National Health Insurance Co (Daman) - Care Platinum DNE with Dental

National Health Insurance Co (Daman)
Yearly Cover
AED 5,000,000.00
Deductible
AED 50 per out-patient consultation within Abu Dhabi Emirate; 20% co-insurance per out-patient consultation up to a maximum of AED 50 outside Abu Dhabi Emirate
Coverage
Worldwide
Chronic Conditions
Covered
Pre-Existing Conditions
Not Covered

In-Patient

Ambulance Coverage
Covered
Hospital Accomodation
Private Room (Standard Suite) with pre-authorization
Hospital Cash Benefit
Not Covered
Parent Accomodation
Up to AED 500 per day with pre-authorization

Out-Patient

Vaccination
Covered for children up to 6 years as per DHA on reimbursement basis
Physiotherapy
Covered with pre-authorization
Scans
Covered; pre-authorization required for in-patient scans & out-patient specialized scans
Health Checks
Diabetes screening as per DHA on reimbursement; Covered with pre-authorization: annual breast cancer screening (females above 35); annual prostate cancer screening (males above 45); colorectal cancer screening once every 2 years for FIT & once every 10 years for colonoscopy (males & females above 50); annual health check-up for a claim free year on renewal of policy
Psychiatric Treatment
Not Covered
Alternative Medicine
Up to AED 1,500 on reimbursement basis for chiropractic services & alternative medicine
Prescription Drugs
Not Covered
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Network
Network Coverage
163 Hospitals
1147 Clinics
49 Laboratories
1119 Pharmacies
238 Dentals
0 Optics
Treatment Outside Area of Cover
Not Covered
Treatment Outside Network
80% of covered non-emergency cost subject to network rates on reimbursement basis; 100% of emergency cost on reimbursement basis
Maternity
Pregnancy Cover
Covered up to AED 50,000 within the UAE & up to AED 15,000 outside the UAE; AED 25 deductible per out-patient consultation within Abu Dhabi Emirate; 10% co-insurance (maximum AED 25) per out-patient consultation outside Abu Dhabi Emirate; pre-authorization required for in-patient treatment
Newborn Baby Cover
Covered with pre-authorization
Natal Complications
Covered up to AED 150,000; pre-authorization required for in-patient treatment
Dental
Dental Coverage
Up to AED 5,000 with 20% co-pay & pre-authorization (x-rays, extractions, fillings & RCT)
Accidental Damage to Teeth
Covered