Takaful Emarat
Basic Enhanced Plus
The short version
NEXTCARE — PCP-RN3What Basic Enhanced Plus does and does not do, before you read the insurer's own Table of Benefits.
Annual limit
AED 135,000
Medical network
NEXTCARE — PCP-RN3
Consultation
AED 20 per visit; not applicable for follow up within 7 days
Pharmacy
AED 2,500 with 20% 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
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 135,000
Area of Coverage
UAE (excluding Abu Dhabi and Dubai) for non-emergency treatment; extended to Abu Dhabi and Dubai for emergency cases only
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 115000
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)
AED 20 per visit; 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 2,500 Per person per year (including co-insurance) (Restricted to formulary products where available). 20% co-insurance in respect of every prescription.
Maternity
Not coveredWomen 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 10,000 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 coveredSpecialist 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 coveredFollow-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 coveredDay 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 150 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 150 per night
- Accommodation for a beneficiary below 16 years of age
- Parent accommodation accompanying an insured child under 16 years of age: up to AED 150 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