Key Benefits

HOSPITALISATION BENEFITS

INPATIENT MEDICAL COVER

This pertain to hospitalization confinement expenses for non pregnancy related conditions as follows:

  • Hospital room charges for confinements inclusive of patient's meal charges
  • Hospital services and supplies including:
  • Physician, surgeon or anesthetist fees;
  • Prescription drugs;
  • Prescribed Pathological and Radiological investigations;
  • Blood transfusions;
  • Operation theater charges;
  • Physiotherapy;
  • Radiotherapy and Chemotherapy;
  • Diagnostic or therapeutic endoscopic procedures;
  • Post-hospitalization medical care;
  • Any other medically necessary services.
  • Pre-hospitalization cover: prescribed diagnostic tests and treatments followed by an immediate and related hospitalization within 30 days.
  • Post-hospitalization out-patient expenses: e xpenses in post hospitalization period (30 days) after discharge from the hospital

EXTENDED MEDICAL COVER (OPTIONAL)

Per person annual benefit up to the age of 59 years for treatment upon hospitalization when Inpatient Medical Cover Limit is exhausted.

ADDITIONAL BENEFITS

  • Terrorist cover: hospitalization cover of any innocent insured person (not taking part in terrorist activities) injured in any act of terrorism.
  • Day surgery : Pertains to coverage of specialized procedures as follows:
  • Cataract;
  • Lithotripsy;
  • Hernia
  • Endoscopy
  • Other day surgeries
  • Specialized Investigations: covered from hospitalization:
  • CT Scan;
  • MRI;
  • Thallium Scan
  • Angiography etc.
  • International cover: Coverage of emergency hospitalization during overseas travel of insured persons with reimbursement in Pak Rupee equivalent to cost for similar procedure in Pakistan.
  • Complimentary cover for accidental injury: A utomatic enhancement of In Patient Medical Limit by 100 % for hospitalization due to an accidental injury.

OPTIONAL BENEFITS:

MATERNITY BENEFITS

  • Maternity (hospitalization relating to pregnancy) pertains to:
  • Normal delivery/Forceps;
  • Caesarean section;
  • Multiple birth;
  • Ectopic/extra-uterine pregnancy;
  • This entails the following services and supplies:
  • Hospital room charges with patient meal charges.
  • Miscellaneous hospital services and supplies.
  • Labor room or operation theatre charges.
  • Doctor's fees for delivery and subsequent visits during confinement.
  • Nursery care for the baby while the mother is confined.
  • This optional cover for maternity benefits is available to married female employees and wives of employees.
  • Pre-natal (up to 9 months before delivery) and post natal (up to 6 weeks after delivery) expenses for medicines, consultation and diagnostic tests related to pregnancy
  • Midwife expenses for delivery at home
  • Circumcision expenses of newly born baby boy.

OUT-PATIENT BENEFITS

This pertains to reasonable and customary charges for medically necessary treatment, & services of a licensed physician/ surgeon to the insured person for day to day illnesses or injuries and may include the following:

  • Consultation charges for allopathic, homeopathic or herbal medicine treatment;
  • Prescribed medicine, diagnostic lab tests, X Rays and other diagnostic tests
  • Dental care except supply of denture, scaling, polishing, capping, dental braces;
  • Physiotherapy/acupuncture, Osteopathy,
  • ECG, EMG and EEG examinations and other diagnostic tests;
  • Pre-natal treatments, test & supplies;
  • Cost of eye testing.

VALUE ADDED FEATURES

  • Photo-ID Health Cards: W e are the first company in Pakistan to offer Photo-ID Health Cards for availing cash free treatment at Network Hospitals.
  • No Pre-Authorization required: for quick hassle-free services at network hospitals.
  • Hospital Network: 125 + facilities nationwide.
  • Facility of direct settlement of hospital bills as per entitlement at network hospitals. The insured person need not pay any cash against security deposit or settlement charges.
  • Emergency Hotline Numbers: 24/7 *365 available nationwide.
  • Claims Settlement Time: Fastest turnaround time of 10 working days.
  • Non-Accidental Emergencies: Selective life threatening conditions are covered as per prudent common person definition.
  • Unlimited ICU stay: I CU cover is available without any limit on the number of days.
  • Coverage for new born babies: Insured automatically from their date of birth, as per policy terms.
  • Vaccinations: 1st dose covered at birth under maternity benefits.
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