Standard Benefits | Elite (AUH) – General Network | Select (AUH) – Restricted Network | Classic (AUH) – Super Restricted Network | Core (AUH) – Workers Network |
---|---|---|---|---|
AGGREGATE LIMIT | AED 500,000 per person per annum | AED 400,000 per person per annum | AED 300,000 per person per annum | AED 250,000 per person per annum |
LOCAL NETWORK | General Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Restricted Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Super Restricted Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Workers Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
OUTPATIENT LIMIT | Within the aggregate Limit . | Within the aggregate Limit . | Within the aggregate Limit . | Within the aggregate Limit |
In compliance with HAAD Circular no (DG/32/17) dated 13/08/2017 Patients seeking a second or subsequent outpatient appointment for the same specialty within 21 days, without doctor referral, will only be covered if the patient obtains pre-approval by calling the “Company” claims’ centre. This process excludes the following: Patient’s first visit for a specific symptom, children (under the age of 18), patients aged 60 years and above, health screening visits, vaccination visits, and emergencies. |
Pharmaceuticals are 80% covered with 20% copayment | Pharmaceuticals are 80% covered with 20% copayment | Pharmaceuticals are 80% covered with 20% copayment | Pharmaceuticals are 70% covered with 30% copayment upto 3000 AED per person per annum |
Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | Physician Consultation (GP):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | |
Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50per physician consultation (not applicable for follow up within 7 days) | Specialty Consultation (Specialist / Consultant):100% Covered – With Patient deductible of AED 50 per physician consultation (not applicable for follow up within 7 days) | |
Diagnostics Services: 100% Covered for Laboratory & Imaging Services with AED 30/- deductible per visit | Diagnostics Services: 100% Covered for Laboratory & Imaging Services with AED 30/- deductible per visit | Diagnostics Services: 100% Covered for Laboratory & Imaging Services with AED 30/- deductible per visit | Diagnostics Services: 100% Covered for Laboratory & Imaging Services with AED 30/- deductible per visit | |
Imaging Services to cover: | Imaging Services to cover: | Imaging Services to cover: | Imaging Services to cover: | |
X-rays | X-rays | X-rays | X-rays | |
MRI | MRI | MRI | MRI | |
CT-scan, | CT-scan, | CT-scan, | CT-scan, | |
Ultra Sound | Ultra Sound | Ultra Sound | Ultra Sound | |
Laboratory Services to cover: | Laboratory Services to cover: | Laboratory Services to cover: | Laboratory Services to cover: | |
Biochemistry | Biochemistry | Biochemistry | Biochemistry | |
Hematology | Hematology | Hematology | Hematology | |
Virology | Virology | Virology | Virology | |
Bacteriology | Bacteriology | Bacteriology | Bacteriology | |
Pathology | Pathology | Pathology | Pathology | |
OUTPATIENT APPROVAL REQUIREMENTS | CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to HAAD Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
INPATIENT COVER Subject to Prior-Approval |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
SETTLEMENT BASIS INSIDE NETWORK IN UAE | Direct Billing | Direct Billing | Direct Billing | Direct Billing |
BASIC TERRITORY | Worldwide excluding USA, Canada. | Worldwide excluding USA, Canada and Europe | UAE, Arab Countries, Middle East, Indian Sub-continent and South East Asia Countries | UAE |
TRAVEL EXTENSION (OUTSIDE BASIC TERRITORY) |
Worldwide, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy. Reimbursement will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest tariff. |
Worldwide excluding USA & Canada, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 60 days during the Period of policy. Reimbursement will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest tariff. |
Not Covered | Arab Countries, South East Asia, and Indian Sub-continent, Applicable only in case of emergency while on vacation or business trip provided the maximum aggregate period of stay does not exceed 60 days during the Period of policy. Reimbursement will be up to 80% of reasonable & customary charges applicable in the in the country of treatment subject to not exceeding the applicable UAE network highest tariff. |
INTERNATIONAL ASSISTANCE | While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
Not Covered | Not Covered | Not Covered |
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 60 days outside UAE |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: are subject providing proper documentation. Lab and Imaging Services: are subject providing proper documentation. Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: are subject providing proper documentation. Lab and Imaging Services: are subject providing proper documentation. Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: are subject providing proper documentation. Lab and Imaging Services: are subject providing proper documentation. Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: are subject providing proper documentation. Lab and Imaging Services: are subject providing proper documentation. Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
OUTSIDE UAE while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy |
Treatment Outside UAE inside the Basic Territory: Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Covered as mentioned under the clause of travel extension. |
Treatment Outside UAE inside the Basic Territory: Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Covered as mentioned under the clause of travel extension. |
Treatment Outside UAE inside the Basic Territory: Covered at 80% with applicable deductible, up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Covered as mentioned under the clause of travel extension. |
Treatment Outside UAE inside the Basic Territory: N/A Treatment Outside UAE Outside the Basic Territory: Covered as mentioned under the clause of travel extension. |
EMERGENCY & TREATMENT NOT AVAILABLE WITHIN NETWORK in UAE | Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any) | Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any) | Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any) | Covered 100% within UAE (Subject to policy terms, conditions & exclusions and applicable deductible/co-payment if any) |
ROOM TYPE | Private Room | Private Room | Private Room | Semi Private Room |
