Watania Takaful Aafiya - Plan A : Choose Best Health Insurance Plan From Watania Takaful

Plan Summary

Plan NameAafiya - Plan A

Cover AmountAED 75,000

Pharmacy LimitUpto AED 1,500

TPANAS

Watania Takaful - Aafiya - Plan A Details

Maternity Cover

Out-patient Maternity Services

Requires prior approval from the insurance company.10% Co-payment. PHC Visits to include reviews. (All Care provided by Primary Health care obstetrician for low risk or specialist obstetrician for high risk referrals.)Covered (12 months waiting period)

In-patient Maternity Services

10% co-payment payable by the Policy Holder.Maximum benefit AED 7500 per delivery

New Born Cover

New born babies not covered must be enrolled from day 1 in a separate policy

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

Waiting period of 12 months

Pre-existing diseases (PED)

Covered only if declared on additional payment

Hospital Access

Referral procedure to be followed:- Customer has to visit GP, after GP refers then customer can visit the specialist in clinics.

Dental and Gum Treatment

Co-Payment

20% Co-payment

Covered

Covered only if related to a medical emergency, subject to 20% co-payment

Hearing and Vision Aids

Co-Payment

20% Co-payment

Covered

Covered only if related to a medical emergency, subject to 20% co-payment

Coverage Type

Clinic Only

Out-Patient Services

Co-Payment - This is what you'll pay your health provider when claiming with this policy

20% Co-payment

In-Patient Services

Co-Payment - This is what you'll pay your health provider when claiming with this policy for hospitalization

20% Co-payment upto AED 1000

Room Type

Shared Room

Ambulance Service

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

Companion Accomodation

Covered up to AED 100 per nightCovered up to AED 100 per night

Territorial Scope Of Coverage

Coverage

UAE Excluding Abu Dhabi & Al Ain EmiratesInsurance Coverage is only for Northern Emirates visa holders.

Network

Aafiya APNAafiya APN

Other Services

Laboratory Tests

Covered

Radiology diagnostic

Covered

Physiotherapy Treatment

Maximum 10 sessions per year.CoveredCovered

Test, diagnosis, treatments related to surgeries in hospitals

Prior approval required from the insurance company / TPA.

Emergency Treatment

Approval required from the insurance company within 24 hours of admission to the authorized hospital.

Healthcare services for emergency cases

Approval required from the insurance company within 24 hours of admission to the authorized hospital.

Medication

Co-Payment

0.3

Limit

Maximum Limit AED 1500

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.