Takaful Emarat
APN Plus
The short version
AAFIYA — APN PlusWhat APN Plus does and does not do, before you read the insurer's own Table of Benefits.
Annual limit
AED 300,000
Medical network
AAFIYA — APN Plus
Consultation
Covered
Pharmacy
AED 1,500 with 30% co-pay
What is good
Good to know
Get your price to download this plan's Table of Benefits and your quote.
Everything in the policy
Medical Network
AAFIYA — APN Plus
Annual Limit per Person
AED 300,000
Area of Coverage
UAE + Home Country. Coverage outside the UAE is limited to 60 days per treatment; a single holiday or business trip may not exceed 60 days.
In-patient Services
Tests, diagnosis, treatments and surgeries in hospitals for non-urgent medical cases, subject to prior approval. Intensive care unit and coronary artery disease treatment covered.
Out-patient Services
Day care treatment and out-patient surgery covered.
Hospital Accommodation
Private
Consultation Deductible (Co-Pay)
Direct Specialist access. GP: AED 20 and Specialist: AED 30 per Visit. No co-pay on follow-up consultation within 7 days for the same treatment with the same doctor.
Diagnostics & Laboratory Services
Laboratory, radiology and diagnostics (X-ray, MRI, CT-scan, ultrasound and endoscopy) covered with 20% co-pay, maximum AED 50 per invoice.
Medicine Limit
AED 1,500 with 30% Co-Pay
Maternity
Inside Abu Dhabi: combined in-patient and out-patient limit up to the policy annual benefit limit; delivery inside Abu Dhabi is subject to an AED 500 deductible as per DOH. Outside Abu Dhabi: combined in-patient and out-patient limit of AED 10,000. The same out-patient deductible as the selected plan applies to maternity consultations. Covers pre and post natal treatment, normal delivery, medically necessary caesarean section, maternity complications and medically necessary legal terminations. In-patient maternity treatment is subject to prior approval. 6-month waiting period for delivery on first membership, unless you show continuous cover
Abu Dhabi law excludes pregnancy and delivery cover for women enrolled as unmarried (Law 23/2005, Art. 13(5)).
Women and maternity on this plan
Married women pay an extra maternity premium on this plan; single women pay the standard price.
Get a quote to see the amount for your family.
Alternative Medicines
Not coveredPhysiotherapy
Fully covered with 0% co-pay, subject to prior approval.
Routine Optical Benefits
Not coveredPre-existing / Chronic Conditions
All pre-existing conditions must be declared in the medical application form and are subject to medical underwriting; undeclared conditions are not covered during the policy period and are underwritten at renewal. A 6-month waiting period applies to in-patient treatment of diabetes mellitus, arterial diseases, COPD, all cancer cases, neurosurgery, cerebrovascular diseases and all delivery cases, unless there is continuity of health insurance coverage.
Emergency Road Ambulance Services
In medical emergency only, and if required followed by admission.
Vaccination for Children (as per MOH, UAE)
As per MOH schedule; requires pre-authorisation.
Repatriation of Mortal Remains
AED 7,500
Specialist access
Direct specialist access; no GP referral is required.
Within the Network (Direct Billing)
Inside UAE covered up to a maximum of 100% of UAE applicable network rates. Emergency treatments within the network: 100% of actual covered cost.
Outside the Network (Reimbursement)
Reimbursement in home country at 80% of actual covered cost, subject to a maximum of 100% of UAE applicable network rates, whichever is lesser. Reimbursement inside the UAE is covered. Emergency treatments outside the network: 100% of actual covered cost.
Emergency Treatment
Emergency treatments within the network and outside the network are covered at 100% of the actual covered cost.
Air-Ticket for Insured Member
Covered for insured members in respect of elective treatment, subject to: the cost of treatment outside the UAE for the required medical procedure being less than 70% of UAE customary rates with a minimum difference of AED 3,000; in-patient treatment only, with an accompanying person not covered; an economy-class round-trip ticket up to a maximum of AED 2,000; reimbursement basis only.
Follow-up consultation co-pay (within 7 days)
No copay.
Coverage Criteria for Treatment outside UAE
Coverage outside the UAE is limited to 60 days per treatment. A single holiday or business trip may not exceed 60 days.
Day care Treatment
Covered.
Dental, hearing & vision aids, vision correction
Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are covered.
Elective Treatment
Elective treatment is covered subject to prior approval.