PARENT ACCOMMODATION | Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 300/- per night) | Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) | Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) | Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) |
ACCOMPANYING PERSON | Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 300/- per night) |
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) |
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) |
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) |
LOCAL AMBULANCE | Transportation services for medical emergencies inside the UAE by an authorized party is 100% covered | Transportation services for medical emergencies inside the UAE by an authorized party is 100% covered | Transportation services for medical emergencies inside the UAE by an authorized party is 100% covered | Transportation services for medical emergencies inside the UAE by an authorized party is 100% covered |
PHYSIOTHERAPY | 100% Covered, subject to prior approval | 100% Covered, subject to prior approval | 100% Covered, subject to prior approval | 100% Covered, subject to prior approval |
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY Waiting period of 180 days on In-Patient cases only (unless there is proof of continuity of health insurance coverage). Subject to Prior Approval. |
1. Deductible: AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: Covered up to aggregate. 3. Out Side Abu Dhabi: Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section. The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits. Emergency inside UAE covered 100% up to the policy limit Treatment not available within the network is covered 100% up to maternity limit within UAE. |
1. Deductible: AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: Covered up to aggregate. 3. Out Side Abu Dhabi: Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section. The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits. Emergency inside UAE covered 100% up to the policy limit Treatment not available within the network is covered 100% up to maternity limit within UAE. |
1. Deductible: AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: Covered up to aggregate. 3. Out Side Abu Dhabi: Covered up to AED 15,000/- for Normal Delivery and for Cesarean Section. The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits. Emergency inside UAE covered 100% up to the policy limit Treatment not available within the network is covered 100% up to maternity limit within UAE. |
1. Deductible: AED 500/- per Delivery & AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: Covered up to aggregate. 3. Out Side Abu Dhabi: Covered up to AED 10,000/- for Normal Delivery and Cesarean Section. The antenatal care (visits, ultra sounds, etc…) is inclusive of the above limits. Emergency inside UAE covered 100% up to the policy limit Treatment not available within the network is covered 100% up to maternity limit within UAE. |
WORK RELATED ACCIDENTS As per Federal Law No. 8 of 1980 concerning the regulation of work relation as amended and applicable laws in this regard. |
Covered inside Abu Dhabi only. | Covered inside Abu Dhabi only. | Covered inside Abu Dhabi only. | Covered inside Abu Dhabi only. |
OTHER BENEFITS | Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
ADDITIONAL BENEFITS | ||||
ORGAN TRANSPLANT | Covered, only for Heart, Kidney and Liver up to maximum of AED 50,000/-, subject to Prior Approval. Organ donation, expenses of the donor and acquisition of the organ are excluded. |
Not Covered | Not Covered | Not Covered |
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, Chiropractic, Homeopathy, Traditional Chinese Medicine, Ayurveda, Osteopathy, Hypnotism, Aromatherapy |
Covered up to 2,500/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
Covered up to 1,500/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
Not Covered | Not Covered |
HOME NURSING | Covered up to maximum of 4 week with a sublimit of 5,000/- (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. On Reimbursement basis only This benefit will be covered without limiting or affecting any minimum benefit as per health insurance law |
Covered up to maximum of 4 week with a sublimit of 2,000/- (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. On Reimbursement basis only This benefit will be covered without limiting or affecting any minimum benefit as per health insurance law |
Covered up to maximum of 4 week with a sublimit of 2,000/- (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. On Reimbursement basis only This benefit will be covered without limiting or affecting any minimum benefit as per health insurance law |
Not Covered |
ROUTINE VACCINATIONS | Covered up to maximum of AED 1,000/- for children up to 6 yrs only As Per DOH Guidelines (Subject To Prior Approval) |
Covered up to maximum of AED 1,000/- for children up to 6 yrs only As Per DOH Guidelines (Subject To Prior Approval) |
Not Covered | Not Covered |
PSYCHIATRIC TREATMENTS | Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only |
Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only |
Not Covered Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only |
Not Covered Transient mental disorder or an acute reaction to stress are covered up to policy limit in UAE only |
VITAMINS | Covered if prescribed by doctor as a part of treatment and not as a supplement | Covered if prescribed by doctor as a part of treatment and not as a supplement | Covered if prescribed by doctor as a part of treatment and not as a supplement | Covered if prescribed by doctor as a part of treatment and not as a supplement |
REHABILITATION IMMEDIATELY AFTER ACUTE MEDICAL TREATMENT | Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi Inside UAE (Elective cases only): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
ROUTINE DENTAL | Covered subject to prior approval up to AED 3,000/- per person per annum with 20% copayment on all procedures, the covered procedures are: Examination Required tooth cleaning (following treatment only) once a year Fillings Root Treatment Tooth extraction X-Ray Local Anesthesia Prescribed drugs |
Covered subject to prior approval up to AED 2,000/- per person per annum with 20% copayment on all procedures, the covered procedures are: Examination Required tooth cleaning (following treatment only) once a year Fillings Root Treatment Tooth extraction X-Ray Local Anesthesia Prescribed drugs |
Not Covered | Not Covered |
