A wide range of hospitalization coverage
General Benefits
Age limit
0 - 60
Annual Aggregate Limit
16,000 JOD
Network
All our hospitals except (Al-Kahldi Medical Center, Arab Medical Center, Istishari Hospital, Abdali Medical Center, Farah Hospital)
In-Hospital Benefits
A
Annual limit per member per case for in hospital coverage
4,000 JOD
Co-payment on In-Hospital benefits
0%
Medical, Surgical or Endoscopic Treatment
Needs prior approval
(Day Cases) Diagnostic Endoscopic/Surgical Procedures
Covered with copayment 20%
Emergency Treatment (ER room)
Excluded
Pre-Operative Tests
Covered
Physiotherapy Treatment related to a Covered Hospitalization
Covered
Morgue expenses Or Burial indemnity
400 JOD
Hospital Indemnity
Excluded
Home Care following Hospitalization
Excluded
Parental Accommodation (for children below 13 Years)
Covered
Appendectomy by Laparoscopy
Covered
Guaranteed Renewability
Excluded
Hernia
Covered after 6 months waiting period
Nose Surgeries
Covered after 6 months waiting period
Maternity and Congenital Cases for GM Baby
Delivery (Normal)
Covered up to 600 JOD after one year waiting period
Delivery (Ceasarian)
Covered up to 900 JOD JOD after one year waiting period
Nursery Boarding Cost
Covered
Incubator for baby
Covered up to 500
Pediatric Consultation
Covered, Only one consultation
Coverage from day zero
Covered
Circumcision
Covered
Epidural
Excluded
Free of Charge Insurance for Eligible New Born - First Year
Excluded
Free of Charge Insurance for Eligible New Born - Extra Year
Excluded
Congenital Cases
Covered up to 1,000 JOD
Maternity Complications (including Medically Justified Abortion)
Covered up to 300 JOD after one year waiting period
Amniocentesis & Triple Test
Excluded
Ultrasound
Excluded
Abortion Not Medically Mandated
Excluded
Congenital
Congenital diseases
Excluded
Accidents
Work Related Accidents
Excluded
Dental and Gum Medical or Surgical Treatment including Prothesis and Disorder of Temporomandibular Joints
Covered
Cosmetic and/or Plastic Surgeries
Covered
Nose Related Surgeries
Covered
The Cost of All Kinds of Prothesis
Covered
Pacemaker
Excluded
Rehabilitation
Rehabilitation Post Cardio-Vascular Accident
Excluded
Prosthesis (Not Accident Related)
Mesh Related to Hernia Surgeries (Ordinary Mesh only)
Covered after 6 months waiting period
Coronary Stent
Covered after 6 months waiting period
Cardiac Valve
Covered after 6 months waiting period
Other Prosthesis
Covered
Organ Transfer and Transplantation
Surgery of Organ Transfer and/or Transplantation for the recipient
Covered
Surgery of Bone Marrow Transfer and/or Transplantation
Covered
Cornea Transplant (Surgery Cost)
Covered
Cost of Organ
Excluded
Cancer
Radiotherapy
Excluded
Chemotherapy
Excluded
Surgery
Excluded
Breast Re-Construction
Excluded
Heart Procedures
Angioplasty
Covered after 6 months waiting period
Open Heart
Covered after 6 months waiting period
Valves Related to heart Surgeries
Covered after 6 months waiting period
Kidney Diseases
Peritoneal dialysis, Hemodialysis and Arterio Venostomy
Excluded
Acute Renal Failure
Excluded
Psychatric Illnesses
Mental or Psychiatric Disorders, Nervous Breakdown and Psychological Tests or Evaluations
Excluded
Rest Cures, Sanatorium, Custodial Care and Period of Quarantine. Weight Control Procedures and Surgeries
Excluded
Sexual Diseases, Infertility and Birth Control
Sexually Transmitted Diseases and all related treatments,including HIV
Excluded
Birth Control Procedures
Excluded
Endometriosis
Excluded
Fallopian Tubes Legation
Excluded
Impotence/Sterility Treatment
Excluded
Varicoceles
Covered after one year waiting period
Medication and Treatments Related to Infertility (e.g. Spermogram, Hystero-Salpingography, Spermoculture, Testicular Pelvic Echo-Doppler)
Excluded
In-Vitro and Artificial Insemination
Excluded
Sexually Fortifying Treatment
Excluded
Procedures Related to Change of Sex
Excluded
Sleep Disorder
Sleep Disorder Treatments and Polysomnography
Excluded
Other Benefits under In-Hospital Plan
Road Ambulance expenses
Covered for emergency cases which need Surgical procedure or requires at least one overnight stay
Treatment related to Falling of Hair and treatment of Hirsutism and all related Consequences
Excluded
Parkinson Disease treatment and surgery
Excluded
Pre-existing Conditions
Excluded
Individual medical underwriting
Applied
Other Exclusions to In-Hospital Plan
Special Diets and Weight Control Procedures and Surgeries
Excluded
Vertoplasty, Nucleoplasty, and Khyphoplasty supplements
Excluded
Suicide and Self-Inflicted Injury
Excluded
Claims caused by War, Civil Strife, illegal acts and Crimes
Excluded
Claims Arising from Insured Participating in Hazardous Sport
Excluded
Treatment of Injuries and Sickness due to the Participation in Hazardous Sports
Excluded
General check up
Excluded
Claims Arising from Ionization, Polluting Chemicals or Nuclear Contamination
Excluded
Vertebroplasty, Nucleoplasty and Kyphoplasty surgeries
Excluded
Dynamic Phototherapy Procedures (Lazer for Skin Tumer)
Excluded
Speech therapy
Excluded
Pandemic and Epidemics
Excluded
Surgical Resection of Prostate by HIFUS Procedure
Excluded
Linear Accelerator
Excluded
Other benefits
Traffic accidents
Excluded
Personal Accident
Covered (medical expenses)
Death benefit for a case not covered by insurance
Excluded
Total Permanent Disability
Excluded
Partial Permanent Disability
Excluded
Passive War Risk
Excluded
Travel Insurance once/year
Excluded
Second medical opinion
Excluded
International Assistance (IAG)
Excluded
Length of stay at hospital after expiry of policy
Up to 30 days
Discharge medications
Covered
Reimbursement
OUT of Network for cold cases (Other than DV plan)
Excluded
OUT of Network for Doctors Visits plan
Excluded
OUT of Network for emergency cases
Excluded
Waiting Periods
Cardiovascular system
6 Months
Hernia
6 Months
Hemorrhoids, anal fissures and fistula
6 Months
Tonsilectomy, adenoids, deviated septum, simusitis
6 Months
Delivery
12 Months
Uterine fibroids, Hystrectomy, Endometriosis
12 Months
Varicoceles, Hydroceles, Varicose Veins
12 Months
Non-accident related to back pain, vertebral column and spinal cord
12 Months
Non-accident related Knee surgery
12 Months
Non-accident Shoulder surgery
12 Months