Plan Summary

Basic (Abu Dhabi) Plan

Plan Summary – Basic (Abu Dhabi) Plan

Plan Name - Basic (Abu Dhabi) Plan

Annual Benefit Limit - AED 250,000 Per Person Per Policy Year
- Emirate of Abu Dhabi
Territorial Limit - Outside Emirates of Abu Dhabi (Within UAE): Emergency
Cover only
- Respective Abu Dhabi Plan Network (Network 3)
Network (Allowing
- In & out-patient on direct billing in Provider Network in
direct billing at
Abu Dhabi with HAAD Providers (Hospitals and PHCs) and
designated providers)
selected private PHCs
- The waiting period of 6 months applies to Inpatient
treatment only for the following medical conditions;
Waiting Period for
Diabetes mellitus, Arterial diseases, COPD (Chronic
Medical conditions as
Obstructive Pulmonary Disease), All cancer cases,
defined in the Health
Neurosurgery, Cerebro Vascular diseases, All delivery
Insurance Law of Abu
cases (Maternity). This waiting period of 6 months shall
Dhabi
not apply; if pre-requisition of uninterrupted (pre-
coverage is fulfilled)
- Expatriates with a monthly total salary up to AED 5,000
Eligibility without accommodation (or up to AED 4,000 +
accommodation)
Accommodation Type - General Room (2+beds)
Hospital
- 100% at Network Providers
Accommodation and
- AED 0 at Non-Network Providers
Services
Consultant’s,
Surgeon’s & - 100% at Network Providers
Anesthetist’s Fees and - AED 0 at Non-Network Providers
other fee
Ambulance Services
- 100%
(in Medical emergency
only, subject to
General exclusions)
Parent
Accommodation for
accompanying an - Maximum limit of AED 100 per day
Insured Child under 10
years of age
Companion
Accommodation for - Maximum limit of AED 100 per day
Critical Illness
Outpatient Treatment
- 100% at Network Providers

- AED 0 at Non-Network Providers

- Deductible AED 20 per physician consultation (not

Physician Consultation
applicable for follow up within 7 days)

- Access to outpatient specialists in hospitals only upon

referral and with additional deductible of AED 10 (not
applicable for follow up within 7 days)
Plan Summary – Basic (Abu Dhabi) Plan

- 100% at Network Providers

Diagnostics (X-Ray, MRI, CT- - AED 0 at Non-Network Providers

Scan, Ultra Sound, etc.),
Laboratory - MRI, CT and Endoscopies with pre-authorization only

- Deductible AED10 for lab tests and AED 10 for X-rays

- 70% at Network Providers (equals a co-insurance of
30%)

Pharmaceuticals - AED 0 at Non-Network Providers

- Annual limit of AED 1,500

- Prescription Drugs above AED 500 with pre-

authorization only
Physiotherapy - 100% at Network Providers with pre-authorization

- AED 0 at Non-Network Providers

Emergency Treatment in UAE - 100%
Diagnostic and treatment
services for dental and gum
- 100%
treatment (Medical emergency
cases)
Hearing and vision aids, and
vision correction by surgeries and - 100%
laser (Medical emergency cases)
Healthcare services for work
illnesses and injuries as per - 100% at Network Providers
Federal Law No.8 of 1980
concerning the Regulation of
Work Relations, as amended, and - AED 0 at Non-Network Providers
applicable laws in this respect
- All in-patient Maternity Treatments are subject to pre-
Maternity
approval
- 100% at Network Providers

- AED 0 at Non-Network Providers

Inpatient Maternity
- Deductible AED 500 for delivery
- Covered with 6 months waiting period unless pre-
requisition of uninterrupted (pre-) coverage is fulfilled)
- 100% at Network Providers

- AED 0 at Non-Network Providers

Outpatient Maternity - Deductible AED 20 per physician consultation (not

applicable for follow up within 7 days)

- Access to outpatient specialists in hospitals only upon

referral and with additional deductible of AED 10 (not
applicable for follow up within 7 days)
Important Note: This product overview is for information purposes only. The complete list of benefits, definitions, exclusions, terms and
conditions will be set out in the specific policy agreed between yourself and Daman. While every effort is made to ensure the accuracy of
the content, Daman cannot be held liable for any typographical errors, errors of fact or any other error or inconsistency found in this
document.
 PM/E/0005/E002/010417/V1R2/P

www.damanhealth.ae
800 4 DAMAN (32626)
customerinfo@damanhealth.ae