OPTICAL BENEFITS | Prior approval is required. The cover is up to maximum annual limit of AED 1,000/- per member. Direct Billing is available within the designated Optical Network. The cover includes the following only: 1, One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum. 2, Lenses for spectacles are covered once a year inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription 3, Any other services related to correction of vision are not covered. |
Prior approval is required. The cover is up to maximum annual limit of AED 1,000/- per member. Direct Billing is available within the designated Optical Network. The cover includes the following only: 1, One elective diagnostic service for correction of vision in a licensed healthcare provider in a medical center or hospital per person per annum. 2, Lenses for spectacles are covered once a year inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription 3, Any other services related to correction of vision are not covered. |
Not Covered | Not Covered |
IN HOSPITAL CASH BENEFIT | Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE |
AIR TICKET FARE | Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum for every ticket. |
Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum for every ticket. |
Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 50% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum for every ticket. |
Not Covered |
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. |
Standard Benefits | Elite (DXB) – General Network | Select (DXB) – Restricted Network | Classic (DXB) – Super Restricted Network | Core (Dubai) – Workers Network |
---|---|---|---|---|
AGGREGATE LIMIT | AED 500,000 per person per annum | AED 400,000 per person per annum | AED 300,000 per person per annum | AED 150,000 per person per annum |
LOCAL NETWORK | General Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Restricted Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Super Restricted Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Worker Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
SETTLEMENT BASIS INSIDE NETWORK IN UAE | Direct Billing | Direct Billing | Direct Billing | Direct Billing |
BASIC TERRITORY | Worldwide excluding USA, Canada. | Worldwide excluding USA, Canada and Europe | UAE, Arab Countries, Middle East, Indian Sub-continent and South East Asia Countries | UAE |
INTERNATIONAL ASSISTANCE | While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
Not Covered | Not Covered | Not Covered |
EMERGENCY MEDICAL TREATMENT INSIDE UAE | Within all emirates of the UAE subject to policy terms and conditions | Within all emirates of the UAE subject to policy terms and conditions | Within all emirates of the UAE subject to policy terms and conditions | Within all emirates of the UAE subject to policy terms and conditions |
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 60 days outside UAE | 1. Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: Covered with 20% Co-payment and applicable deductible Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. 2. Inpatient Treatment: |
1. Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: Covered with 20% Co-payment and applicable deductible Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. 2. Inpatient Treatment: |
1. Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: Covered with 20% Co-payment and applicable deductible Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. 2. Inpatient Treatment: |
1. Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: Covered with 20% Co-payment and applicable deductible Lab and Imaging Services: Covered with 20% Co-payment and applicable deductible Reimbursement At incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on 80% reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. 2. Inpatient Treatment: |
OUTSIDE UAE while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy |
Treatment Outside UAE inside the Basic Territory: Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Not covered. |
Treatment Outside UAE inside the Basic Territory: Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Not covered. |
Treatment Outside UAE inside the Basic Territory: Covered at 80% up to reasonable and customary charges applicable in the country of treatment on reimbursement basis only subject to not exceeding the applicable UAE network highest tariff. Treatment Outside UAE Outside the Basic Territory: Not covered. |
Treatment Outside UAE inside the Basic Territory: Not covered. Treatment Outside UAE Outside the Basic Territory: Not covered. |
IN-PATIENT TREATMENT AT AUTHORIZED HOSPITALS ü Subject to Prior Approval. |
In-patient services will be received in private room Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 100/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
In-patient services will be received in private room Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 100/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
In-patient services will be received in private room Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 100/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
In-patient services will be received in semi private room Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, (up to a maximum of Dhs. 150/- per night) Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 100/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY ü Subject to Prior Approval. |
Out-patient ante-natal services: 10% coinsurance payable by the insured 8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in UAE Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols 3 ante-natal ultrasound scans In-patient maternity services: New born cover: |
Out-patient ante-natal services: 10% coinsurance payable by the insured 8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in UAE Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols 3 ante-natal ultrasound scans In-patient maternity services: New born cover: |
Out-patient ante-natal services: 10% coinsurance payable by the insured 8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in UAE Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols 3 ante-natal ultrasound scans In-patient maternity services: New born cover: |
Out-patient ante-natal services: 10% coinsurance payable by the insured 8 visits to PHC; all care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals. Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in UAE Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols 3 ante-natal ultrasound scans In-patient maternity services: New born cover: |
OUT-PATIENT IN AUTHORIZED OUT- PATIENT CLINICS OF HOSPITALS, CLINICS & HEALTH CENTERS | Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy treatment services: 20% coinsurance payable per session subject to Prior approval of the insurance company. Drugs and other medicines: 20% payable by the insured in respect of each and every prescription |
