Sukoon - Oman Individual Health Insurance

Q: Q1. Are the benefit limits inclusive of co-insurance?

Ans: Yes, all benefit limits include co-insurance where applicable.

Q: Q2. Can eCards be used for UAE residence visa stamping?

Ans: Yes, eCards can be utilised for the visa stamping process in the UAE.

Q: Q3. Can I seek medical care at facilities outside my network? If so, how do I make payments?

Ans: Access to non-network healthcare facilities depends on your policy's terms and conditions. You will be responsible for covering the entire treatment cost upfront and can then apply for reimbursement, following the policy terms and deductibles for non-network care. For elective hospitalisation, advance notification is essential. If outpatient visits are expected to exceed AED 500, prior approval is required.

Q: Q4. How can I receive medical care in the UAE if I don't have my medical cards with me?

Ans: Even without a physical card, you can access healthcare services. This is because healthcare providers can verify your insurance using your Emirates ID or eCard.

Q: Q5. Is it possible to use my Emirates ID when travelling outside the UAE?

Ans: No, your Emirates ID cannot be used outside the UAE. To validate your eligibility for international direct billing, you'll be required to use eCards provided by the provider.

Q: Q6. My physical card is expiring soon. Is it still valid?

Ans: Yes, your physical card remains valid until its expiration date. In case you forget it, you can use your Emirates ID or display your eCard. However, make sure that your Emirates ID is registered with the company.

Q: Q7. Can my newborn receive medical services if their Emirates ID is still in processing?

Ans: Yes, your newborn can receive medical services as long as they are enrolled in the policy. The primary insured (either parent) can generate an eCard for the baby.

Q: Q8. Is the validity of my medical insurance linked to my Emirates ID?

Ans: No, the validity of your medical insurance is not linked to your Emirates ID. Each one needs to be renewed separately.

Sukoon Insurance, formerly known as Oman Insurance Company, is a distinguished composite insurance company headquartered in the vibrant city of Dubai. Since its inception in 1975, Sukoon has been a steadfast pillar of support for individuals and businesses in the UAE as well as Oman.read more

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Written By

Mousree DasSenior Content Writer (Expertise - Health and Travel Insurance)

Reviewed By

Toshita ChauhanBusiness Head - General Insurance

Last updated on 13 May 2024Editorial Standards

Regulatory credentials

Licensed by the Central Bank of the UAE (Registration No. 123)

DHA Health Insurance Intermediary Permit No. BRK-00041

Emirates Insurance Federation Membership No. B81

Information on this page is for general guidance only - not personalised financial or medical advice.

Known for its extensive range of insurance products, Sukoon caters to the diverse needs of its clientele, offering peace of mind and financial security through its individual health insurance plans and a variety of other coverage options. In an ever-evolving world, Sukoon Insurance remains resolute in its commitment to ensuring the well-being of individuals, providing them with the assurance and protection that they need for a healthier and more secure future.

Let’s find out more about this type of Sukoon health insurance in the UAE.

Sukoon Individual Health Insurance Plans

Have a look at the following table for the top Sukoon individual health insurance plans -

