QIC
Plan 5
The short version
MEDNET — EmeraldWhat Plan 5 does and does not do, before you read the insurer's own Table of Benefits.
Annual limit
AED 1,500,000
Medical network
MEDNET — Emerald
Consultation
AED 50 with 20% co-pay
Pharmacy
Covered with 10% 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
MEDNET — Emerald
Annual Limit per Person
AED 1,500,000
Area of Coverage
Worldwide
In-patient Services
Covered
Out-patient Services
Covered
Hospital Accommodation
Private
Consultation Deductible (Co-Pay)
AED 50 with 20% Co-Pay
Diagnostics & Laboratory Services
Covered with 10% Co-Pay
Medicine Limit
Covered up to the annual benefit limit with 10% Co-Pay
Maternity
Normal delivery up to AED 10,000. Medically necessary Caesarean section and complications up to AED 10,000. Maternity emergencies up to AED 150,000. Out-patient maternity: the screening tests covered as per the DHA antenatal care protocol, including 3 ultrasound scans. 10% co-payment on all maternity treatment, with no deductible
Women and maternity on this plan
Women's premiums on this plan are higher than men's, whether or not they are married.
Get a quote to see the amount for your family.
Alternative Medicines
Covered on reimbursement upto AED 1,600/-
Physiotherapy
Covered with 10% copay up to 15 sessions per member per year
Psychiatric Treatment
In-Patient, Out-Patient, and Emergency cover up to a maximum of AED 10,000/- per person per annum.
Home Nursing
Not coveredRoutine Dental Benefits
AED 3,500 with 20% Co-Pay
Routine Optical Benefits
Not coveredPre-existing / Chronic Conditions
• All pre-existing medical conditions should be declared in the Medical Application Form and is subject to medical underwriting. • All declared Pre-existing and Chronic conditions are covered with a sub limit of AED 150,000/- • Undeclared pre-existing conditions will not be covered during the policy period and will be underwritten at renewal. All adverse findings on health declarations would be priced on each case basis. In case of misrepresentation insurer reserves the right to cancel the policy
Emergency Road Ambulance Services
Covered
Vaccination for Children (as per MOH, UAE)
Covered
Repatriation of Mortal Remains
Covered upto AED 7500/-, settled on Reimbursement basis
Within the Network (Direct Billing)
Covered in network with free access
Outside the Network (Reimbursement)
Reimbursement at 100% of covered cost in SEA, 80% elsewhere within the territorial scope
Assist America
No Financial limitations applicable under this benefit. Worldwide Emergency Medical Evacuation, Worldwide Hospital Admission Assistance, Repatriation of mortal remains to home country from anywhere in the world, including country of residence. Medical Consultation, Evaluation, Referral & Monitoring. Care of minor children & Compassionate visit. *For detailed information please refer Assist America Table of Benefit
Emergency Treatment
Emergency treatment is covered at 100% of the actual covered cost, both within the network and outside the network.
Adult Pneumococcal Conjugate Vaccine
As per DHA Adult Pneumococcal accination guidelines
Air-Ticket for Insured Member
Limited to AED 2,500 per person per annum subject to the following conditions 1) Covered once per policy year 2)Cost of treatment should be 30% lower than UAE treatment rates 3) Covered for Patient only
Cancer Treatments
Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
Follow-up consultation co-pay (within 7 days)
No co-pay on a follow-up consultation within 7 days for the same treatment with the same doctor.
Coverage Criteria for Treatment outside UAE
Coverage outside the UAE is limited to 90 days per treatment. A single holiday or business trip may not exceed 90 days.
Day care Treatment
Covered
Dental, hearing & vision aids, vision correction
Covered in medical emergencies
Elective Treatment
Elective treatment within the network (free access) is covered; outside the UAE it is covered up to a maximum of 100% of UAE applicable network rates. Reimbursement outside the network: in South East Asia, 100% of the actual covered cost, capped at 100% of UAE applicable network rates; elsewhere within the territorial scope of cover, 80% of the actual covered cost, capped at 80% of UAE applicable network rates.
