Table Of Benefits ‫ﺟدول اﻟﻣﻧﺎﻓﻊ‬

‫ ﺣدود اﻟﺗﻐطﯾﺔ‬Benefits Limits ‫ وﺻف اﻟﻣﻧﺎﻓﻊ‬Benefits Description

75000 ‫ﺣدود اﻟﺗﻐطﯾﺔ اﻻﺟﻣﺎﻟﯾﺔ ﻋن ﻛل ﻓرد ﺑﺎﻟﺳﻧﺔ‬
Annual Maximum Limit P ERMEMBER Per Year
( ‫ أﻓراد‬5 ) ‫أﺳرة‬ ‫ﻋدد اﻟﻣﺷﺗرﻛﯾن‬
‫ أﺳرة‬500 ‫ﻻ ﯾﻘل ﻋدد اﻻﺳر ﻋن‬ Numbers Of Member
‫ﺟﻣﮭورﯾﺔ ﻣﺻر اﻟﻌرﺑﯾﺔ‬ ‫اﻟﻧطﺎق اﻟﺟﻐراﻓﻲ‬
Inside Egypt Territorial Limit
‫ﻧوع اﻟﺷﺑﻛﺔ‬
A Network Type
‫ﻣﺑﺎﺷر‬ ‫طرﯾﻘﺔ اﻟﺣﺻول ﻋﻠﻰ اﻟﺧدﻣﺔ‬
Direct Access Type
‫ﺧدﻣﺎت اﻟﻣﺳﺗﺷﻔﯾﺎت‬ Inpatient Benefits
‫اﻟﺣد اﻻﻗﺻﻲ ﻟﻠﺗﻐطﯾﺔ‬ ‫ﺣدود اﻟﺗﻐطﯾﺔ‬
Maximum Annual Limit Limit
‫ﻏرﻓﮫ ﻣﻔرده‬ ‫اﻹﻗﺎﻣﺔ ﺑﺎﻟﻣﺳﺗﺷﻔﯾﺎت‬
Single Room Hospital Accommodation
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫أﺟر اﻟﺟراﺣﯾن و أطﺑﺎء اﻟﺗﺧدﯾر و اﻟﺗﻣرﯾض‬
Full Cover Surgeons Anesthetists and Nursing Fees
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻟﻛﺷف اﻟطﺑﻲ‬
Full Cover Consultation Fees
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻻدوﯾﺔ‬
Full Cover Medication
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻟﻌﻧﺎﯾﺔ اﻟﻣرﻛزة‬
Full Cover Intensive Care
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫ﻣﺳﺗﻠزﻣﺎت اﻟﺟراﺣﺔ‬
Full Cover Surgical Appliances
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫ﻓﺗﺢ ﻏرﻓﺔ اﻟﻌﻣﻠﯾﺎت‬
Full Cover Surgical operating Theatre
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻟﻌﻼج اﻟطﺑﯾﻌﻲ‬
Full Cover Physiotherapy
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻻﺷﻌﺎت‬
Full Cover Scans
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ‫اﻟﺗﺣﺎﻟﯾل‬
Full Cover Laboratory Tests
‫ﺗﻐطﯾﺔ ﻛﺎﻣﻠﮫ‬ ( ‫ﺳﯾﺎرة اﺳﻌﺎف ) ﻓﻲ ﺣﺎﻻت اﻟطوارئ‬
Full Cover Ambulance ( In Case Of Emergency