Plan	Details
Safe	Medical cover of up to AED 150,000 Out-patient Maternity Services – With 10% co-insurance In-patient Maternity Services Coverage for pre-existing conditions Various accommodation-related costs covered Coverage for Intensive Care Unit (ICU) and coronary artery disease treatment Newborn Cover Ambulance Service Coverage for Laboratory Tests and Radiology Coverage for Physiotherapy Treatment Coverage for Immunotherapy & Immunomodulators Emergency Treatment Coverage for Psychiatric Treatment Home Nursing Coverage for Cancer Treatment Coverage for Airfare Ticket (limited area) Coverage for Preventive Services Coverage for HCV Hepatitis C Virus Infection No Coverage for Work-Related Injuries Coverage for Elective Treatment Coverage for Accidental Injuries Assistance Packages including Medical Evacuation and Second Medical Opinion Medication Coverage for Diagnostics (X-RAY, MRI, and CT-SCAN) Coverage for Dental and gum treatment (only in emergencies) Coverage for Hearing and Vision Aid (only in emergencies) Region Coverage includes UAE, Arab Countries, and Southeast Asia No coverage for Alternative Medicine or Circumcision
Home Lite	AED 250,000 Medical Cover Maternity Cover — No Co-Payment Coverage for Post-Natal Consultation, Investigations, and Procedures Coverage for maternity complications, normal delivery, medically necessary C-section, and legal abortion or miscarriage No waiting period for Pre-Existing Diseases and Chronic Conditions (with COC) Private Room Type Accommodation-related costs covered Coverage for Intensive Care Unit and Coronary Artery Disease Treatment Coverage for Newborn Ambulance Service Coverage for Laboratory Tests Coverage for Physiotherapy Treatment Coverage for Immunotherapy & Immunomodulators (if deemed medically necessary) Coverage for Emergency Treatment (including Hepatitis A and Hormone Replacement Therapy) No Coverage for Dental Coverage for Psychiatric Treatment Coverage for Home Nursing Coverage for Cancer Treatment (specific types) Coverage for Airfare Ticket (limited area) No Coverage for Routine Health Checkup Activation of Repatriation of Mortal Remains at 0 Kilometres Coverage for Preventive services Coverage for HCV Hepatitis C Virus Infection No Coverage for Work-Related Injuries Coverage for Elective Treatment Coverage for Accidental Injuries (excluding hazardous sports) Coverage for Death Due to Accident (up to AED 100,000) Coverage for Permanent Total Disability due to Accident (AED 100,000) No Coverage for Circumcision Assist America Package (including Emergency Medical Evacuation, Medical Repatriation, and Second Medical Opinion) Coverage for Medication Coverage for Diagnostics (X-RAY, CT-SCAN, and MRI) Coverage for Psychiatry No coverage for Alternative medicine Coverage for Dental and gum treatment (only in emergencies) Coverage for Hearing and Vision Aids (only in emergencies) Coverage for Region Coverage (UAE, Arab Countries, and Southeast Asia)
Home	Medical Cover of AED 250,000 Out-Patient Maternity Services: With 10% co-insurance In-patient Maternity Services Pre-Existing Disease and Chronic Condition waiting Period: With COC nil waiting period, without COC 6 months waiting period Direct Hospital Access Laboratory Tests: Covered Pharmacy Limit: Prescribed Pharmaceuticals covered Fees Related to Consultants, Anaesthetists, and Surgeons: Covered In-Patient Services Co-Payment: Consultation Deductible/Coinsurance – Nil, Outpatient procedures – 10%, Physiotherapy – 10% Room Type: Private Pre-existing Conditions: Covered up to AED 150,000 both inside and outside the UAE (subject to exclusions) Hospital Accommodation and related Services Intensive Care Unit and Coronary Artery Disease treatment Pre-Existing and Chronic Conditions: Covered up to AED 150,000 per person per year Network: Signature Co-Payment: Prescribed Pharmaceuticals – 10% Maximum out of pocket limit – Not Applicable Post-Natal Prescribed Pharmaceuticals – 10% Maximum out of pocket limit – Not Applicable New Born Cover: Covered up to 30 days as part of the mother's insurance Ambulance Service: Covered Laboratory Tests: Co-Payment: 10% co-insurance for Laboratory and 10% for Radiology Physiotherapy Treatment: Covered up to 10 sessions Immunotherapy and Immunomodulators: Covered if medically necessary Emergency Treatment: - Covered Psychiatric Treatment: Covered up to AED 5,000 per person per year with 30% Coinsurance Home Nursing: Covered up to AED 15,000 per person per year Cancer Treatment: As per the guidelines of DHA for breast, colorectal, or cervical cancer Airfare Ticket: Covered (limited to geographical area specified) Routine Health Checkup: Not Covered Repatriation of Mortal Remains to Home Country: Activated at 0 Kilometres Preventive services: Covered Work-Related Injuries: Not Covered Elective Treatment: Covered Accidental Injuries: Covered up to AED 100,000 — Permanent Total Disability due to Accident up to AED 100,000 Circumcision: Not Covered Assist America Package Medication: Covered Alternative Medicine: Not Covered Diagnostics (X-RAY, MRI, and CT-SCAN): Covered Dental and Gum Treatment: Covered only in cases of medical emergencies Hearing and Vision Aids: Covered only in cases of medical emergencies Physiotherapy Treatment: Covered up to 10 sessions Region Coverage: UAE, Arab Countries, and Southeast Asia
