Adamjee Gold : Choose Best Health Insurance Plan From Adamjee

Adamjee - Gold

Give your family the gift of a wholesome health insurance with Adamjee. This inclusive Adamjee Gold provides coverage for a wide range of medical services. These services include consultation charges, prescription medication, alternative medicines, physiotherapy treatment, etc.You can customise ...read more

Plan Summary

Plan NameGold

Cover AmountAED 1,000,000

Pharmacy LimitUpto AED 1,000,000

TPAMEDNET

Adamjee - Gold Details

Maternity Cover

Out-patient Maternity Services

10% coinsurance payable by the insuredRequires prior approval from the insurance company.10% co-payment payable by the Policy Holder.

In-patient Maternity Services

10% co-payment payable by the insured.Maximum benefit AED 10,000 per normal delivery, AED 10,000 for medically necessary C-section. AED 150,000 for complications and for medically necessary termination (All limits include co-payment) 10% co-payment

New Born Cover

Covered 30 days for new born are in line with DHA benefit guidelines.

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% co-payment upto AED 350020% co-payment upto AED 3500 ( Covered with Pre authorization)

Covered

Hearing and Vision Aids

Co-Payment

0% co-payment10% co-payment20% co-payment

Covered

Only In case of emergency due to accidents.

Coverage Type

Clinic + Hospital Access

Out-Patient Services

Co-Payment

20% max AED 50 per consulation. Rest all Out Patient Services 20% co-payment20% max AED 50 per consulation. Rest all Out Patient Services 10% co-payment20% max AED 50 per consulation. Rest of all OP Services 0% co-payment

In-Patient Services

Co-Payment

Nil

Room Type

Private Room

Ambulance Service

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

Companion Accomodation

CoveredMaximum AED 100 per night.

Territorial Scope Of Coverage

Coverage

Insurance Coverage is only for UAE visa holders.(Exc. AUH/AAN)Worldwide

Network

Mednet - GoldMednet - Gold

Other Services

Laboratory Tests

0% Co-insurance10% co-payment20% co-payment

Radiology diagnostic

20% co-payment10% co-payment0% Co-insurance

Physiotherapy Treatment

20% co-paymentMaximum 15 sessions per year.10% co-paymentPrior approval of the insurance company is required.0% Co-insurance

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

Medication

Co-Payment

20% co-payment10% co-payment0% co-payment

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.

Essential Vaccines & Preventive Services

Co-Payment

Covered

Policybazaar Exclusive Offer

For Pakistani Nationality

If family Size = 1 then the spouse only gets per person benefit limit of 500000 AED and room limit is 21500 AEDFor family size = More than 1 the coverage of 300000 AED is present for Parents only with room limit as 21500 AEDFamily size = More than 1 the coverage of 300000 AED is present for Parents only with room limit as 21500 AED