‫ﺧدﻣﺎت اﻟﻌﯾﺎدات اﻟﺧﺎرﺟﯾﺔ‬ Outpatient Benefits

‫اﻟﺣد اﻻﻗﺻﻲ ﻟﻠﺗﻐطﯾﺔ‬ ‫ﺣدود اﻟﺗﻐطﯾﺔ‬
Maximum Annual Limit Limit
‫ﺗﻐطﯾﮫ ﻛﺎﻣﻠﮫ‬ ‫اﻟﻛﺷف اﻟطﺑﻲ‬
Full Cover Consultation Fees
‫ﺗﻐطﯾﮫ ﻛﺎﻣﻠﮫ‬ ‫اﻻﺷﻌﺎت‬
Full Cover Scans
‫ﺗﻐطﯾﮫ ﻛﺎﻣﻠﮫ‬ ‫اﻟﺗﺣﺎﻟﯾل‬
Full Cover Laboratory Tests
%25 ‫ﻧﺳﺑﮫ اﻟﺗﺣﻣل‬ ‫اﻻدوﯾﺔ‬
25% Co-Payment Medication
 ‫ﺗﻐطﯾﮫ ﻛﺎﻣﻠﮫ‬ ( ‫ﻋﻼﺟﺎت و ﺟراﺣﺎت اﻟﯾوم اﻟواﺣد ) ﻣﺣددة‬
Full Cover Day Care Treatment & Surgery ( Limited )
‫ﺧدﻣﺎت اﻻﺳﻧﺎن‬ Outpatient Benefits
‫اﻟﺣد اﻻﻗﺻﻲ ﻟﻠﺗﻐطﯾﺔ‬ ‫ﺣدود اﻟﺗﻐطﯾﺔ‬
Maximum Annual Limit Limit
‫ﺗﻐطﯾﮫ ﻛﺎﻣﻠﮫ‬ ‫اﻟﻛﺷف اﻟطﺑﻲ‬
Full Cover Consultation Fees
%20 ‫ﻧﺳﺑﺔ ﺗﺣﻣل‬ ‫اﻟﺧﻠﻊ اﻟﻌﺎدي‬
%20 Co-payment Simple Extractions
%20 ‫ﻧﺳﺑﺔ ﺗﺣﻣل‬ ‫اﻟﺧﻠﻊ اﻟﺟراﺣﻲ‬
%20 Co-payment Surgical Extraction
%20 ‫ﻧﺳﺑﺔ ﺗﺣﻣل‬ ‫ﺣﺷوات اﻻﺳﻧﺎن اﻟﻔﺿﺔ‬
%20 Co-payment Amalgam Dental Filling
%20 ‫ﻧﺳﺑﺔ ﺗﺣﻣل‬ ‫ﻋﻼج اﻟﻠﺛﺔ‬
%20 Co-payment Gum Treatment
%20 ‫ﻧﺳﺑﺔ ﺗﺣﻣل‬ ‫اﻻﺷﻌﺎت‬
%20 Co-payment Examination X-ray
‫ ﺧدﻣﺎت اﻟﻧظﺎرات‬Optical Benefits
300 EGP ‫ ﻣن اﻟﻌدد ( ﺣدود اﻟﺗﻐطﯾﺔ‬% 5 )
Limit ( 5 % Of Member )
‫ﻛﺷف ﻧظر‬
‫اﻟﺣد اﻻﻗﺻﻲ ﻟﻠﺗﻐطﯾﺔ‬ Vision Tests
Up to optical limit ‫ﻧظﺎرات طﺑﯾﺔ ﻣرة واﺣدة ﻛل ﺳﻧﺔ‬
Optical Glasses One Every One Year
‫ ﺧدﻣﺎت اﻟﺣﻣل و اﻟوﻻدة‬Maternity Benefts
‫ﻟﺣدود ﺗﻐطﯾﺔ اﻟﺣﻣل واﻟوﻻده‬ ( ‫ ﻣن اﻟﺳﯾدات‬2% ) ‫ﺣدود اﻟﺗﻐطﯾﺔ‬
Limit ( 2 % Of Ladies )
Up to maternity limit

2000 EGP ‫اﻟوﻻدة اﻟطﺑﯾﻌﯾﺔ‬

Normal Delivery
3000 EGP ‫اﻟوﻻدة اﻟﻘﯾﺻرﯾﺔ‬
Caesarean Delivery
‫ﻟﺣدود ﺗﻐطﯾﺔ اﻟﺣﻣل واﻟوﻻده‬ ‫ﻣﺗﺎﺑﻌﺔ اﻟﺣﻣل و ﻣﺿﺎﻋﻔﺎﺗﮫ‬
Prenatal Care and Complications of Pregnancy Treatment
Up to maternity limit
‫ﺧدﻣﺎت أﺧرى‬ Other Benefits
‫اﻟﺣﺎﻻت اﻟﻣزﻣﻧﺔ‬
Chronic Cases
‫اﻟﺣﺎﻻت اﻟﺣرﺟﺔ‬
‫ ﺟﻧﯾﮫ ﻟﺟﻣﯾﻊ اﻟﻣﺷﺗرﻛﯾن‬400000 ‫ﻣﻧﻔﻌﺔ ﻣﺟﻣﻌﺔ‬ Critical Cases
Pool 400000 EGP for All Members ‫اﻟﺣﺎﻻت اﻟﺳﺎﺑﻘﺔ ﻋﻠﻰ اﻟﺗﻌﺎﻗد‬
Pre-existing
‫اﻻﺳﺗﺛﻧﺎءات‬
Exceptions
‫اﻟﻌرض اﻟﻣﺎﻟﻲ‬ Commercial Offer
‫دﻓﻌﺔ واﺣدة‬ ‫طرﯾﻘﺔ اﻟدﻓﻊ‬
Payment Terms
One Chot
‫ ﺟﻧﯾﮫ ﻟﻛل أﺳرة‬4250 ‫اﻟﺳﻌر‬
Price