit.)

Medication

Co-Payment

Nil co-payment. (co-payment by the insured in respect of each and every prescription.)

Limit

upto Policy annual limit

Description

No cover for drugs and medicines in excess of the annual limit. Restricted to a list of formulary products where available at the physician and the pharmacist.