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Orient Insurance P.J.S.C - Family Care - Silver Premium -20% Max AED 50 consultation ded & 10% on all OP

Orient Insurance P.J.S.C - Family Care - Silver Premium -20% Max AED 50 consultation ded & 10% on all OP

Available in Ras Al Khaimah , Dubai , Sharjah , Fujairah , Umm Al Quwain , Ajman

Max. Annual Coverage

AED 1,000,000

Deductible

20% co-pay with a maximum of AED 50 per OP consultation & 10% co-pay on all OP services

Coverage

Worldwide

Chronic Conditions

Covered up to AED 150,000 (with pre-existing conditions)

Pre-Existing Conditions

Not Covered

In-Patient

Ambulance Coverage

Covered for in-patient treatment with pre-authorization

Hospital Cash Benefit

Not Covered

Hospital Accomodation

Private Room with pre-authorization

Parent Accomodation

Covered with pre-authorization

Out-Patient

Vaccination

Covered for children up to 6 years with 10% co-pay & pre-authorization

Psychiatric Treatment

Covered for emergency mental health treatments; 10% co-pay for out-patient treatment

Physiotherapy

Covered with pre-authorization; up to 15 sessions with 10% co-pay for out-patient treatment

Alternative Medicine

Up to AED 1,600 on reimbursement basis with 10% co-pay

Scans

Covered; pre-authorization required for in-patient treatment; 10% co-pay for out-patient treatment

Prescription Drugs

Not Covered

Health Checks

Diabetes screening covered once every year for members over 18 years with 10% co-pay

Network

Network Coverage

139 Hospitals
959 Clinics
69 Laboratories
1516 Pharmacies
9 Dentals
0 Optics

Treatment Outside Area of Cover

Not Covered

Treatment Outside Network

For elective treatment 80% of covered cost (100% for South-East Asia) subject to network rates on reimbursement basis

Maternity

Pregnancy Cover

Covered with 10% co-pay on out-patient maternity treatment; up to AED 10,000 for normal delivery and up to AED 10,000 for medically essential C-section & complications; preauthorization required for in-patient treatment

Newborn Baby Cover

Covered up to AED 150,000 for 30 days from birth; preauthorization required for in-patient treatment

Natal Complications

Covered with 10% co-pay; pre-authorization required for inpatient treatment

Dental

Dental Coverage

Up to AED 3,500 with pre-authorization & 20% co-pay on direct billing (additional 20% co-payment on reimbursement)

Accidental Damage to Teeth

Covered if treated within 3 months; 10% co-pay