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy treatment services: 20% coinsurance payable per session subject to Prior approval of the insurance company. Drugs and other medicines: 20% payable by the insured in respect of each and every prescription |
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy treatment services: 20% coinsurance payable per session subject to Prior approval of the insurance company. Drugs and other medicines: 30% payable by the insured in respect of each and every prescription |
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: 20% coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy treatment services: 20% coinsurance payable per session subject to Prior approval of the insurance company. Drugs and other medicines: 30% payable by the insured in respect of each and every prescription upto AED 3000 per person per annum |
PREVENTIVE SERVICES, VACCINES AND IMMUNIZATIONS | Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
EXCLUDED HEALTHCARE SERVICES EXCEPT IN CASES OF MEDICAL EMERGENCIES | Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
IN HOSPITAL CASH BENEFIT | Covered subject to Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered subject to Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered subject to Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE | Covered subject to Prior Approval up to AED 150/- per day up to maximum 21 days in case of free hospitalization inside UAE |
ORGAN TRANSPLANT | Covered, only for Heart, Kidney and Liver, excluding organ donation, expenses of the donor and acquisition of the organ up to maximum of AED 50,000/-, subject to Prior Approval | Not covered | Not covered | Not covered |
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY | Covered, up to maximum of AED 10,000/- On Reimbursement basis only subject to Prior Approval |
Covered, up to maximum of AED 10,000/- On Reimbursement basis only subject to Prior Approval |
Covered, up to maximum of AED 10,000/- On Reimbursement basis only subject to Prior Approval |
Covered, up to maximum of AED 10,000/- On Reimbursement basis only subject to Prior Approval |
EMERGENCY EVACUATION | Covered for non-availability of treatment only on reimbursement basis; subject to Prior Approval | Covered for non-availability of treatment only on reimbursement basis; subject to Prior Approval | Covered for non-availability of treatment only on reimbursement basis; subject to Prior Approval | Covered for non-availability of treatment only on reimbursement basis; subject to Prior Approval |
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, Chiropractic, Homeopathy, Traditional Chinese Medicine, Ayurveda, Osteopathy, Hypnotism, Aromatherapy |
Covered up to 2500/- with 20% coinsurance for consultations and medications only. If prescribed by a licensed specialist |
Covered up to 1500/- with 20% coinsurance for consultations and medications only. If prescribed by a licensed specialist |
Not covered | (Homeopathy & Ayurveda) Covered up to 2500/- with 20% coinsurance for consultations and medications only. If prescribed by a licensed specialist |
HOME NURSING | Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit) Under the supervision of specialist or consultant. On Reimbursement basis only |
Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit) Under the supervision of specialist or consultant. On Reimbursement basis only |
Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit) Under the supervision of specialist or consultant. On Reimbursement basis only |
Covered up to maximum of 14 days with a sub-limit of 2,500/- (inclusive of the Annual Limit) Under the supervision of specialist or consultant. On Reimbursement basis only |
PATIENT SUPPORT PROGRAMME (PSP) | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder |
ROUTINE DENTAL Coverage subject to reasonable and customary charges on Reimbursement Basis as per out of network procedure in any licensed clinic (if reimbursement is allowed) or in the appropriate dental network on Direct Billing Basis. |
Covered subject to prior approval up to AED 3,000/- per person per annum with 20% copayment on all procedures, the covered procedures are: Examination Required tooth cleaning (following treatment only) once a year Fillings Root Treatment Tooth extraction X-Ray Local Anesthesia Prescribed drugs |
Covered subject to prior approval up to AED 2,000/- per person per annum with 20% copayment on all procedures, the covered procedures are: Examination Required tooth cleaning (following treatment only) once a year Fillings Root Treatment Tooth extraction X-Ray Local Anesthesia Prescribed drugs |
Not Covered | Not Covered |
PSYCHIATRIC TREATMENTS | Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit |
Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit |
Not Covered | Covered on 80% Reimbursement Basis up to 10,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit |
OPTICAL BENEFITS | Prior approval is required. The cover is up to maximum annual limit of AED 1,000/- per member. Direct Billing is available within the designated Optical Network. The cover includes the following only: |
Prior approval is required. The cover is up to maximum annual limit of AED 1,000/- per member. Direct Billing is available within the designated Optical Network. The cover includes the following only: |
Not Covered | Not Covered |
AIR TICKET FARE | Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum per treatment. |
Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum per treatment. |
Air Ticket fare, will be subject to: 1. Treatment within the member’s eligible geographical area for elective treatments as per policy. 2. Inpatient treatments. 3. Cost of treatment is less than 70% of the applicable network customary tariff of the country of policy issuance (including the cost of air fare). 4. Airfare class : Economy. 5. Reimbursement for the patients airfare (no airfare for companions). 6. Reimbursement will be limited to AED 2000/- maximum per treatment. |
Not Covered |
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. |
INFLUENZA VACCINE | Once per Annum |
Standard Benefits | International + | International |
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AGGREGATE LIMIT | AED 1,500,000 per person per annum | AED 1,000,000 per person per annum |
LOCAL NETWORK | Comprehensive Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Comprehensive Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
