Orient Silk Road - Family Care : Choose Best Health Insurance Plan From Orient

Plan Summary

Plan NameSilk Road - Family Care

Cover AmountAED 1,000,000

Pharmacy LimitUpto AED 1,000,000

TPAMEDNET

Orient - Silk Road - Family Care Details

Maternity Cover

10% co-payment payable by the insured.

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 clinics

Dental and Gum Treatment

Co-Payment

20% Copay Covered with sub-limit of AED 3500

Hearing and Vision Aids

Co-Payment

20% co-payment.

Coverage Type

Clinic With Specialist

Out-Patient Services

Description

Out Patient treatment restricted to Clinics Only. From 10 PM to 8AM Out Patient treatments access is

In-Patient Services

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. (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.)Covered (The cost of accomodating a person accompanying an insured child up to the age of 16 years.)

Territorial Scope Of Coverage

Coverage

Worldwide

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 period

Network

MEDNET Silk Road

Other Services

Radiology diagnostic

10% Co Insurance20% Co InsuranceNil Co Insurance

Physiotherapy Treatment

Maximum 15 sessions per year.Prior approval of the insurance company is required.

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 (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

10% co-payment (co-payment by the insured in respect of each and every prescription.)Nil co-payment (co-payment by the insured in respect of each and every prescription.)20% co-payment (co-payment by the insured in respect of each and every prescription.)

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.