Integra Global (Salama Islamic Arab Insurance Co (PSC)) - PremierFamily Silver Premium - Worldwide ex USA - OP 90 - with enhanced dental

Integra Global (Salama Islamic Arab Insurance Co (PSC))
Yearly Cover
AED 7,350,000.00
Deductible
10% co-pay on all out-patient services
Coverage
Worldwide ex-USA
Chronic Conditions
Covered; 10% co-pay on out-patient treatment
Pre-Existing Conditions
Not Covered

In-Patient

Ambulance Coverage
Covered
Hospital Accomodation
Private Room with pre-authorization; 50% co-pay if pre-authorization not taken
Hospital Cash Benefit
AED 200 per day if accommodation taken in Semi-Private Room
Parent Accomodation
Covered with pre-authorization; 50% co-pay if pre-authorization not taken

Out-Patient

Vaccination
Covered 100% for children up to 6 years as per DHA; up to AED 2,700 (with wellness benefit) for adults
Physiotherapy
Covered 100% with pre-authorization; maximum 50 visits for out-patient treatment; 50% co-pay if pre-authorization not taken for in-patient treatment
Scans
Covered; MRI, CT & PET scans covered only for in-patient treatment; preauthorization required for in-patient treatment; 50% co-pay if pre-authorization not taken
Health Checks
Diabetes screening as per DHA; annual pap smear; wellness up to AED 2,700 (with vaccinations) for adults; up to AED 3,600 (ages 40-50) & AED 5,500 (ages 50+) for high level physical examination once every 3 years; up to AED 1,800 (child up to 12 months) & AED 1,100 (child above 13 months) for routine medical, preventive care & hearing tests
Psychiatric Treatment
Up to AED 92,000 for in-patient & out-patient treatment (up to AED 9,200 for mental illness, maximum 15 out-of-hospital visits); up to AED 150,000 in case of an emergency; preauthorization required for in-patient treatment; 50% co-pay if pre-authorization not taken
Alternative Medicine
Up to AED 5,500 each for chiropractic services & complementary medicine
Prescription Drugs
Not Covered
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Network
Network Coverage
166 Hospitals
1111 Clinics
74 Laboratories
1947 Pharmacies
24 Dentals
0 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
100% of covered cost subject to network rates on reimbursement basis
Maternity
Pregnancy Cover
Covered 100% for out-patient maternity treatment (8 visits to PHC & 3 ultra scans for first 12 months); up to AED 7,000 for first 12 months & up to AED 75,000 thereafter per normal delivery; up to AED 10,000 for first 12 months & up to AED 110,000 thereafter per complicated pregnancy; 10% co-pay on in-patient maternity; up to AED 150,000 in case of an emergency; preauthorization required for in-patient treatment; 50% co-pay if pre-authorization not taken
Newborn Baby Cover
Covered up to AED 150,000 (including premature births, congenital conditions and birth anomalies); preauthorization required for in-patient treatment; 50% co-pay if pre-authorization not taken
Natal Complications
Up to AED 10,000 for first 12 months & up to AED 110,000 thereafter per complicated pregnancy; 10% co-pay on in-patient maternity; pre-authorization required for inpatient treatment; 50% co-pay if pre-authorization not taken
Dental
Dental Coverage
Up to AED 5,500 for General preventive (Class I); up to AED 10,000 for Basic restorative (Class II) & up to AED 6,600 for Major restorative (Class III), with 10% co-pay & pre-authorization; waiting period of 6 months for Class III & orthodontic services
Accidental Damage to Teeth
Covered 100% for in-patient treatment