Standard Plan
“JOFICO” Jordan French Insurance Company, offers “Standard” health insurance program which provides in-patient and out-patient coverages.
Benefits and Services Provided |
- Providing medical forms at clinics and emergency centers which allows subscribers to only use medical insurance card for treatments.
- Issuing a medical insurance card with JOFICO’s logo and information of the beneficiary.
- Med.Service network contracted with more than 3800 medical centers with different specialties.
- Med.Service provides Medical Pre-approval Center with high efficiency operating 24/7 to facilitate hospital admissions and give approvals as fast as possible.
- Quick and efficient settlement of medical reimbursement claims upon completion of all necessary documents.
Schedule of Benefits (Inside Jordan) |
- In Patient Cover
Class A | ||
Maximum per person per year | 25000 | |
Maximum per case | 7500 | |
Coverage for network | Coverage for non-network | |
– Room and Board | 100% | 70% |
– I.C.U, MRI & CT Scan | 100% | 70% |
– Doctors; (visits, surgery, anesthesia) | 100% | 70% |
– Lab tests, medicines and diagnostic procedures | 100% | 70% |
– Accompanying parent for the child under the age of 13 years | 100% | 70% |
– Ambulance | 100% | 70% |
- Out Patient Cover
Coverage | |||
Maximum per person per year | 900 | ||
Maximum forms per person | 12 | ||
Coverage for network | Coverage for non- network | ||
– Deductible for general practitioner | One JD | 70% | |
– Deductible for specialists. | Two JDs | 70% | |
– Drugs max per disability | 80% | 70% | |
– X-ray max per disability | 4 visits | 70% | |
– Labs max per disability | 4 visits | 70% | |
– Physiotherapy annually | 100 JD for 10 visits yearly | 100 JD for 10 visits yearly | |
Waiting Periods |
Waiting periods not apply to those who already are in the insurance at the beginning of contract, while applied to new participants are added after their entry date.
Endoscopy and lithotripsy | Waiting period 6 months |
Hotripsy , ulcer and gallbladder | Waiting period 6 months |
Spine and joints diseases | Waiting period 6 months |
Hemorrhoids, fistulas and anal fissures | Waiting period 6 months |
Tonsillectomy adenoids, and paranasal sinuses | Waiting period 6 months |
Non-cosmetic perversion | Waiting period 6 months |
Uterine endometriosis and hysterectomy | Waiting period 12 months |
Chronic diseases (heart disease, arterial and venous diseases, diabetes, hypertension, etc.) | Waiting period 12 months |
* Exclude previous diseases or disorders, which exist before the issuance of this policy or during waiting periods.
Exclusions |
(Unless stated otherwise in the terms and conditions of the policy)No reimbursement shall be made for any disability treatment, services, diagnostic tests, or complications as a result of injury or illness caused directly or indirectly, totally or partially by:
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0.00JD