Emergency dental (accidental damage)
Treatment required within three months following accidental damage to sound natural teeth caused by violent external means is covered when given by a physician, dentist or dental surgeon. No treatment is covered after 3 months of the accident. Treatment required as a result of consuming food or drink, or any foreign bodies contained in such food or drink, is not covered.
Emergency Mental health Treatments
Covered.
Hearing Emergencies
Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are covered.
Intensive care & coronary artery disease
Covered.
New Born baby coverage
Babies born inside and outside the UAE: newborn expenses are covered from date of birth under the mother's card for the first 30 days from date of birth, up to the mother's annual benefit limit. Newborn babies will be added to the principal policy only on the policyholder's request and subject to medical underwriting. Coverage for newborns is in line with DOH benefit guidelines.
Out Patient Surgery
Covered.
Preventive services (members over 18)
Not coveredOrgan transplantation (recipient only)
Organ transplantation covers the transplantation as recipient, excluding any cost related to the donor and excluding the acquisition and organ cost. Organs covered are: heart, lung, kidney, pancreas and liver.
Accompanying person accommodation
Accommodation of an accompanying person in the same room in cases of critical conditions, on the recommendation of the attending physician and subject to prior approval, is covered up to a maximum of AED 100 per night.
Vision Emergencies
Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are covered.
Work Related Injuries and Illness
Health services for work illnesses and injuries, as per Federal Law No. 8 of 1980 concerning the Regulation of Work Relations as amended, are covered in-patient. Out-patient, they are covered subject to the out-patient consultation deductible.
Only on this plan
Benefits this plan adds beyond the rows compared above.
Everyday care
Out-patient care you are likely to use in a normal year- Dental, hearing & vision aids, vision correction
- Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are…
- Emergency dental (accidental damage)
- Treatment required within three months following accidental damage to sound natural teeth caused by violent external means is covered when given by a physician,…
- Emergency Mental health Treatments
- Covered.
- Hearing Emergencies
- Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are…
- Out Patient Surgery
- Covered.
- Vision Emergencies
- Diagnostic and treatment services for dental and gum treatments, hearing and vision aids, and vision correction by surgeries and laser, emergency cases only, are…
Cash back and waived fees
Money paid back to you, and charges this plan does not make- Air-Ticket for Insured Member
- Covered for insured members in respect of elective treatment, subject to: the cost of treatment outside the UAE for the required medical procedure being less than…
- Follow-up consultation co-pay (within 7 days)
- No copay.
Hospital and recovery
What the plan does around a hospital stay- Emergency Treatment
- Emergency treatments within the network and outside the network are covered at 100% of the actual covered cost.
- Coverage Criteria for Treatment outside UAE
- Coverage outside the UAE is limited to 60 days per treatment. A single holiday or business trip may not exceed 60 days.
- Day care Treatment
- Covered.
- Elective Treatment
- Elective treatment is covered subject to prior approval.
- Intensive care & coronary artery disease
- Covered.
- New Born baby coverage
- Babies born inside and outside the UAE: newborn expenses are covered from date of birth under the mother's card for the first 30 days from date of birth, up to the…
- Organ transplantation (recipient only)
- Organ transplantation covers the transplantation as recipient, excluding any cost related to the donor and excluding the acquisition and organ cost.
- Accompanying person accommodation
- Accommodation of an accompanying person in the same room in cases of critical conditions, on the recommendation of the attending physician and subject to prior…
- Work Related Injuries and Illness
- Health services for work illnesses and injuries, as per Federal Law No. 8 of 1980 concerning the Regulation of Work Relations as amended, are covered in-patient.
- Accommodation for a beneficiary below 16 years of age
- Covered up to AED 100 The cost of accommodation of a person accompanying a beneficiary below 16 years of age in the same room, in cases of medical necessity, at the…
- Congenital Conditions
- Congenital conditions are covered for emergency life-threatening conditions only; elective cases are excluded.
- Inpatient coverage of high-cost medical conditions (6-month waiting period)
- A 6-month waiting period applies to in-patient treatment for the following conditions: diabetes mellitus, arterial diseases, COPD (chronic obstructive pulmonary…
Other benefits
Named in this plan's document and not easily grouped- NRI Benefit
- For Indian nationals residing in the UAE: cashless in-patient-only benefit for planned treatment, with access to a 16,000-hospital network in India; and continuity…
Named exclusions
Written into this plan's own document, so you do not find out later- Preventive services (members over 18)
- Not covered. (The row is printed as 'Preventive services covered for members over 18 years of age * Prior Approval is required to Access facility (non-AUH)'.)