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Health Insurance Coverage Limits

The document outlines the coverage details of a health insurance policy, including various categories of coverage like inpatient, outpatient, maternity, dental, and optical care. It provides the patient share percentage and financial limits for each category. Key coverage includes inpatient care up to 30 days, normal delivery coverage up to KD 1,543, outpatient coverage up to the overall policy limit of KD 214,285 per person annually, and chronic medication coverage after outpatient limits are exhausted.

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Udaya Kumar
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64 views2 pages

Health Insurance Coverage Limits

The document outlines the coverage details of a health insurance policy, including various categories of coverage like inpatient, outpatient, maternity, dental, and optical care. It provides the patient share percentage and financial limits for each category. Key coverage includes inpatient care up to 30 days, normal delivery coverage up to KD 1,543, outpatient coverage up to the overall policy limit of KD 214,285 per person annually, and chronic medication coverage after outpatient limits are exhausted.

Uploaded by

Udaya Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Zain policy

Minor
OUT
procedures MRI & CT Scan Psychiatric Maternity
Inpatient Consultation Medication diagnostic X- Dental Optical Chronic & Pre-existing
& Day case ‫األشعة المقطعية‬ Treatment ‫نساء ووالدة‬
‫دخول المستشفى‬ ‫استشارة‬ ‫العالج‬ ray, Lab ‫اسنان‬ ‫النظارات‬ ‫االمراض المزمنة‬
Surgery ‫والسونار‬ ‫العالج النفسي‬
‫ أشعة‬- ‫مختبر‬
‫جراحة اليوم الواحد‬

Patient Share 0% KD 4 0% 0% 0% 0% 0% 0% 0% 0% 0%

Inpatient up to below
Inpatient up to 30 Normal Delivery
KD 285 Policy limit
days KD 1,543

Up to below
Up to below
Financial Limit Policy KD 1,715 KD 121 Outpatient up to Outpatient
Policy Limitation
Limitation limit
Cleaning covered Complication of Maternity
Outpatient up to with maximum up to Policy Limit
outpatient limit
KD 48
Chronic Medication up to
below policy limitation*

Total Financial
Limit per
person per KD 214,285
Year (policy
Limitation)

*When the Out-Patient limit is exhausted chronic patients can receive their chronic medications up to the policy limit. This process is a manual and not automated.

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