What Basic Enhanced does and does not do, before you read the insurer's own Table of Benefits.
Annual limit
AED 85,000
Medical network
NEXTCARE — PCP-RN3
Consultation
Nil deductible; not applicable for follow up within 7 days
Pharmacy
AED 1,500 with 30% co-pay
What is good
This plan's Table of Benefits does not state enough for us to pick out a highlight. The full sheet is below.
Good to know
Network Restriction: Outpatient: clinics only.
Get your price to download this plan's Table of Benefits and your quote.
Everything in the policy
Medical Network
NEXTCARE — PCP-RN3Outpatient: Clinics only
Annual Limit per Person
AED 85,000
Area of Coverage
UAE (excluding Abu Dhabi and Dubai) for both emergency and non-emergency treatment; extended to Abu Dhabi and Dubai for emergency cases only, if life threatening
In-patient Services
20% co-insurance Sublimit: AED 30,000 per In-Patient claim and Total sublimit for In-Patient per person per year of AED 65,000
Out-patient Services
Sublimit: AED 20,000 per person per year. No costs incurred for advice, consultations or treatments provided by specialists or consultants without the insured first consulting a General Practitioner.
Hospital Accommodation
General Ward
Consultation Deductible (Co-Pay)
Nil deductible; not applicable for follow up within 7 days
Diagnostics & Laboratory Services
20% coinsurance payable by the insured (MRI, CT and endoscopies with pre-authorization only)
Medicine Limit
Covered up to AED 1,500 Per person per year (including co-insurance) (Restricted to formulary products where available). 30% co-insurance in respect of every prescription.
Maternity
Not covered
Women and maternity on this plan
Men and women pay the same premium on this plan.
Get a quote to see the amount for your family.
Pre-existing / Chronic Conditions
Covered subject to a waiting period of 6 months. Sublimit on pre-existing and declared chronic conditions (after the end of the waiting period): AED 5,000 per person – per year for inpatient and 1,500 for Outpatient
Emergency Road Ambulance Services
Ground ambulance services: covered
Vaccination for Children (as per MOH, UAE)
Not covered
Specialist access
No costs incurred for advice, consultations or treatments provided by specialists or consultants without the insured first consulting a General Practitioner
Within the Network (Direct Billing)
Direct billing: 100%, subject to the applicable co-pay or deductible
Outside the Network (Reimbursement)
Not covered
Follow-up consultation co-pay (within 7 days)
The physician consultation deductible / copay is not applicable for follow up within 7 days
Coverage Criteria for Treatment outside UAE
Not covered
Day care Treatment
Inpatient and daycare treatment (including pre and post in-hospital treatment): covered up to the sublimit of in-patient per claim per person per year
Dental, hearing & vision aids, vision correction
Diagnostic and treatment services for dental and gum treatments: covered for medical emergency cases only, co-insurance 20%
Hearing Emergencies
Hearing aids: covered for medical emergency cases only, co-insurance 20%
Influenza Vaccine
Of preventive services, vaccines and immunizations, only flu vaccination is covered
Accompanying person accommodation
Companion accommodation in cases of medical necessity at the recommendation of the treating doctor: up to AED 125 per night
Vision Emergencies
Vision aids, and vision correction by surgeries and laser: covered for medical emergency cases only, co-insurance 20%
Only on this plan
Benefits this plan adds beyond the rows compared above.
Everyday care
Out-patient care you are likely to use in a normal year
Dental, hearing & vision aids, vision correction
Diagnostic and treatment services for dental and gum treatments: covered for medical emergency cases only, co-insurance 20%
Hearing Emergencies
Hearing aids: covered for medical emergency cases only, co-insurance 20%
Vision Emergencies
Vision aids, and vision correction by surgeries and laser: covered for medical emergency cases only, co-insurance 20%
Prevention & screening
Checks and vaccinations, before there is anything wrong
Influenza Vaccine
Of preventive services, vaccines and immunizations, only flu vaccination is covered
Cash back and waived fees
Money paid back to you, and charges this plan does not make
Follow-up consultation co-pay (within 7 days)
The physician consultation deductible / copay is not applicable for follow up within 7 days
Hospital and recovery
What the plan does around a hospital stay
Day care Treatment
Inpatient and daycare treatment (including pre and post in-hospital treatment): covered up to the sublimit of in-patient per claim per person per year
Accompanying person accommodation
Companion accommodation in cases of medical necessity at the recommendation of the treating doctor: up to AED 125 per night
Accommodation for a beneficiary below 16 years of age
Covered up to AED 125
Parent accommodation accompanying an insured child under 16 years of age: up to AED 125 per night
Doctor, Surgeon, Anesthetist Fees
Consultant's, surgeon's and anesthetist's fees and other fees: covered
Other benefits
Named in this plan's document and not easily grouped
Network Restriction
Outpatient: clinics only
NRI Benefit
Covered. Cashless in-patient only benefit (planned treatment) with access to a 16k hospital network in India.
Named exclusions
Written into this plan's own document, so you do not find out later
Coverage Criteria for Treatment outside UAE
Not covered
Not Covered
12 benefits named in this plan's own document. A benefit missing from this list is neither promised nor refused — ask us and we will confirm it with the insurer before you buy.
