What does the policy cover?
The policy covers hospitalization expenses incurred as a result of an illness/ disease or injury. These expenses include room and boarding expenses, Ambulance charges, Surgeon’s, Anesthetist’s, Specialist’s fee, Operation Theatre charges, Drugs and medicines, Diagnostics etc. Pre and post hospitalization expenses are also covered.
Who is eligible to take the cover?
An individual, his / her spouse up to the age of 65 years and their dependent children. Groups of employees, their spouse up to the age of 65 years and their dependent children.
What is not covered in the policy?
In addition to other specific exclusions, policy does not cover –
Persons below 14 days and above 65 years
Illnesses pre- existing at the time of taking the cover.
Expenses directly or indirectly resulting from or consequent to congenital defects/ deformities.
Dental treatment unless arising from disease or injury and necessitating hospitalization.
Surgery for correction of eye sight and related expenses.
What do you mean by pre and post hospitalization cover?
Pre and post hospitalization expenses mean relevant medical expenses up to 30 days prior to hospitalisation and 30 days after discharge from hospital.
Are there any options?
You have the option to select any or all of the following options along with the basic hospitalization cover – Out-patient cover for a maximum sum insured of RO 750/- which takes care of expenses towards consultations, lab tests, diagnostics etc. Personal Accident Cover of RO 3000/- in case of accidental death of an insured.
I am traveling frequently, which countries can I opt to take the cover for?
In addition to Oman, you have a choice to opt for India, Sri Lanka, Bangladesh, Thailand, Philippines, GCC, UK and Hong Kong under 3 different schemes.
What are the medical check-ups that I need to undergo to take the policy?
For all persons above the age of 40 years, a medical check-up is required. An ECG (print out with report), Fasting Blood Sugar, Post Blood Sugar and Urine Sugar reports are to be submitted for taking the cover.
Does the policy cover treatments other than Allopathic?
No, the policy provides for Allopathic treatment cover only.
Whom do I approach in case I require a treatment?
In case of an emergency or planned hospitalization, it is required that our TPA be contacted on the Helpline number provided on the reverse of the Insurance Card. The TPA shall provide all relevant details regarding the coverage, the nearest hospitals available and will also pre – authorize the hospital in case it is their network hospital.
If I go to a hospital/ clinic of my choice, who pays the bill?
In case an in-patient/ out-patient treatment is taken in a network hospital or clinic, i.e. a hospital having tie- up arrangement with our TPA, no payment is required to be made by the insured person. He gets cash-less service and 100% payment is available to him subject to conditions.
However, if the hospital chosen is a non net work hospital, the insured needs to pay his bills to the hospital and send all relevant documents along with claim form for reimbursement to the Insurance Company. Payment in this case would be restricted to 90% of the eligible amount.
Why do I need health insurance?
Health insurance will protect you and your family against any financial contingency arising due to a medical emergency.
What is a Health Card?
A health card is a card that comes along with the Policy. It is similar to an Identity card. This card would entitle you to avail cashless hospitalisation facility at any of our network hospitals.
What are the benefits of a health card?
A health card mentions the contact details and the contact numbers of the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.
Health insurance will protect you and your family against any financial contingency arising due to a medical emergency. A health card is a card that comes along with the Policy.It is similar to an Identity card. This card would entitle you to avail cashless hospitalisation facility at any of our network hospitals. A health card mentions the contact details and the contact numbers of the TPA. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.