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Benefits and Services |
Coverages (Inside Jordan) |
In-Patient Coverage
(In Hospital): | Class A | |
Maximum per person per year | 50000 | |
Maximum per case | 7500 | |
Coverage for network | Coverage for non- network | |
– Room and Board | 100% | 80% |
– I.C.U, MRI and CT Scan | ||
– Doctors (visits, surgery, anesthesia) | ||
– lab tests, medicines and diagnostic procedures | ||
– Accompanying parent for the child under the age of 13 years | ||
– Ambulance | ||
– Emergency cases | 100% |
Out-Patient Coverage
Class A | ||
Maximum forms per person | 10 forms | |
Coverage for network | Coverage for non- network | |
– Deductible for general practitioner | Platinum 1: 2 JD
Platinum 2: 100% |
5 JD MAX |
– Deductible for specialists | 10 JD MAX | |
– Medication | 80% | 50% |
– Radiology | ||
– Lab Tests | ||
– Physiotherapy annually | MAX 5 JD per visit | |
Cash Claims will be reimbursed based on the minimum prices of the Jordan Medical Association of 2008, medical network approved prices and according to the deductible percentage above, whether the claim was in or out patient. Subject to provide the insurance company with a medical form with each claim. |
Additional benefits within previously stated limits and conditions |
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Pregnant women will be provided 9 additional forms that would be used for pregnancy cases only and dispensed for the remaining duration of the pregnancy in accordance to a medical report. |
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Coverage of neonatal incubators for newborns provided having no congenital malformations with a limit of 1000 JD. |
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Coverage of minerals, calcium and vitamins which are subject to 16% sales tax. |
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Coverage of child circumcision. |
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Coverage of all children vaccines registered by the ministry of health’s national program. |
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Coverage All registered vitamins prescribed as medication by a physician for covered cases. |
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Coverage of tests and treatments of Vitamin B12 deficiency. |
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Coverage of non-fertility related hormonal disorders (outpatient procedures only). |
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Coverage of kidney stones laser lithotripsy. |
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Coverage of Mammogram screening related to covered cases. |
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Coverage of sedatives related to covered cases. |
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Coverage of ophthalmological diseases and conditions not related to vision correction. |
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Coverage of Registered eye drops medication prescribed by a physician. |
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Coverage of Accompanying parent for children under the age of 13 during inization. |
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Coverage of non-chronic dermatological diseases. |
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Coverage of ambulance utilization expenses for emergency cases. |
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Royal medical services hospitals are included within (Med. Service) network for this coverage plan. |
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Coverage of Physiotherapy treatment with a limit of 12 sessions at an appointed medical center, using one form only per year. |
“Waiting Periods” |
It is understood and agreed that the following conditions and any resulting complications will not be covered until the conclusion of their specified waiting periods mentioned below:
Waiting period: 12 months |
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Waiting period: 12 months |
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Waiting period: 12 months |
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Waiting period: 12 months |
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Waiting period: 12 months |
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Waiting period: 6 months |
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Waiting period: 6 months |
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Waiting period: 6 months |
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Waiting period: 6 months |
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Waiting period: 6 months |
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Waiting period: 6 months |
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Waiting period: 24 months |
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Waiting period: 24 months |
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* In order to obtain maternity and delivery benefits, all family members must be included in the insurance contract as per the family book.