CATEGORY - C

M/s Emirates Hospital

Orient UNB Takaful
SECTION ONE - COVERAGE DETAILS
REGULATORY DHA & Northern Emirates
Worldwide excluding USA & Canada subject to
Area of Cover reasonable and customary charges of applicable
network in UAE
Worldwide subject to reasonable and customary
Emergency Treatment Outside Area of Cover
charges of applicable network in UAE
Aggregate Limit Per Person Per Year CAT C - AED 300,000

Network Selection CAT C - Nextcare RN (Including EHG)

Not covered within UAE & Outside UAE covered on
Treatment Outside Network 80% reimbursement basis & inside UAE allowed only
for treatment not available inside network.
Pre-Existing & Chronic Conditions Covered up to annual limit
SECTION TWO - IN PATIENT BENEFITS NO REFERRAL REQUIRED
Single private room at network hospital but limited to
Room & Board (subject to prior approval)
AED 650 outside the network
Intensive Care Unit Fully Covered
Diagnostic Tests and procedures Fully Covered
Drugs, Medicines, Surgical Dressings Fully Covered
Doctor, Surgeon & Specialist Consultations Fully Covered
Local Road Ambulance Fully Covered
Accommodation Charges for One Parent to Stay Covered up to 16 years of age for AED 300/night
Covered if insured is recipient however the expenses
Organ Transplant
incurred in procurement of organ is excluded
SECTION THREE - OUT PATIENT BENEFITS NO REFERRAL REQUIRED
CAT C: Covered with 20% Copay in EHG & outside EHG
Physician & Specialist consultation fees 20% without cap – Specialist consultation is only on
referral by General Practitioner
CAT C: Covered with 20% Copay in EHG & outside EHG
Diagnostic Tests and procedures
20% without cap
CAT C: Covered with 20% Copay in EHG & outside EHG
Surgical Procedures
20% without cap

Prescribed Drugs & Medicines CAT C: Covered with 30% Copay

Prescribed Physiotherapy (Subject to prior approval) CAT C: Covered up to 10 sessions with 20% Copay

Accidental damage to natural teeth

(Only initial treatment is Covered; Follow up not covered. No Covered

Cover for treatment resulting from consumption of food or
drink or any foreign bodies contained in such food/drink)
Covered - Vitamins prescribed as replacement therapy
Vitamins (Subject to prior approval) for known vitamin deficiency conditions up to
prescribed pharmaceutical limit only.

OUTFL Quote No. V6 – 24/08/2020 for M/s. EMIRATES HOSPITAL GROUP Page 7 of 10
 SECTION FOUR - ADDITIONAL BENEFITS
Out Patient eligible Maternity expenses are covered
up to annual limit

The following screening tests are covered as per DHA

Antenatal care protocol:
o FBC and Platelets
o Blood group, Rhesus status and antibodies
Maternity Benefits
o VDRL
(Out-Patient ante-natal services)
o MSU & urinalysis
o Rubella serology
o HIV
o Hepatitis C offered to high risk patients
o GTT, if high risk
o FBS, Random blood sugar OR HbA1C
o Ultrasonography : 3 scans

Maternity- Outpatient Copay / Deductible CAT C: Covered with 10% copay.

CAT C: Covered up to AED 15,000 for normal delivery

and up to AED 20,000 for medically necessary C-
Maternity Benefit Section
(In-Patient ante-natal services) (Outside Network/UAE- Limited up to AED 10,000 and
outside EHG Limited up to AED 10,000 for all
maternity expenses)
Maternity Inpatient Copay / Deductible CAT C: 10% Copay with a limit of AED 500.
Cover for 30 days from birth.
BCG, Hepatitis B and neo-natal screening tests
Newborn Baby Coverage
(Phenylketonuria (PKU), Congenital Hypothyroidism,
sickle cell screening, congenital adrenal hyperplasia)
Dental Benefits
(Consultations, Extractions, Amalgam Fillings, Composite
CAT C - Covered up to AED 2000 with 20% copay
Fillings, Glass Ionomer, Dental X‐Rays, Root Canal Treatment
and Gum Treatment)
Optical Benefits
CAT C: Not Covered
(Consultations, Medications, Vision tests, Lens & Frame)
Frequency restricted to: Diabetes: Every 3 years from
age 30 High risk individuals annually from age 18.
Preventive Services, Vaccines & Immunizations
Vaccination Covered as per MOH schedule (For
Children up to 6 years)
Diagnostic and Treatment Services for Dental and Gum
Covered with 20% copay
(For Medical Emergency Cases)
Hearing and Vision Aids, and Vision Correction by Surgeries
Covered with 20% copay
and laser (For Medical Emergency Cases)
Hospital Cash Benefit if inpatient treatment is received free of
Covered up to AED 400 per day
charge in a Government Hospital in UAE Only
Home Nursing.
Nursing at home by a registered nurse (following an Covered up to AED 5,000
immediate Inpatient treatment)

OUTFL Quote No. V6 – 24/08/2020 for M/s. EMIRATES HOSPITAL GROUP Page 8 of 10
 Covered over & above the Workmen's Compensation
Work Related Injury
(WC) policy
CAT C: Covered with 20% Copay, AED 5,000
Only below treatment are covered
Alternative Medicine
Ayurvedic, Osteopathy, Herbal treatment,
Acupuncture, Chiropractic & Homeopathy
Covered up to AED 20,000 per person per annum on
Repatriation of Mortal Remains to the Country of Domicile
reimbursement basis

COVID-19 treatment Covered as per local regulatory guidelines.

OUTFL Quote No. V6 – 24/08/2020 for M/s. EMIRATES HOSPITAL GROUP Page 9 of 10