Max	AED 500,000 Medical Cover Out-patient Maternity Services with 10% co-insurance In-patient Maternity Services Pre-Existing Disease and Chronic Condition waiting Period: With COC nil waiting period, without COC 6 months waiting period Direct access to hospital Out-Patient Services In-Patient Services Hospital Accommodation and related Services Pre-Existing and Chronic Conditions – Covered up to AED 150,000 per person per year Network Signature+Medcare Other Services Co-Payment Prescribed Pharmaceuticals - 10% Maximum out of pocket limit - Not Applicable Post-Natal Prescribed Pharmaceuticals - 10% Maximum out of pocket limit - Not Applicable New Born Cover: Covered up to 30 days Ambulance Service: Covered Laboratory Tests: Co-Payment: 10% co-insurance for Laboratory and Radiology Physiotherapy Treatment: Covered up to 10 sessions Immunotherapy and Immunomodulators: Covered if medically necessary Emergency Treatment Psychiatric Treatment Home Nursing: Up to AED 15,000 per person per year Cancer Treatment: As per the DHA guidelines for breast, colorectal or cervical cancer Airfare Ticket: Covered (limited to geographical area specified) Routine Health Checkup: Covered up to AED 500 per person per year Repatriation of Mortal Remains to Home Country: Activated at 0 Kilometres Preventive Services: Diabetes screening is covered along with Basmah Initiative and Adult Pneumococcal Conjugate Vaccine HCV Hepatitis C Virus Infection: Covered Work-Related Injuries: Not Covered Elective Treatment: Covered Accidental Injuries: Recreational non-hazardous sports activities (professional and hazardous sports activities even if recreational are not covered) - Covered Death due to Accident: Covered Up to AED 100,000 Permanent Total Disability due to Accident - AED 100,000 Circumcision: Not Covered Assist America Package: Emergency Medical Evacuation, Medical Repatriation, and Second Medical Opinion - Covered Medication Covered Diagnostics (X-RAY, MRI, and CT-SCAN): Covered Psychiatry: Covered up to AED 7,500 per person per year with 30% Coinsurance Alternative medicine: Enhanced Alternative Medicine – Services to be performed only by a licensed practitioner — Covered up to AED 3,000 per person per year Dental and gum treatment: Covered Hearing and Vision Aid: Covered only in cases of medical emergencies Physiotherapy Treatment: Covered up to 10 sessions Region Coverage: Worldwide excluding Canada and the USA
Pro	Medical Cover of up to AED 3,000,000 Out-patient Maternity Services — Covered but subject to 10% coinsurance In-patient Maternity Services Pre-Existing Disease and Chronic Condition waiting Period: With COC nil waiting period, without COC 6 months waiting period Direct access to hospital Out-Patient Services In-Patient Services Hospital Accommodation and related Services Pre-Existing and Chronic Conditions — Covered up to AED 150,000 per person per year Network Edge Other Services Co-Payment Prescribed Pharmaceuticals - 10% Maximum out of pocket limit - Not Applicable Post-Natal Prescribed Pharmaceuticals - 10% No maximum out-of-pocket limit New Born Cover: Covered up to 30 days Ambulance Service: Covered Laboratory Tests: Co-Payment: 10% co-insurance for Laboratory and 10% for Radiology Physiotherapy Treatment: Covered up to 10 sessions Immunotherapy and Immunomodulators: Covered if medically necessary Emergency Treatment Hepatitis A - Covered Hormone replacement therapy (Excluding growth hormone and excluded medical conditions) - Covered Psychiatric Treatment: Covered up to AED 10,000 per person per year with 30% Coinsurance Home Nursing: Covered up to AED 15,000 per person per year Cancer Treatment: In accordance with DHA guidelines for breast, colorectal or cervical cancer Airfare Ticket: Covered (limited to geographical area specified) Routine Health Checkup: Covered up to AED 1,000 per person per year Repatriation of Mortal Remains to Home Country: Activated at 0 Kilometres Preventive services Work-Related Injuries: Not Covered Elective Treatment: Covered Accidental Injuries: Recreational non-hazardous sports activities (professional and hazardous sports activities even if recreational are not covered) - Covered Death due to Accident: Covered Up to AED 100,000 Permanent Total Disability due to Accident - AED 100,000 Circumcision: Not Covered Assist America Package Alternative Medicine: Enhanced Alternative Medicine - Covered up to AED 3,000 per person per year Diagnostics (X-RAY, CT-SCAN, and MRI): Covered Alternative medicine – Services to be performed only by a licensed practitioner - Covered up to AED 3,000 per person per year Dental and gum treatment: Covered Hearing and Vision Aid: Covered only in cases of medical emergencies Physiotherapy Treatment: Covered up to 10 sessions Region Coverage: Worldwide excluding Canada and the USA
Prime	Medical Cover of AED 5,000,000 Out-patient Maternity Services — 10% coinsurance applicable In-patient Maternity Services Pre-Existing Disease and Chronic Condition waiting Period: With COC nil waiting period, without COC 6 months waiting period Direct access to hospital Out-Patient Services In-Patient Services Hospital Accommodation and related Services Pre-Existing and Chronic Conditions - Covered up to AED 150,000 per person per year Network Premium Other Services Co-Payment: Prescribed Pharmaceuticals - 10% Maximum out of pocket limit - Not Applicable Post-Natal Prescribed Pharmaceuticals - 10% Maximum out of pocket limit - Not Applicable New Born Cover: Covered up to 30 days Ambulance Service Laboratory Tests Physiotherapy Treatment: Covered up to 10 sessions Immunotherapy and Immunomodulators: Covered if medically necessary Emergency Treatment: Hepatitis A - Covered, Hormone replacement therapy (Excluding growth hormone and excluded medical conditions) - Covered Psychiatric Treatment: Covered up to AED 15,000 per person per year with 30% Coinsurance Home Nursing: Covered up to AED 15,000 per person per year Cancer Treatment: As Per DHA for breast, colorectal or cervical cancer Airfare Ticket: Covered (limited to geographical area specified) Routine Health Checkup: Covered up to 3,000 per person per year Repatriation of Mortal Remains to Home Country: Activated at 0 Kilometres Preventive services Hearing and vision aids Elective Treatment: Covered Accidental Injuries: Recreational non-hazardous sports activities (professional and hazardous sports activities even if recreational are not covered) - Covered Death due to Accident: Covered Up to AED 100,000, Permanent Total Disability due to Accident - AED 100,000 Circumcision: Not Covered Assist America Package Medication: Medication Alternative Medicine: Enhanced Alternative Medicine - Covered up to 5,000 per person per year Diagnostics (X-RAY, MRI, and CT-SCAN): Covered Psychiatry: Covered up to AED 10,000 per person per year with 30% Coinsurance Alternative medicine: Enhanced Alternative Medicine – Services to be performed only by a licensed practitioner - Covered up to 3,000 per person per year Dental and gum treatment: Covered Hearing and Vision Aid: Covered only in cases of medical emergencies Physiotherapy Treatment: Covered up to 10 sessions Region Coverage: Worldwide excluding USA and Canada

