Watania Takaful EBP : Choose Best Health Insurance Plan From Watania Takaful

Plan Summary

Plan NameEBP

Cover AmountAED 150,000

Pharmacy LimitUpto AED 1,500

TPANAS

Watania Takaful - EBP Details

Maternity Cover

Out-patient Maternity Services

Requires prior approval from the insurance company.10% coinsurance payable by the insured. 8 visits to PHC Visits to include reviews.10% co-payment payable by the Policy Holder. (All Care provided by Primary Health care obstetrician for low risk or specialist obstetrician for high risk referrals.)

In-patient Maternity Services

10% co-payment payable by the insured.Maximum benefit AED 7,000 per normal delivery, AED 10,000 for medically necessary C-section, complications and for medically necessary termination (All limits include co-payment).

New Born Cover

Cover from 30 days from birth BCD, Hepatitis B and neo-natal screening test.

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 6 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

In case of emergency only.

Hearing and Vision Aids

Co-Payment

20% co-payment.

Covered

In case of emergency only.

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 (Services are provided in authorized out-patient clinics of hospitals, clinics and health centers)

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 500. Aggregate Co-payment upto AED 1000 (In-patient treatment at authorized hospitals)

Room Type

Semi-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.)Maximum AED 100 per night. (The cost of accomodating a person accompanying an insured child up to the age of 16 years.)

Territorial Scope Of Coverage

Coverage

Insurance Coverage is only for Dubai visa holders.UAE (except Abu Dhabi & Al Ain) and extended to ISC

Pre-Existing and Chronic Conditions

Waiting Period

6 Months (Treatment for chronic and pre-existing conditions excluded for first 6 months of first scheme membership. After 6 months covered to the annual policy limit subject to declaration)

Network

NAS-VNNAS-VNNAS-VN

Other Services

Laboratory Tests

20% Co Insurance

Radiology diagnostic

20% Co Insurance ,In Case of non-medical emergiencies, the insurance company's prior approval is required for MRI, CT scans and endoscopies.

Physiotherapy Treatment

20% co-payment.Prior approval of the insurance company is required.Maximum 6 sessions per year.

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

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

Limit

AED 1,500 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.