| BENEFITS |
CLASSIC PLAN |
ADVANTAGE PLAN |
PREMIER PLAN |
| Maximum Limit ppppy: |
QR 25,000 |
QR 50,000 |
QR 100,000 |
| Consultation fee per visit |
QR 100 |
QR 150 |
QR 200 |
| Home visit fee: |
Not applicable |
QR 100 |
QR 150 |
| Room& Board/day “at preferred provider network” |
Semi-private room |
Private room |
Private room |
| Room& Board/day “at non preferred provider
network” |
QR 200 |
QR 400 |
QR 900 |
| ICU per day |
|
|
|
| Day care “surgery and/or medical” |
QR 400 |
QR 1,000 |
QR 1200 |
| Lab./ Radiology investigations |
Full refund |
Full refund |
Full refund |
| CT/ MRI “after prior approval” |
Full refund |
Full refund |
Full refund |
| Prescribed medicine& dressings |
Full refund |
Full refund |
Full refund |
| Surgeon/ Anesthetist/ Physician and professional fees |
Full refund |
Full refund |
Full refund |
| Nursing fee, medical ancillary charges and theatre
charges |
Full refund |
Full refund |
Full refund |
| Out patient surgical procedures |
Full refund |
Full refund |
Full refund |
| Physiotherapy up to 5 sessions “post an accident
and/or spinal surgery” |
Not applicable |
QR 500 |
QR 1,000 |
| Dental sub-limit ppppy “for dental extraction
and amalgam filling as a result of an accidental damage
to the natural teeth incurred during the policy period” |
Not applicable |
QR 500 |
QR 2,000 |
| Optical sub-limit ppppy “ for one refraction
test/ one pair of ordinary lenses” |
Not applicable |
Not applicable |
Not applicable |
| Maternity sub-limit for wives& married female
employees “NVD, CS, Legal abortion once ppy including
anti/ post natal care w/ waiting period 280 days from
the effective date of the policy |
Not applicable |
Not applicable |
NVD: QR 5,000- CS: QR 10,000, Abortion:
QR 2,500 |
| Local ambulance “emergency services |
Full refund |
Full refund |
Full refund |
| Pre-existing sub-limit “waiting period 365 days” |
Not applicable |
QR 2,000 |
QR 10,000 |
| Repatriation of moral remains or local burial expenses |
Not applicable |
QR 2,000 |
QR 10,000 |
| Deductible per each& every out patient claim |
20% |
20% |
20% |
| Deductible per each& every in patient claim |
10% |
Nil |
Nil |
| Co-insurance ‘for maternity, Optical, Dental,
Pre-existing and cash reimbursement expenses” |
20% |
20% |
10% |
| Helpline medical assistance |
Applicable |
Applicable |
Applicable |
| Territorial scope of cover “outside Qatar for
emergency only on the annual vacation, training&
business trip for a maximum 30 days on accumulation
basis” |
State of Qatar only |
State of Qatar, GCC, Indian subcontinents countries |
World wide Exclude USA & Canada |