OUTPATIENT LIMIT In compliance with HAAD Circular no (DG/32/17) dated 13/08/2017 Patients seeking a second or subsequent outpatient appointment for the same specialty within 21 days, without doctor referral, will only be covered if the patient obtains pre-approval by calling the “Company” claims’ centre. This process excludes the following: Patient’s first visit for a specific symptom, children (under the age of 18), patients aged 60 years and above, health screening visits, vaccination visits, and emergencies. |
Within the aggregate Limit. Pharmaceuticals are 80% covered Physician Consultation (GP):AED 50 (not applicable for follow up within 7 days) Specialty Consultation (Specialist / Consultant):AED 50 (not applicable for follow up within 7 days) Diagnostics Services: 100% Covered for Laboratory & Imaging Services Imaging Services to cover: X-rays MRI CT-scan Ultra Sound Laboratory Services to cover: Biochemistry Hematology Virology Bacteriology Pathology |
Within the aggregate Limit. Pharmaceuticals are 80% covered Physician Consultation (GP): 50 (not applicable for follow up within 7 days) Specialty Consultation (Specialist / Consultant):AED 50 (not applicable for follow up within 7 days) Diagnostics Services: 100% Covered for Laboratory & Imaging Services Imaging Services to cover: X-rays MRI CT-scan Ultra Sound Laboratory Services to cover: Biochemistry Hematology Virology Bacteriology Pathology |
OUTPATIENT APPROVAL REQUIREMENTS | CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to DOH Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
CT and MRI scans Endoscopies All additional therapies e.g. Physiotherapy, Chiropractic, etc. Any additional benefits to DOH Basic Product such as Optical and Dental treatment, Psychiatry, vaccination, etc. |
INPATIENT COVER | Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). |
SETTLEMENT BASIS INSIDE NETWORK IN UAE | Direct Billing | Direct Billing |
BASIC TERRITORY | Worlwide Including USA & Canada | Worlwide Excluding USA & Canada |
TRAVEL EXTENSION (OUTSIDE BASIC TERRITORY) |
N/A | Not Covered |
INTERNATIONAL ASSISTANCE | While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 90 days outside UAE |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: covered with 20% Co-payment Lab and Imaging Services: covered with 20% Co-payment Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: covered with 20% Co-payment Lab and Imaging Services: covered with 20% Co-payment Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. Inpatient Treatment: |
OUTSIDE UAE while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy |
Treatment Outside UAE inside the Basic Territory: Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while Inpatient is covered on Direct billing where Network is available). Treatment Outside UAE Outside the Basic Territory: |
Treatment Outside UAE inside the Basic Territory: Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while Inpatient is covered on Direct billing where Network is available). Treatment Outside UAE Outside the Basic Territory: |
EMERGENCY & TREATMENT NOT AVAILABLE WITHIN NETWORK WITHIN UAE | Covered 100% at actual cost | Covered 100% at actual cost |
ROOM TYPE | Private Room | Private Room |
PARENT ACCOMMODATION | Daily benefit for one parent accompanying an insured child under 14 years of age, Full Refund | Daily benefit for one parent accompanying an insured child under 14 years of age, Full Refund |
ACCOMPANYING PERSON | Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) |
Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) |
LOCAL AMBULANCE | Transportation services for medical emergencies by an authorized party is 100% covered | Transportation services for medical emergencies by an authorized party is 100% covered |
PHYSIOTHERAPY | 100% Covered, subject to prior approval | 100% Covered, subject to prior approval |
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY Waiting period of 180 days on In-Patient cases only (unless there is proof of continuity of health insurance coverage). Subject to Prior Approval. |
1. Deductible: AED 500/- per Delivery & 20% up to AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: 3. Out Side Abu Dhabi: |
1. Deductible: AED 500/- per Delivery & 20% up to AED 50/- per consultation (same conditions of OP consultations will apply). 2. Inside Abu Dhabi: 3. Out Side Abu Dhabi: |
WORK RELATED ACCIDENTS As per Federal Law No. 8 of 1980 concerning the regulation of work relation as amended and applicable laws in this regard. |
Covered inside Abu Dhabi only. | Covered inside Abu Dhabi only. |
OTHER BENEFITS | Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
Diagnostic and treatment services for dental and gum treatments emergency cases only. Hearing and vision aids, and vision correction by surgeries & ophthalmology, and laser are covered for emergency cases only. |
ADDITIONAL BENEFITS | ||
ORGAN TRANSPLANT | Covered, Full Refund, subject to Prior Approval. Organ donation, expenses of the donor and acquisition of the organ are excluded. |
Covered, up to maximum of AED 250,000/-, subject to Prior Approval. Organ donation, expenses of the donor and acquisition of the organ are excluded. |
RENAL DIALYSIS | Full Refund | Covered, up to maximum of AED 100,000/-, subject to Prior Approval. |
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: CHIROPRACTIC, OSTEOPATHY Prescribed Herbal Medicines, Acupuncture, Homeopathy, Traditional Chinese Medicine, Ayurveda, Hypnotism, Aromatherapy |
Covered up to 7,500/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
Covered up to 5,000/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
HOME NURSING | Covered following Inpatient or Day-patient Treatment upon the recommendation of your specialist, up to maximum of 60 Days (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per visit. On Reimbursement basis only |
Covered following Inpatient or Day-patient Treatment upon the recommendation of your specialist, up to maximum of 30 Days (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per visit. On Reimbursement basis only |
ROUTINE VACCINATIONS | Covered for children up to 6 yrs. only As Per DOH Guidelines (Subject To Prior Approval) |
Covered for children up to 6 yrs. only As Per DOH Guidelines (Subject To Prior Approval) |
PSYCHIATRIC TREATMENTS | Covered on 80% Reimbursement Basis up to 5,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only |
Covered on 80% Reimbursement Basis up to 3,000 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only |
