Orient - D-Med

Your family's health is paramount, and Orient D-Med offers the ideal health insurance coverage to prove it. This Orient D-Med includes a plethora of medical services, such as maternity care, critical illness cover, dental and gum treatment, hearing and vision aids, and more. You can also make changes in your plan by including riders/ add-ons to make it more beneficial for your family.read more

Worldwide Coverage

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Expert Advice

Plan Summary

Plan NameD-Med

Cover AmountAED 150,000

Pharmacy LimitUpto AED 1,500

TPANextcare

Orient - D-Med Details

Maternity Cover

10% co-payment payable by the insured.40 Days ( any pregnancy, which arises within 40 calendar days from policy inception will be at the discretion of the insurer)10% co-payment payable by the Policy Holder. 8 Check-ups + 3 ante-natal ultrasound scans are covered at the Primary Health Care Centre. (All Care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals.)

Waiting Period

Maternity

any pregnancy, which arises within forty calendar days from the date of policy issuance, shall not be covered under this policy under any condition No waiting period for maternity coverage upon payment of an additional premium, as per underwriting guidelines – coverage begins from Day 1.

Chronic Condition

Waiting period of 6 months

Pre-existing diseases (PED)

Covered only if declared on additional payment

Additional Information

No waiting period applies to the above cases upon payment of an additional premium, as per underwriting guidelines—coverage begins from Day 1. Also, for renewals, no waiting period is applicable.

Hospital Access

Referral procedure to be followed:- Customer has to visit GP, after GP refers then customer can visit the specialist in clinics.

Hearing and Vision Aids

Co-Payment

20% co-payment.

Coverage Type

GP Clinic

In-Patient Services

Room Type

In-patient services will be received in rooms of two or more beds.

Ambulance Service

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

Companion Accomodation

Maximum AED 100 per night. (The cost of accomodating a person accompanying an insured child up to the age of 16 years.)Maximum AED 100 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.)

Pre-Existing and Chronic Conditions

All declared Pre-existing and Chronic conditions are covered with a sub limit of AED 150,000/-, Undeclared pre-existing and Chronic conditions will not be covered during the policy periodAny new Chronic condition will have a waiting period of 6 months.

Network

Network - PCP/RN3

Other Services

Radiology diagnostic

20% Co-payment is applicable alongwith a prior approval from the insurance company

Physiotherapy Treatment

Prior approval of the insurance company is required.Maximum 6 sessions per year.

Test, diagnosis, treatments related to surgeries in hospitals

Covered

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

30% co-payment (co-payment by the insured in respect of each and every prescription.)

Limit

AED 1,500 Annually

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.