Orient Takaful Gold : Choose Best Health Insurance Plan From Orient Takaful

Plan Summary

Plan NameGold

Cover AmountAED 1,000,000

Pharmacy LimitUpto AED 1,000,000

TPAMEDNET

Orient Takaful - Gold Details

Maternity Cover

Normal Delivery expenses are covered up to a sub limit of AED 10,000/- , Medically necessary Caesarean Section and complication expenses are covered up to a sub limit of AED 10,000/- , Any Medical Emergency expenses related to Maternity will be covered up to a sublimit of AED 150,000/- , Out Patient eligible Maternity expenses are covered up to Annual limit - 10% co-payment applicable on all Maternity treatments, including out- patient Maternity consultation (no Deductible applies)

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

Coverage Type

Clinic + Hospital Access

Out-Patient Services

New Born Cover

As per DHA benefit guidelines.

Dental

Free Access - Covered with 20% Co-Payment with an annual Sub-Limit of AED 3,500, Reimbursement - Additional 20% co-payment applicable over free access with annual sub limit of AED 3,500

Alternative Medicine

Covered up to AED 1,600/- PMPY

Vaccinations (Adults)

Covered both on Free Access & reimbursement basis

Physician Consultation

Covered with Co-pay of 20% max 50 per consultation

In-Patient Services

Room Type

Private Room

Ambulance Service

Covered

Emergency Treatment

100% of Actual Covered Cost

Parent Accommodation for child under 18 years

For children upto 16 Years of Age - Covered maximum up to 100 AED per night

Repatriation of Mortal Remains to Home Country

Covered up to AED 7,500/-

Pre-Existing and Chronic Conditions

All pre-existing medical conditions should be declared in the Medical Application Form and is subject to medical underwriting., All declared Pre-existing and Chronic conditions are covered with a sub limit of AED 150,000/- , Undeclared pre-existing conditions will not be covered during the policy period and will be underwritten at renewal.

Network

Gold

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

Covered with 0% co-pay per invoiceCovered with 10% co-pay per invoiceCovered with 20% co-pay per invoice

Psychiatry

Covered In Case Of Emergency Only

Alternative medicine

Covered up to AED 1,600/- PMPY

Dental and gum treatment

Covered subject to the following: • Sub-limit: AED 3,500 • Coinsurance: 20%

Hearing and Vision Aid

Covered only in cases of medical emergencies

Physiotherapy Treatment

Covered up to 15 sessions/ Per member Per year - 20% Co-paymentCovered up to 15 sessions/ Per member Per year - 10% Co-paymentCovered up to 15 sessions/ Per member Per year - 0% Co-payment