VITAMINS | Covered if prescribed by doctor as a part of treatment and not as a supplement | Covered if prescribed by doctor as a part of treatment and not as a supplement |
REHABILITATION IMMEDIATELY AFTER ACUTE MEDICAL TREATMENT | Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi (except Emergency within UAE): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
Inside the Emirate of Abu Dhabi and Emergency cases within UAE: Covered as per DOH Regulations subject to prior approval. Outside the Emirate of Abu Dhabi (except Emergency within UAE): Covered subject to prior approval up to 120 days per medical condition as below: Physical Therapy to help strength, mobility & fitness – covered Occupational Therapy to help you with your daily activities – not covered Speech-Language therapy to help with speaking, understanding, reading, writing and swallowing – not covered. |
Routine Dental Examination Fillings (standard amalgam or composite) Root Canal Treatment Gum Treatment, excluding Flap Surgeries Extractions |
The cover is up to maximum annual limit of AED 3,500/- per member . | The cover is up to maximum annual limit of AED 2,000/- per member. |
OPTICAL BENEFITS One Routine eye examination Lenses for spectacles are covered once inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription |
The cover is up to maximum annual limit of AED 1,800/- per member. | Not Covered |
IN HOSPITAL CASH BENEFIT | Covered up to AED 700 per night in case of free hospitalization | Covered up to AED 500 per night in case of free hospitalization |
ROUTINE CHECK-UP: One check up every two years available after 12 months continuous cover |
Covered up to AED 1,000/- pppa | Covered up to AED 500/- pppa |
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. |
PASSIVE WAR RISK (detailed wordings in ‘Passive War Risk Cover’ Sheet) | Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following the outbreak. |
Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following the outbreak. |
Standard Benefits | International + | International |
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AGGREGATE LIMIT | AED 1,500,000 per person per annum | AED 1,000,000 per person per annum |
LOCAL NETWORK | Comprehensive Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
Comprehensive Network (Abu Dhabi National Takaful reserves the right to add or remove any medical provider to the applicable network without prior notice. When Takaful applies any changes to the existing network, The updated network list of medical providers will be sent accordingly to the policy holder.) |
SETTLEMENT BASIS INSIDE NETWORK IN UAE | Direct Billing | Direct Billing |
BASIC TERRITORY | Worlwide Including USA & Canada | Worlwide Excluding USA & Canada |
INTERNATIONAL ASSISTANCE | While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
While they are travelling abroad, insured members will be advised through our International Assistance Program (Eurocross / Mideast Assistance) upon contacting the number at the back of the medical card, about a suitable medical facility according to their medical condition. Benefit will cover mainly : 1. Evacuation and Repatriation 2. Repatriation of Mortal Remains 3. Travel Information Service 4. Referral to Medical Correspondents Abroad 5. Long Distance Medical Advice 6. Delivery of Urgent Messages 7. Transportation to Join Member 8. Return of Dependent Children 9. Compensation for Delay in the Arrival of Luggage 10. Total Loss or Disappearance of Baggage 11. Loss of Passport, Driving License, or National Identity Card Abroad For Full Details and list of Benefits, conditions & exclusions: please refer to the International assistance brochure. |
EMERGENCY MEDICAL TREATMENT | Full Refund | Full Refund |
OUT-OF-NETWORK INSIDE UAE. Claims to be submitted within 30 days inside UAE and within 90 days outside UAE | Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: covered with 20% Co-payment Lab and Imaging Services: covered with 20% Co-payment Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. |
Outpatient Treatment: Physician Consultation (GP) covered with 20% Co-payment and applicable deductible Specialist Consultation (SP) covered with 20% Co-payment and applicable deductible Pharmaceutical: covered with 20% Co-payment Lab and Imaging Services: covered with 20% Co-payment Reimbursement At 80% of the incurred cost, subject to maximum of The Applicable Network Tariff (Reasonable & Customary charges) on reimbursement basis only. Any treatment initiated outside the network will be settled as an out of Network. |
OUTSIDE UAE while on vacation or business trip provided the maximum aggregate period of stay does not exceed 90 days during the Period of policy |
Treatment Outside UAE inside the Basic Territory: Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while Inpatient is covered on Direct billing where Network is available). Treatment Outside UAE Outside the Basic Territory: N/A |
Treatment Outside UAE inside the Basic Territory: Covered at 100% subject to applicable deductible up to reasonable and customary charges applicable in the country of treatment (Out-patient is covered on reimbursement basis only, while Inpatient is covered on Direct billing where Network is available). Treatment Outside UAE Outside the Basic Territory: Not Covered |
IN-PATIENT TREATMENT AT AUTHORIZED HOSPITALS Subject to Prior Approval. |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, Full Refunf Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
Within the aggregate Limit (100% Covered Except for Exclusions) Hospital Accommodation, Inpatient Services & Inpatient Medications (Medical, Surgical & ICU). Ground transportation services in the UAE provided by an authorized party for medical emergencies. Daily benefit for one parent accompanying an insured child under 16 years of age, Full Refunf Accommodation of an accompanying person in the same room in case of critical conditions and as per recommendation of attending physician, subject to prior approval (up to a maximum of AED 150/- per night) Prior approval is required from the insurance company (For Emergency Treatment Approval required from the insurance company within 24 hours of admission to the authorized hospital). |
MATERNITY / Obstetrical & Follow up (IP & OP) FOR MARRIED FEMALES ONLY
Note: Where any condition develops which becomes life threatening to either the mother or the new born, the medically necessary expenses will be covered up to AED 150,000/- Subject to Prior Approval. |
Out-patient ante-natal services: 10% coinsurance payable by the insured Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in unable Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols ante-natal ultrasound scans In-patient maternity services: New born cover: |
