Al Rajhi company for cooperative Insurance Majed Al- Rasheedi Turkey Alotibe.

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Presentation transcript:

Al Rajhi company for cooperative Insurance Majed Al- Rasheedi Turkey Alotibe

Policy holder: BAVIPclass kingdom of Saudi ArabiaLocation health insurance As Per CCHINature of coverage one year as from the date to be advisedPeriod of coverage – in & out- patient, pre – existing & chronic, dental, optical & maternity Benefits

COVERAGE LIMITSTABLE OF BENFFITS SR 250,000 Overall annual maximum cover payable per member BAVIP Room accommodation semi – privatePrivate SR 2,000Dental

SR 250 Optical SR 10,000 Maternity SR 50 SR 150 SR 50 Consultation fees - - General practitioner - Specialist (referred by G.P) - Specialist (not referred by G.P)

20% maximum SR. 100 Deductible per out- patient visit ( includes consultation, examination & medicine, and not for each procedure separately Kingdom of Saudi Arabia – extended worldwide for business trips, vacation and Holidays for 60 days. Geographical Area Reimbursement of claims (100%) is applied only in emergency cases outside of the network of healthcare providers Coverage outside Network

subject to 100% Reimbursement for Emergency cases of Insured's while on Vacation or Business trip not exceeding sixty ( 60 ) days & subject to Saudi customary charges, policy terms & conditions Worldwide cover covered and is limited to Tooth Extraction, Fillings Root Canal and Gum Treatment and X- ray only and subject further to the above sub limits Dental Benefit

covered for two vision tests and one pair of regular lenses Excludes optical appliances, contact lenses, Frames and other related expense and subject to the above sub limits. Optical benefit covered from day one (1) up to the expiry of the policy. one ( 1) maternity benefit per spouse per year only. delivery outside Saudi Arabia will be subject to prior approval and up to the cost of similar services in the kingdom of Saudi Arabia and the maternity limits Maternity Benefits

covered only for new born babies Circumcision Covered when prescribed by the attending physicians medical necessary Hearing tests & optical examinations benefit when prescribed by the attending physician as medical necessary up to maximum SR 1500 P.P.P. Hearing Aids Benefit covered from day one ( 1 ) Including congenital and premature diseases New Born Babies

covered only after accidents & surgical treatments and is further limited to twelve ( 12 ) sessions only and / or if prescribed by Doctor Physiotherapy covered and is limited to SR 10, 000 Repatriation of Mortal remains to home country covered only on Emergency cases within the city limits Ambulance cost

SPECIAL CONDITIONS On pro – Rata Basis, with a minimum of one month. Cancellation and / or Deletion of the insured's will be effected only upon return of the Medical Cards issued to the member Additions & Deletions of the Insured's Thirty (30) days cancellation clause by either party Cancellation Quarterly in advancePremium payment All eligible dependents of the Employees of the policy Holder are eligible for coverage under the insurance policy. All eligible members of the family must be included in the same Class & Benefits

( ARCCI ) Will issue Individual medical Access Cards and deliver them to the assured within seven working days from receipt of final approval and the Correct Census Application & Enrolment The Claims Center and the Customer or any related issues with providers Service help desk is available ( 24 / 7 ) nonstop to serve the company's clients, for pre- approvals Claims Administration and Pre- Approval NO PRE – APPROVAL LIMITSLimits of pre-approval