Emergency dental (accidental damage)
Under this benefit the treatment required within three months following accidental damage to sound natural teeth caused by a violent external means when the treatment is given by a Physician, dentist or dental surgeon is covered. *No treatment will be covered after 3 months of the accident. **Treatment required as the result of the consumption of food or drink or any foreign bodies contained in such food or drink is not covered.
Emergency Mental health Treatments
Covered
Hepatitis B Virus Screening and treatment
Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
Hepatitis C Infection
Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
Influenza Vaccine
Covered once Per Annum
Intensive care & coronary artery disease
Covered
New Born baby coverage
Babies born inside and out-side UAE - New born expenses are covered from Date of Birth under the mother’s card for the first 30days from date of birth upto Annual Benefit Limit of mother. New born babies will be added to the principle policy only upon requested by the policy holder and is subject to Medical underwriting. Coverage for new born are in line with DHA benefit guidelines.
Out Patient Surgery
Covered
Preventive services (members over 18)
Frequency restricted to: Diabetes: • Every 3 years from age 30 • High risk individuals annually from age 18
Organ transplantation (recipient only)
Coverage upto limit of AED 100,000/-. Coverage for Recipients only Outpatient: 20% co-insurance payable by the insured per visit
Second Medical Opinion
Not coveredAccompanying person accommodation
Covered (Max upto AED 400 per night)
Work Related Injuries and Illness
Not coveredOnly 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
- Covered in medical emergencies
- Emergency dental (accidental damage)
- Under this benefit the treatment required within three months following accidental damage to sound natural teeth caused by a violent external means when the…
- Emergency Mental health Treatments
- Covered
- Out Patient Surgery
- Covered
- Disease Management Programs
- Covered as per terms, conditions and exclusions of the program defined by DHA
Prevention & screening
Checks and vaccinations, before there is anything wrong- Adult Pneumococcal Conjugate Vaccine
- As per DHA Adult Pneumococcal accination guidelines
- Hepatitis B Virus Screening and treatment
- Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
- Hepatitis C Infection
- Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
- Influenza Vaccine
- Covered once Per Annum
- Preventive services (members over 18)
- Frequency restricted to: Diabetes: • Every 3 years from age 30 • High risk individuals annually from age 18
- Herpes Zoster (Shingles) Vaccine
- As per DHA guidelines
Cash back and waived fees
Money paid back to you, and charges this plan does not make- Air-Ticket for Insured Member
- Limited to AED 2,500 per person per annum subject to the following conditions 1) Covered once per policy year 2)Cost of treatment should be 30% lower than UAE…
- Follow-up consultation co-pay (within 7 days)
- No co-pay on a follow-up consultation within 7 days for the same treatment with the same doctor.
Hospital and recovery
What the plan does around a hospital stay- Assist America
- No Financial limitations applicable under this benefit. Worldwide Emergency Medical Evacuation, Worldwide Hospital Admission Assistance, Repatriation of mortal…
- Emergency Treatment
- Emergency treatment is covered at 100% of the actual covered cost, both within the network and outside the network.
- Cancer Treatments
- Covered as per terms, conditions and exclusions of the program defined by DHA (To be followed as per the guidelines laid out under Basmah program)
- Coverage Criteria for Treatment outside UAE
- Coverage outside the UAE is limited to 90 days per treatment. A single holiday or business trip may not exceed 90 days.
- Day care Treatment
- Covered
- Elective Treatment
- Elective treatment within the network (free access) is covered; outside the UAE it is covered up to a maximum of 100% of UAE applicable network rates.
- Intensive care & coronary artery disease
- Covered
- New Born baby coverage
- Babies born inside and out-side UAE - New born expenses are covered from Date of Birth under the mother’s card for the first 30days from date of birth upto Annual…
- Organ transplantation (recipient only)
- Coverage upto limit of AED 100,000/-. Coverage for Recipients only Outpatient: 20% co-insurance payable by the insured per visit
- Accompanying person accommodation
- Covered (Max upto AED 400 per night)
- Dialysis
- Covered to a limit of AED 60,000/- Outpatient: 20% coinsurance payable by the insured per visit
Named exclusions
Written into this plan's own document, so you do not find out later- Second Medical Opinion
- Not Covered
- Work Related Injuries and Illness
- Not Covered