Orient D-Med (HSB) : Choose Best Health Insurance Plan From Orient

Plan Summary

Plan NameD-Med (HSB)

Cover AmountAED 150,000

Pharmacy LimitUpto AED 2,500

TPANextcare

Orient - D-Med (HSB) Details

Maternity Cover

10% co-payment payable by the Policy Holder. 8 Check-ups + 3 ante-natal ultrasound scans are covered at the Primary Health Care Centre. (All Care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals.)40 Days ( any pregnancy, which arises within 40 calendar days from policy inception will be at the discretion of the insurer)10% co-payment payable by the insured.

Waiting Period

Maternity Waiting Period

Maternity Waiting Period 40 days

Chronic Condition Waiting Period

Chronic Conditions waiting period 6 month

Pre-existing diseases (PED)

Pre-existing diseases (PED) waiting period 6 months

Dental and Gum Treatment

Co-Payment

20% co-payment.

Hearing and Vision Aids

Co-Payment

20% co-payment.

Coverage Type

Clinic Only

In-Patient Services

Room Type

In-patient services will be received in rooms of two or more beds.

Ambulance Service

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

Companion Accomodation

Maximum AED 100 per night. (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.)

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 periodAny new Chronic condition will have a waiting period of 6 months.

Network

Network - PCP/RN3

Other Services

Radiology diagnostic

20% Co-payment is applicable alongwith a prior approval from the insurance company

Physiotherapy Treatment

Prior approval of the insurance company is required.Maximum 6 sessions per year.

Test, diagnosis, treatments related to surgeries in hospitals

Covered

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

30% co-payment (co-payment by the insured in respect of each and every prescription.)

Limit

AED 2500 Annually

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.