Note: All the mentioned rates or premiums are indicative and may change depending upon an individual applicant’s medical background, coverage requirement, and more.

Check Out More About Sukoon Health Insurance Plans

Key Benefits of Sukoon Individual Health Insurance

Listed below are the major benefits of Sukoon individual health insurance -

Sukoon has extensive experience of over 40 years, serving more than 500,000 members in the region.
Offers a simple reimbursement process for consulting doctors outside the network
Provides convenient online access to direct billing network lists, hospital searches, and necessary forms via their website and mobile app
Ease of arranging for medical treatment in the member's home country with roundtrip airfare coverage in select regions
Flexible Employee Benefits solutions that can be customised to meet specific requirements are provided
Provides access to over 1,000 healthcare providers and 1,500 pharmacies across all Emirates, with the option to extend direct billing internationally.
Delivers excellent customer service with personalised assistance from multilingual experts
Offers a wide range of comprehensive plans (including custom options), all compliant with local regulatory authorities.
Provides budget-friendly plans with customisable networks, limits, and deductible levels.
Features a proactive wellness program that promotes a healthy lifestyle and early disease detection with monthly offers

Eligibility Criteria for Sukoon Individual Health Insurance

One can buy Sukoon individual health insurance on fulfilling the following eligibility criteria –

Category	Eligibility Criteria
Minimum Age	18 years

Sukoon Individual Health Insurance Inclusions

Listed below are the general inclusions of Sukoon individual health insurance -

In-Patient Services
Hospital accommodation
Tests and diagnostics — X-rays, CT scans, and more
Transportation services for medical emergency
Cost of medicine
Pre-existing and chronic conditions

Exclusions of Sukoon Individual Health Insurance

The general exclusions of Sukoon individual health insurance are as follows -

Cosmetic procedures
Self-harm or suicide-related injuries.
Injuries or illnesses resulting from illegal activities.
Hazardous sports activities (terms apply)

Check out some frequently asked questions related to Sukoon individual health insurance -

FAQ's

Ans: Yes, all benefit limits include co-insurance where applicable.

Ans: Yes, eCards can be utilised for the visa stamping process in the UAE.

Ans: Access to non-network healthcare facilities depends on your policy's terms and conditions. You will be responsible for covering the entire treatment cost upfront and can then apply for reimbursement, following the policy terms and deductibles for non-network care.

For elective hospitalisation, advance notification is essential. If outpatient visits are expected to exceed AED 500, prior approval is required.

Ans: Even without a physical card, you can access healthcare services. This is because healthcare providers can verify your insurance using your Emirates ID or eCard.

Ans: No, your Emirates ID cannot be used outside the UAE. To validate your eligibility for international direct billing, you'll be required to use eCards provided by the provider.

Ans: Yes, your physical card remains valid until its expiration date. In case you forget it, you can use your Emirates ID or display your eCard. However, make sure that your Emirates ID is registered with the company.

Ans: Yes, your newborn can receive medical services as long as they are enrolled in the policy. The primary insured (either parent) can generate an eCard for the baby.

Ans: No, the validity of your medical insurance is not linked to your Emirates ID. Each one needs to be renewed separately.