Applicable only for (DXB visa holders) with Gross Salary Above AED 4,000.

S. No.

Benefits

Flexi Dubai - Platinum

Flexi Dubai - Diamond

Flexi Dubai - Gold

Flexi Dubai - Silver

Flexi Dubai - Bronze

AED 1,500,000/=

AED 750,000/=

AED 250,000/=

AED 150,000/=

Worldwide excluding
USA & Canada

UAE, GCC, ME, SEA

including Indian Subcontinent

UAE, GCC, ME, SEA

including Indian Subcontinent

UAE, GCC, ME, SEA

including Indian Subcontinent

UAE, Indian Subcontinent and

Philippines

Dubai residents
(UAE Nationals &
Expatriates having a
Valid Dubai
Residence Visa)
GN + AH
Opt1: Nil.
Opt2: Treatment in
American Hospital
*15% Co Insurance in
Op only

Dubai residents
(UAE Nationals &
Expatriates having
a Valid Dubai
Residence Visa)
GN
Opt1: Nil.
Opt2: Treatment in
Mediclinic Group & Al
Zahra Group *15% Co
Insurance in Op only

Dubai residents
(UAE Nationals &
Expatriates having
a Valid Dubai
Residence Visa)
RN
Opt1: Nil.
Opt2: Treatment in
Zulekha Hospital
*15% Co Insurance in
Op only

Dubai residents
(UAE Nationals &
Expatriates having
a Valid Dubai
Residence Visa)
RN2
Opt1: Nil.
Opt2: Treatment in
Zulekha Hospital
*15% Co Insurance in
Op only

Dubai residents
(UAE Nationals &
Expatriates having
a Valid Dubai
Residence Visa)

0 to unlimited

0 to unlimited

0 to unlimited

0 to unlimited

Aggregate Limit

Under the terms and

conditions of the plan, we
will pay necessary,
customary and reasonable
expenses up to an overall
maximum, per insured
member per year.
Area of Cover

Eligibility

Network

Age Limit

Al Sagr National Insurance

AED 150,000/=

RN3 (Outpatient
treatment restricted
to clinics only)

0 to unlimited

Page 1

Treatment Outside the

Network

If treatment is taken
outside the network for
eligible medical condition
covered under the policy,
reimbursement would be
allowed subject to 20% Coinsurance based on Usual,
Customary and Reasonable
(UCR) Network Charges.
( UCR charges are as per
the discretion of the insurer
)

Claims Settlement Basis

( as per Usual, Customary

and Reasonable Charges of
the Network in UAE).

20% Co-insurance
subject to UCR
Network Charges

20% Co-insurance
subject to UCR
Network Charges

Within the Network

on Direct Billing Basis

Within the Network

on Direct Billing Basis

Outside the Network

on Reimbursement
Basis

Outside the Network

on Reimbursement
Basis

Treatment out-side
the Network is not
allowed and will not
be reimbursed.

Treatment out-side
the Network is not
allowed and will not
be reimbursed.

Treatment out-side
the Network is not
allowed and will not
be reimbursed.

Within the Network

on Direct Billing Basis
Outside the Network
on Reimbursement
Basis
( if eligible )

Within the Network

on Direct Billing Basis
Outside the Network
on Reimbursement
Basis
( if eligible )

Within the Network

on Direct Billing
Basis
Outside the Network
on Reimbursement
Basis
( if eligible )

Covered in Full

Covered in Full

In-Patient Treatment
a

Accidents and emergencies,

intensive care and theatre
costs

Al Sagr National Insurance

Covered in Full

Covered in Full

Covered in Full

Page 2

d
e

g
h
i

Hospital Accommodation (
Room Charges )
Nursing Fees, medical
expenses and ancillary
charges
Surgeons', consultants,
anesthetist', specialists' ,
General Practitioners' fees
Prescribed Medicine and
drugs
Reconstructive surgery
following an accident or
following surgery for an
eligible medical condition
Prostheses: artificial body
parts surgically implanted
to form permanent parts of
an insured member's body
MRI, PET, CT Scans
X-Rays, Pathology,
diagnostic tests and
procedures
Oncology tests, drugs and
consultants' fees including
cover for chemotherapy
and radiotherapy
Physiotherapy
recommended / referred
by a General Practitioner or
a Specialist,

Al Sagr National Insurance

Private Room
Covered

Private Room
Covered

Private Room
Covered up to AED
750 per day

Semi Private Room

Covered up to AED
450 per day

Semi Private Room

Covered up to AED
450 per day

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered up to 7 sessions per ailment/condition per person per year