Out-patient ante-natal services: 10% coinsurance payable by the insured Initial investigations to include: FBC and Platelets, Blood group, Rhesus status and antibodies ,VDRL, MSU & urinalysis, Rubella serology, HIV, Hep C offered to high risk patients, GTT if high risk. FBS , random s or A1c for all due to high prevalence of diabetes in unable Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols ante-natal ultrasound scans In-patient maternity services: New born cover: |
OUT-PATIENT | Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy : full Refund (subject to Prior approval of the insurance company) Drugs and other medicines: |
Examination, diagnostic and treatment services by authorized general practitioners, specialists and consultants: 20% coinsurance payable by the insured per visit (not to exceed Dhs.50 /-) No coinsurance if a follow-up visit made within seven days. Laboratory test services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured Radiology diagnostic services carried out in the authorized facility assigned to treat the insured person: Nill coinsurance payable by the insured In cases of non-medical emergencies, the insurance company’s prior approval is required for MRI, CT scans and endoscopies. Physiotherapy : full Refund (subject to Prior approval of the insurance company) Drugs and other medicines: |
PREVENTIVE SERVICES, VACCINES AND IMMUNIZATIONS | Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates (currently the same as Federal MOH). Preventive services as stipulated by DHA to include initially diabetes screening Frequency restricted to: Diabetes: Every 3 years from age 30 High risk individuals annually from age 18 yrs. Adult Pneumococcal Conjugate Vaccine: As per DHA Adult Pneumococcal Vaccination guidelines. Hepatitis C Virus Screening and treatment: To be followed as per the guidelines laid out in the Hepatitis C support program. Cancer Screening and treatment: To be followed as per the guidelines laid out in the Cancer support program |
EXCLUDED HEALTHCARE SERVICES EXCEPT IN CASES OF MEDICAL EMERGENCIES | Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
Diagnostic and treatment services for dental and gum treatments: Covered for Emergency cases only Subject to 20% coinsurance Hearing and vision aids, and vision correction by surgeries and laser : Covered for Emergency cases only Subject to 20% coinsurance |
IN HOSPITAL CASH BENEFIT | Covered up to AED 700 per night in case of free hospitalization | Covered up to AED 500 per night in case of free hospitalization |
ORGAN TRANSPLANT | Covered, Full Refund, subject to Prior Approval. Organ donation, expenses of the donor and acquisition of the organ are excluded. |
Covered, up to maximum of AED 250,000/-, subject to Prior Approval. Organ donation, expenses of the donor and acquisition of the organ are excluded. |
RENAL DIALYSIS | Full Refund | Covered, up to maximum of AED 100,000/-, subject to Prior Approval. |
ALTERNATIVE MEDICINE TREATMENT INCLUDING ONLY THE FOLLOWING TREATMENTS: Prescribed Herbal Medicines, Acupuncture, , Homeopathy, Traditional Chinese Medicine, Ayurveda, Hypnotism, Aromatherapy, Chiropractic, Osteopathy |
Covered up to 7,500/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
Covered up to 5,000/- With 20% Co-payment (no additional copayment outside the applicable Network) If prescribed by a licensed specialist subject to prior approval |
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY | ||
EMERGENCY EVACUATION | ||
ALTERNATIVE MEDICINE TREATMENT | ||
HOME NURSING | Covered up to maximum of 60 Days (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per visit. On Reimbursement basis only |
Covered up to maximum of 30 Days (inclusive of the Annual Limit) subject to prior approval Under the supervision of specialist or consultant. Home Visit in case of emergency (if insured member is unable to visit clinic for Out-Patient consultation due to a severe medical reason) not to exceed AED 1,000/- per visit. On Reimbursement basis only |
PATIENT SUPPORT PROGRAMME (PSP) | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder | Available for all Dubai visa holder in compliance with DHA regulations. Separate manual on the process to be provided to the policy holder |
PSYCHIATRIC TREATMENTS | Covered on 80% Reimbursement Basis up to 3,500 Dhs. per member per year (No additional copayment outside the applicable network) Subject to prior-approval Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only |
Outpatient Psychiatric Care: Not Covered Transient mental disorder or an acute reaction to stress are covered up to policy limit inside UAE only |
VITAMINS | Covered if prescribed by doctor as a part of treatment and not as a supplement | Covered if prescribed by doctor as a part of treatment and not as a supplement |
Routine Dental Examination Fillings (standard amalgam or composite) Root Canal Treatment Gum Treatment, excluding Flap Surgeries Extractions |
The cover is up to maximum annual limit of AED 3,500/- per member . | The cover is up to maximum annual limit of AED 2,000/- per member. |
OPTICAL BENEFITS One Routine eye examination Lenses for spectacles are covered once inclusive of the maximum optical limit subject to Ophthalmologist / optometrist prescription |
The cover is up to maximum annual limit of AED 1,800/- per member. | Not Covered |
ROUTINE CHECK-UP: One check up every two years available after 12 months continuous cover |
Covered up to AED 1,000/- pppa | Covered up to AED 500/- pppa |
PROSTHESIS INSERTED INTO THE BODY DURING THE COURSE OF A SURGICAL PROCEDURE | Covered if medically necessary and prescribed by a doctor to be integral part of the body. | Covered if medically necessary and prescribed by a doctor to be integral part of the body. |
PASSIVE WAR RISK (detailed wordings in ‘Passive War Risk Cover’ Sheet) | Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following the outbreak. |
Passive War and/or Passive terrorism as an innocent bystander is covered. However; Passive war is excluded in Iraq, Afghanistan& Syria and any other country where war or war like operation takes place. It is also excluded for any member who travels to any country where war has been declared or war like operations takes place and remains there for more than 28 days following the outbreak. |
Provider Name | Address | P.O.Box | Telephone |
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It is advisable to consult us for detailed assistance while filing a claim.
