Orient Gold - Family Care : Choose Best Health Insurance Plan From Orient

Plan Summary

Plan NameGold - Family Care

Cover AmountAED 1,000,000

Pharmacy LimitUpto AED 1,000,000

TPAMEDNET

Orient - Gold - Family Care Details

Maternity Cover

10% co-payment payable by the insured.

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

All medical underwritten conditions will have no waiting period. Undeclared pre-existing conditions will not be covered during the policy period and will be underwritten at renewal.

Pre-existing diseases (PED)

Covered only if declared on additional payment

Hospital Access

Direct access to hospital

Dental and Gum Treatment

Co-Payment

20% Copay Covered with sub-limit of AED 3500

Hearing and Vision Aids

Co-Payment

20% co-payment.

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

Covered (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.)

Territorial Scope Of Coverage

Coverage

Worldwide

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 period

Network

MEDNET Gold

Other Services

Radiology diagnostic

10% Co Insurance20% Co InsuranceNil Co Insurance

Physiotherapy Treatment

Prior approval of the insurance company is required.Maximum 15 sessions per year.

Test, diagnosis, treatments related to surgeries in hospitals

Prior approval required from the insurance compay / 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

10% co-payment (co-payment by the insured in respect of each and every prescription.)20% 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.

Diagnostics (X-RAY, MRI, CT-SCAN)

Covered with 20% CopayCovered with 10% CopayNil co-payment

Psychiatry

Not Covered

Alternative medicine

Covered up to AED 1,600/- PMPY

Dental and gum treatment

20% Copay Covered with sub-limit of AED 3500

Hearing and Vision Aid

In case of emergency only

Physiotherapy Treatment

Maximum 15 sessions per year.

Region Coverage

- Where this policy is applicable

Worldwide

Related Health Insurance

182 Orient - Gold - Family Care Added Network Hospitals

Plan Name

Type

Name

Address

NMC ROYAL WOMENS -ABU DHABI / MF3186 (Hospitals)

ABU DHABI - 02-5082000

Mediclinic Hospitals L.L.C. (Airport Road Hospital) / Mf2270 DR. MARC FRANCIS SINCLAIR (Consultant-Paediatric Orthopedic Surgeon) - Mediclinic will be collecting additional payment towards his consultation fee from the patients directly. THIS EXTRA AMOUNT IS NOT A SUBJECT FOR REIMBURSEMENT AND MEDNET WILL ONLY PAY THE AGREED CONSULTANT RATES WITH MEDICLINIC. (Hospitals)

AIRPORT ROAD, SHK. MOHD BIN BUTTI BLDG. - 02-4944813

MAGRABI SPECIALIZED HOSPITAL- BRANCH (Hospitals)

AL KHALEEJ AL ARABI STREET, AL MUSHRIF - 02-4446565

IMPERIAL COLLEGE LONDON DIABETES CENTRE (Hospitals)

AL KHALEEJ AL ARABI STREET, EMBASIES AREA - 02-4040800

Gulf Diagnostic Center Hospital Covered for EBP OP Access for the following: Dhabi Contracting Co, AL RAKHA GEN CONT LLC, ABS Bus & car rental, Sultan Al Ghashmi Technical Works LLC, ALNASR CONTRACTING CO LLC, CITYTECH LLC, WORDSMART, C G TECHNOLOGY LLC; Silk Road OP Access for Non Abu Dhabi Al Futtaim card holders are covered at this facility. EFF: 03-SEPT-2018 - Provider not eligible to accept the members from Policy Group Code: 11782, Policy Group Name: Tornado Group Basic EFF: 06-SEPT-2018 - Provider not eligible to accept the members for Policy Number: 251264 , Policy Group Name: Eagle Environmental Services and Pest Control (Hospitals)

AL KHALEEJ AL ARABI STREET, MUSASFA ROAD , AFTER SHK MOHAMMED PALACE - 02-4177222

SEHA EMIRATES HOSPITAL (Hospitals)

AL LEDEEM STREET - 02-4438999

CLEVELAND CLINIC ABU DHABI LLC (Hospitals)

AL MAQAM TOWER, AL FALAH STREET, ABU DHABI GLOBAL MARKET SQUARE, AL MARYAH ISLAND - 02-6590200

MAGRABI EYE & EAR CENTER (Hospitals)

BANIYAS STREET, AL NAKHEEL TOWER - 02-6345000

***Lifecare Hospital Covered for EBP OP Access for the following: Dhabi Contracting Co, AL RAKHA GEN CONT LLC, ABS Bus & car rental, Sultan Al Ghashmi Technical Works LLC, ALNASR CONTRACTING CO LLC, CITYTECH LLC, WORDSMART, C G TECHNOLOGY LLC; Silk Road OP Access for Non Abu Dhabi Al Futtaim card holders are covered at this facility. EFF: 03-SEPT-2018 - Provider not eligible to accept the members from Policy Group Code: 11782, Policy Group Name: Tornado Group Basic EFF: 06-SEPT-2018 - Provider not eligible to accept the members for Policy Number: 251264 , Policy Group Name: Eagle Environmental Services and Pest Control (Hospitals)

BANIYAS STREET, WATHBA, GATE NO. 6 AL RAHA VILLAGE - 02-5856333

DANAT AL EMARAT HOSPITAL FOR WOMEN & CHILDREN LLC-ABU DHABI-MF2278 (Hospitals)

BEN AL JESREEN STREET, ABU DHABI GATE - 02-6149999