Page 3

Parent accommodation

Hospital accommodation
cost in respect of a parent
or legal guardian staying
with an Insured member
who is under 18 years of
age and is admitted to a
Hospital as an In-Patient.
Ground transportation
services in the UAE
provided by an authorized
party for medical
emergencies
Accidental Damage to
Teeth
Treatment received in an
Emergency room in a
Hospital within 48 hours of
incurring Accidental
damage caused to sound,
natural teeth as a result of
an Accident.
Hospital Cash Benefit
When treatment is received
as an In-Patient for an
eligible Medical Condition
in a Government Hospital,
where no costs were
incurred for
accommodation and/or for
treatment, then this benefit
pays for a daily cash

Al Sagr National Insurance

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered up to
AED 300/= per day

Covered up to
AED 300/= per day

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Covered up to
AED 200/= per day

Page 4

benefit for In-Patient stay

more than 3 days.
This benefit is not
applicable for Accident &
Emergency admissions.

Deductible for ( In-Patient

Services
p

( Applicable if treatment is
taken in a facility
in-side/outside the
Network of providers )
Medical emergencies on
Hearing and vision aids,
and vision correction by
surgeries and laser.
Accidental damage to
teeth & Gum Treatment
received in an emergency
room in a hospital within
48 hours of incurring
accidental damage caused
to sound , natural teeth as
a result of an accident.

Al Sagr National Insurance

NIL

NIL

NIL

NIL

20% coinsurance
With a cap of 500
AED payable per
encounter and an
annual aggregate
cap of 1000 AED.
Above these caps the
insurer will cover
100% of treatment

Cover : Emergency Treatment required to save or alleviate danger to life

Cover : Emergency Treatment required to save or alleviate danger to life

Page 5

Maternity - In patient
services.
Nil waiting periods subject
to declaration.

10% coinsurance
payable by the insured
Maximum benefit 15
,000 AED per normal
delivery, 20 ,000 AED
for medically necessary
C-section,
complications and for
medically necessary
termination (All limits
include coinsurance)

10% coinsurance
payable by the insured
Maximum benefit 10
,000 AED per normal
delivery, 15 ,000 AED
for medically
necessary C-section,
complications and for
medically necessary
termination (All limits
include coinsurance)

10% coinsurance
payable by the
insured Maximum
benefit 7 ,000 AED
per normal delivery,
10 ,000 AED for
medically necessary
C-section,
complications and for
medically necessary
termination (All limits
include coinsurance)

10% coinsurance
payable by the
insured Maximum
benefit 7 ,000 AED per
normal delivery, 10
,000 AED for medically
necessary C-section,
complications and for
medically necessary
termination (All limits
include coinsurance)

10% coinsurance
payable by the
insured Maximum
benefit 7 ,000 AED
per normal delivery,
10 ,000 AED for
medically necessary
C-section,
complications and for
medically necessary
termination (All limits
include coinsurance)

Where any condition develops which becomes an emergency, the medically necessary expenses will be covered up to Maximum limit AED 150,000 PPPY

Out-Patient & Day-care Treatment

Deductible /Co insurance
for ( Out-Patient Services )
1

Free follow up with

the same
doctor for the same
ailment within seven days.
Primary Consultation and
treatment to include
General Practitioners' fees,
prescribed medicines, drugs
and dressings
X-ray, pathology,
diagnostic tests and
procedures
Prescribed Medicine and
drugs

Al Sagr National Insurance

20% coinsurance on OP
consultation or AED
50/- on all OP
consultation whichever
is lower.

20% coinsurance on
OP consultation or
AED 50/- on all OP
consultation
whichever is lower.

20% coinsurance on
OP consultation or
AED 50/- on all OP
consultation
whichever is lower.

20% coinsurance on
OP consultation or
AED 50/- on all OP
consultation
whichever is lower.

20% coinsurance on
OP consultation or
AED 50/- on all OP
consultation
whichever is lower.