To file your claim online, please click on one of the following:
To file your claim through phone, please call on one of the following numbers:
Non-Motor Claims | Motor Claims | ||
---|---|---|---|
Abu DhabiTamouh Tower +971 2 410 7700
+971 2 410 7800 |
Abu Dhabi3rd floor, Ahmad Saeed Al Houtta Al Ameri Building, +971 2 419 7444
+971 2 626 0777 |
DubaiThe Regal Tower, 30th floor, Business Bay +971 4 210 8700
+971 4 210 8777 |
Al AinEmirates Islamic Bank Building, Mezzanine 1st floor, Opposite Al Ain Mall, +971 3 716 6700
+971 3 766 0555 |
Please download and complete the Claim Form.
A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.
Complete the claim form and provide all the required documents.
Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.
Submit the completed claim form and provide all the required documents.
The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.
A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
To file your claim through phone, please click here to contact us.
Please download and complete the Claim Form.
A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.
Complete the claim form and provide all the required documents.
Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.
Submit the completed claim form and provide all the required documents.
The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.
A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
Important Note:
Please make sure that Date of Loss, Nature of loss and Cause of Loss in stated.
To file your claim through phone, please click here to contact us.
Please click here to know about the Medical Claim Process.
Please download and complete the Claim Form.
A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.
Complete the claim form and provide all the required documents.
Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.
Submit the completed claim form and provide all the required documents.
The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.
A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
To file your claim through phone, please click here to contact us.
Please download and complete the Claim Form.
A claim can be filed for benefits under the policy by submitting a written intimation from the policyholder.
Complete the claim form and provide all the required documents.
Always remember to mention the event date, cause of the event and the complete contact information of the claimant while intimating the claim.
Submit the completed claim form and provide all the required documents.
The original documents will be required by Abu Dhabi National Takaful Co. PSC during the claim assessment stage.
A claim is assessed as soon as the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
In order for prompt settlement of the claim, kindly ensure that the completed claim form and all required documents are provided to Abu Dhabi National Takaful Co. PSC.
To file your claim through phone, please click here to contact us.
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Abu Dhabi National Takaful Co. PSC, Tamouh Tower, 25th Floor, Al Reem Island, P.O. Box 35335, Abu Dhabi, United Arab Emirates
Telephone: +971 2 410 7700 Fax: +971 2 410 7800 Email: info@takaful.ae
Timings: Mondays to Thursdays from 8:00 am to 5:00 pm, Fridays from 8:00 am to 12:00 pm
Tamouh Tower, 25th Floor
Marina Square, Al Reem Island
P.O. Box 35335
Abu Dhabi
+971 2 410 7700
+971 2 410 7800
Mr. Nasr K Abdul Rahman
Branch Manager – Personal Line Business & Motor Insurance
3rd floor, Ahmad Saeed Al Houtta Al Ameri Building,
Al Nahyan Camp Area. Behind the Civil Defense HQ
Google map: 53 Hameem St – Al Nahyan – E6
PO Box 35335
Abu Dhabi
+971 2 419 7400
MR. MOHAMED ADNAN ASAD
In-charge of Muroor BranchTraffic Vehicles Inspection & Registration Centre
P.O. Box 35335
Abu Dhabi
+971 2 410 7700
+971 2 449 2506
MR. SAMER AHMED HALIME
Branch ManagerAbu Dhabi National Takaful PSC., Emirates Islamic Bank Building, Mezzanine 1 Floor, Opposite Al Ain Mall, Al-Murabbaa District, P.O Box 64166, Al Ain.
+971 3 7166700
+971 3 766 0555
MR. MOHAMMAD ALBURENI
Assistant Underwriting OfficerTraffic Vehicles Inspection & Registration Centre
P.O. Box 64166
Al Ain
+971 2 449 2504
+971 3 781 1244
MR. ARJUN GC
Head of Dubai and Northern EmiratesThe Regal Tower, 30th floor, Business Bay
P.O. Box 53389
Dubai
+971 4 210 8700
+971 4 210 8777