Adamjee Silk Road : Choose Best Health Insurance Plan From Adamjee

Plan Summary

Plan NameSilk Road

Cover AmountAED 1,000,000

Pharmacy LimitUpto AED 1,000,000

TPAMEDNET

Adamjee - Silk Road 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

Referral procedure to be followed:- Direct access to specialist in the clinincs

Dental and Gum Treatment

Co-Payment

20% co-payment upto AED 3500

Covered

Hearing and Vision Aids

Co-Payment

20% co-payment

Covered

Only In case of emergency due to accidents.

Coverage Type

Clinic With Specialist

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.

Description

From 10 PM to 8 AM Out Patient treatments access is available at Network Hospital

Out-Patient (OP Services)

From 10 PM to 8 AM Out Patient treatments access is available at Network Hospital

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

Maximum AED 100 per night.Covered

Territorial Scope Of Coverage

Coverage

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

Network

Mednet - Silk roadMednet - Silk road

Other Services

Laboratory Tests

10% co-payment20% co-payment0% Co-insurance

Radiology diagnostic

10% co-payment0% Co-insurance20% co-payment

Physiotherapy Treatment

10% co-paymentMaximum 15 sessions per year.Prior approval of the insurance company is required.0% Co-payment20% co-payment

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

10% co-payment20% 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

Family size = More than 1 the coverage of 300000 AED is present for Parents only with room limit as 6500 AEDIf family Size = 1 then the spouse only gets per person benefit limit of 400000 AED and room limit is 12000 AED