Plan Summary
Classic Bronze
Plan Summary – Classic Bronze
Plan
Classic Bronze Plan is a cost effective health insurance plan having core benefits in an optimal manner. This plan is offered to Dubai and Northern Emirate corporate customers with a choice of network to allow flexibility and ease to the members and is in compliance with the Health Insurance Law applicable in the Emirate of Dubai.
Concept
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Choice of Network between: Option 1: Essential 5 Option 2: 06 For services availed within the plan’s list of providers (Network) – 100% on direct billing For services outside the network (Non-Network) – No Coverage (except in case of Emergency)
Some services may follow specific benefit limits or Co-insurance. These conditions would be listed in your policy. Eligibility
Offered to groups with a minimum group size of 50 employees.
Annual Limit
AED 160,000 Per Person Per Policy Year
Territorial Limit
UAE
Emergency Treatment
UAE
Network (Allowing direct billing at designated providers)
Pre-existing conditions
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Network Within UAE: Option 1: Essential 5 Option 2: 06 In & out-patient on direct billing in Provider Network Network Outside UAE: Not applicable Covered with a 6 months waiting period for Inpatient and Outpatient treatments.. No waiting period if pre-requisition of uninterrupted (pre) coverage is fulfilled.
Reimbursement
100% in Non-Network providers for Emergency cases only
Inpatient Benefits
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Inpatient & Day Treatment Up to the relevant annual benefit limit Per Person (including Pre & Post In Hospital Treatment covered) Accommodation Type- General Room (2 or more beds) Consultant’s, Surgeon’s & Anesthetist’s Fees and other fee Hospital Accommodation & Services Childbirth or any pregnancy related complications New born care Parent Accommodation for accompanying an Insured Child under 16 years of age Companion Accommodation in cases of medical necessity at the recommendation of the treating doctor
Plan Summary – Classic Bronze
Outpatient Benefits
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Physician Consultation (Access to outpatient specialists only upon referral by a General Practitioner) Pharmaceuticals through Pharmacy Benefit Management Diagnostic tests such as X-rays, blood tests, MRI Physiotherapy sessions
Other Benefits
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Preventive services, vaccines and immunizations Repatriation of mortal remains to country of origin Emergency Treatment: Diagnostic and treatment services for dental and gum treatment Hearing and vision aids, and vision correction by surgeries and laser
Coinsurance
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A co-insurance of 30% is applicable for pharmaceuticals A co-insurance of 10% is applicable for Physician Consultation and outpatient maternity treatments
Exclusions
Refer to the Policy Wording
Specific Conditions
The following benefits are covered with applicable sublimits: Parent and Companion Accommodation, pharmaceuticals, Physiotherapy, Repatriation, Maternity benefits.
Important Note: This product overview is for information purposes only. The complete list of benefits, definitions, exclusions, terms and conditions will be set out in the specific policy agreed between yourself and Daman. While every effort is made to ensure the accuracy of the content, Daman cannot be held liable for any typographical errors, errors of fact or any other error or inconsistency found in this document.
PM-E-0031-ClB-010315-V1R1-P
www.damanhealth.ae 800 4 DAMAN (32626)
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