Covered

Covered

Covered

Covered

20% Coinsurance

Covered

Covered

Covered

Covered

20% Coinsurance

Covered

Covered

Covered

Covered

30% Coinsurance
Maximum Limit AED
1,500
Page 6

6
7
8
9

Physiotherapy
recommended / referred
by a General Practitioner or
a Specialist,
Oncology tests, drugs and
consultants' fees including
cover for chemotherapy
and radiotherapy
MRI, PET, CT Scans
Out-Patient Surgical
Operations
Post - Hospitalization
Treatment

Covered up to 7 sessions per ailment/condition per person per year

Covered up to 6
sessions per
ailment/condition
per person per year

Covered

Covered

Covered

Covered

20% Coinsurance

Covered

Covered

Covered

Covered

20% Coinsurance

Covered

Covered

Covered

Covered

20% Coinsurance

Covered

Covered

Covered

Covered

20% Coinsurance

Other Benefits

ab

Pre-existing Conditions &

Chronic Medical Conditions
( Where any condition
develops which becomes an
emergency, the medically
necessary expenses will be
covered up to the annual
aggregate limit. )
- For declared cases only

-Maximum limit AED 150,000 PPPY

- Treatment for chronic Or pre-existing conditions excluded for first 6 months of first membership. Included thereafter

ac

Maternity - Outpatient
services.

10% Copay , Maximum 8 visits checks and tests in accordance with DHA Antenatal Care Protocols

New born cover

_Cover for 30 days from birth.

_BCG, Hepatitis and neo-natal screening tests. (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening,
congenital adrenal hyperplasia)

ad

Al Sagr National Insurance

Page 7

ae

af

ag

ah

Life threatening congenital

conditions ( life threatening birth defects,
deformities and congenital
diseases for new born
children only )
Nursing at Home
Immediately following
Hospital discharge on the
recommendation of a
specialist and must be
provided by a qualified
nurse. All treatments
under this benefit must be
pre-authorized by us.
Reconstructive Surgery
Reconstructive surgery
following an Accident or
following surgery for an
eligible medical conditions,
which is not pre-existing
and the incident has not
occurred prior to
commencing this cover
under the policy.
Dental Cover
Below dental procedures
excluding any surgeries.
Root Canal, Fillings,
Extractions, Antibiotics for
Infection of Gums
Consultation and X-ray.

Al Sagr National Insurance

- Maximum limit AED 150,000 PPPY

Covered up to a limit of
AED 5,000/=

Covered up to a limit
of
AED 4,000/=

Covered up to a limit
of
AED 2,500/=

Covered up to a limit
of
AED 1,000/=
Not covered

for a period not exceed

30 days in aggregate.

for a period not

exceed 30 days in
aggregate.

for a period not

exceed 30 days in
aggregate.

for a period not

exceed 30 days in
aggregate.

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered in Full

Covered up to a limit of
AED 2,000/= with AED
100/= as deductible

Not Covered

Not Covered

Not Covered

Not Covered

Page 8

Optical Cover
ai

aj

ak

al

Cover for a pair of lenses

only.

Preventive services

Vaccines and
immunizations
Essential vaccinations and
inoculations for newborns
and children as stipulated
in the DHAs policies and its
updates in the assigned
facilities from age 0-6
years.
Return Air Fare to Patient
for Surgery in Home
Country
(if treatment is not
available in the country of
residence or the treatment
expense is up to 50% of the
cost in UAE). Pre-approval
from ASNIC required

Al Sagr National Insurance

Covered up to a limit of
AED 200/= for a pair of
lenses

Not Covered

Not Covered

Not Covered

Not Covered

*Preventive services as stipulated by DHA to include initially diabetes and Papanicolaou test.
*Frequency restricted to:
Diabetes: Every 3 years from age 30
High risk individuals annually from age 18 Papanicolaou: Every 3 years for married female

Covered - Only available for services administered at DHA facilities with 10% Copay on Reimbursement basis only

AED 2,000/=
Plus
AED 2,000/= for
accompanying Family
Member

AED 2,000/=
Insured patient only

AED 2,000/=
Insured patient only

AED 2,000/=
Insured patient only

AED 2,000/=
Insured patient only

Page 9

am

an

Global Emergency services

- Assist America Key
services:

Covered
(Refer to Global Emergency Services brochure for complete information on coverage, conditions and exclusions)
Medical Consultation, Evaluation & Referral, Hospital Admission Assistance, Emergency Medical Evacuation, Medical
Monitoring, Medical Repatriation, Prescription Assistance, Compassionate Visit, Care of Minor Children, Return of Mortal
Remains, Lost Luggage or Document Assistance, Interpreter & Legal Referrals, Pre-trip Information.

Second Medical Opinion

(International Medical
Consultation)

Covered
(Refer to Global Emergency Services brochure for complete information on coverage, conditions and exclusions)
- Confirmation of Diagnosis
- Evaluation of cases where diagnosis has not been possible
- Determination of the most appropriate course of treatment
- Follow up on a previously reported case.

Al Sagr National Insurance

Page 10