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Summary of Coverage

summary

Table of Benefits (summary)

Maximum Benefit limit for each person each year

SR 250,000

Out-patient Clinic Treatment Charges:

Deduction/Portability: the percentage paid by the beneficiary(the insured) when calling on an outpatient physician inclusive all what the doctor does in terms of consultation, requests for laboratory tests, x-rays and medicine, and any other treatment requirements. Also follow up visit and referral for same disease and not for each procedure separately.

20% for each visit subject to a maximum of SR 100 per visit

Maximum consultation fee:

General Practitioner

SR 50

Specialist

SR 100

Consultant

SR 150

Rare specialization such as cardiac, brain and nuero surgery, blood vessels surgery and micro specializations as per Saudi Health Specializations Board. (Beneficiary examined according to services provision sequence except when service is not available in the service providing facility)

SR 250

In-patient charges:
Deduction/Portability

None

Daily accommodation and catering limit for patient including bed, nursing, visits, medical supervision and catering. Medicines and medical supplies requested by the doctor are excluded.

Shared room, maximum SR 600/day

Daily accommodation and catering limit for accompanying person

Shared room, maximum SR 150/day

Pregnancy and delivery includes Normal Delivery, Post-natal and anti-natal services. However, Caesarean Section, legal Abortion and maternity complications are covered up to policy limit. (if the employee is on married status)

Maximum SR 15,000 during the policy period

Delivery of premature child

Maximum policy benefit limit

Dental

Maximum benefit SR 2,000 during the policy period

Optical

Maximum benefit SR 200 during the policy period

Dialysis

Maximum benefit SR 100,000 during the policy period

Acute psychiatric cases

Maximum SR 15,000 during the policy period

Repatriation of remains of deceased to original country

Maximum SR 10,000 during the policy period

Area of cover

Kingdom of Saudi Arabia

Emergency Treatment

Inside and Outside KSA for 60 days while in vacation or business trips.