Schedule of Benefits (Core Bronze without Dental)

Plan Name Core Bronze without Dental

Annual Benefit Limit AED 250,000 Per Person Per Policy Year
Territorial Limit1 UAE
Extended to Southeast Asia, India Subcontinent and Arab Country* for inpatient
treatment only on reimbursement basis for elective and emergency treatment
Network (Allowing direct Network Within UAE: Narrow NW
billing at designated In & Out-patient on direct billing in UAE
provider)
Network Outside UAE: Not applicable
Pre-existing Conditions Fully Covered
Inpatient Treatment Network Non-Network
Inpatient & Day Treatment 2
100% covered 50% covered
(including Pre & Post In Hospital Treatment Covered)
Accommodation Type-Shared Room 100% covered 50% covered
Hospital Accommodation & Services 100% covered 50% covered
Consultant’s, Surgeon’s & Anesthetist’s Fees and other fee 100% covered 50% covered
Ambulance Services
100% covered 100% covered
(Medical emergency cases, subject to General exclusions)
Parent Accommodation for accompanying an Insured Child under 10 years
of age 100% covered 50% covered
(Maximum limit of AED100 per day)
Companion Accommodation for Critical Illness
100% covered 50% covered
(Maximum limit of AED 100 per day)
Out-patient Treatment Network Non-Network
Physician Consultation
(Deductible AED 50) 100% covered 50% covered
(Deductible not applicable for follow up within 7 days)
Diagnostics (X-Ray, MRI, CT-Scan, Ultra Sound, etc.), Laboratory
(Specialized investigation and scan including but not limited to MRI, Scan, 100% covered 50% covered
Endoscopies with Pre-authorization only)
Pharmaceuticals
(Maximum Annual Limit AED 1,500 Per Person)
70% covered 50% covered
(Long term medications to be dispensed up to 30 days without pre-
authorization)
Physiotherapy2 100% covered 50% covered
Other Benefits Network Non-Network
Repatriation of Mortal Remains to country of origin3
100% covered 100% covered
(Maximum limit AED 5,000 Per Person)
Emergency Treatment 100% covered 100% covered7
Diagnostic and treatment services for dental and gum treatment
100% covered 100% covered
(Medical emergency cases)
Hearing and vision aids, and vision correction by surgeries and laser
100% covered 100% covered
(Medical emergency cases)
Healthcare services for work illnesses and injuries as per Federal Law No.
8 of 1980 concerning the Regulation of Work Relations, as amended, and 100% covered 50% covered
applicable laws in this respect
Annual Breast Cancer Screening
100% covered 50% covered
(applicable for females> 35 years) 2,4
Annual Prostate Cancer Screening
100% covered 50% covered
(applicable for males> 45 years) 2,5
Colorectal Cancer Screening
100% covered 50% covered
(applicable for males and females> 40 years) 2,6
Maternity Network Non-Network
Inpatient Maternity (Maximum annual limit per person)1,2
Within UAE: 100% Covered
100% covered 50% covered
Outside UAE: AED 8,000
(Deductible AED 500 Per delivery)
Outpatient Maternity
100% covered 50% covered
(Deductible physician consultation AED 50)

National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
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 Schedule of Benefits (Core Bronze without Dental)

(Deductible not applicable for follow up within 7 days)

Dental Not Covered Network Non-network
Other Services covered (Through Service Providers Only)
Teleconsultation healthcare services
(Deductible Nil)
International Assistance Service through service provider only
Second Medical Opinion through service provider only

*As defined by Daman

1
Please note: (1) A single holiday or business trip may not exceed 90 days. (2) Coverage outside UAE is limited to 90 days
per treatment. Exception: For Maternity benefit, coverage is extended up to 180 days.
2
Pre-authorization required to avail this benefit. All Emergency cases do not require pre-authorization but should be notified
to Daman within 24 hours
3
Available on reimbursement only. Non-network Providers covered on re-imbursement only
4
Includes: a) Clinical Examination b) Mammogram c) Pelvic Sonogram (if medically indicated) d) CA 15.3 (if medically
indicated)
5
Includes: a) Clinical Examination b) PSA c) Rectal sonogram
6
Includes: a) FIT (Fecal Immunochemical Test) every 2 years; b) Colonoscopy every 10 years
7
Exception: For inpatient maternity treatment at Non Network Provider, 50% covered outside UAE

SOB REF NO: SOB-US-6486-170820/DOH Approval No: 39602

Package NO: 26753 & 26754

National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
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 Schedule of Benefits (Core Bronze without Dental)

Plan Name Core Bronze without Dental-MEDIA ZONE ( PARTNER & FREELANCER)
Annual Benefit Limit AED 250,000 Per Person Per Policy Year
Territorial Limit1 UAE
Extended to Southeast Asia, India Subcontinent and Arab Country* for inpatient
treatment only on reimbursement basis for elective and emergency treatment
Network (Allowing direct Network Within UAE: Narrow NW
billing at designated In & Out-patient on direct billing in UAE
provider)
Network Outside UAE: Not applicable
Pre-existing Conditions Fully Covered
Inpatient Treatment Network Non-Network
Inpatient & Day Treatment 2
100% covered 50% covered
(including Pre & Post In Hospital Treatment Covered)
Accommodation Type-Shared Room 100% covered 50% covered
Hospital Accommodation & Services 100% covered 50% covered
Consultant’s, Surgeon’s & Anesthetist’s Fees and other fee 100% covered 50% covered
Ambulance Services
100% covered 100% covered
(Medical emergency cases, subject to General exclusions)
Parent Accommodation for accompanying an Insured Child under 10 years
of age 100% covered 50% covered
(Maximum limit of AED100 per day)
Companion Accommodation for Critical Illness
100% covered 50% covered
(Maximum limit of AED 100 per day)
Out-patient Treatment Network Non-Network
Physician Consultation
(Deductible AED 50) 100% covered 50% covered
(Deductible not applicable for follow up within 7 days)
Diagnostics (X-Ray, MRI, CT-Scan, Ultra Sound, etc.), Laboratory
(Specialized investigation and scan including but not limited to MRI, Scan, 100% covered 50% covered
Endoscopies with Pre-authorization only)
Pharmaceuticals
(Maximum Annual Limit AED 1,500 Per Person)
70% covered 50% covered
(Long term medications to be dispensed up to 30 days without pre-
authorization)
Physiotherapy2 100% covered 50% covered
Other Benefits Network Non-Network
Repatriation of Mortal Remains to country of origin3
100% covered 100% covered
(Maximum limit AED 5,000 Per Person)
Emergency Treatment 100% covered 100% covered7
Diagnostic and treatment services for dental and gum treatment
100% covered 100% covered
(Medical emergency cases)
Hearing and vision aids, and vision correction by surgeries and laser
100% covered 100% covered
(Medical emergency cases)
Healthcare services for work illnesses and injuries as per Federal Law No.
8 of 1980 concerning the Regulation of Work Relations, as amended, and 100% covered 50% covered
applicable laws in this respect
Annual Breast Cancer Screening
100% covered 50% covered
(applicable for females> 35 years) 2,4
Annual Prostate Cancer Screening
100% covered 50% covered
(applicable for males> 45 years) 2,5
Colorectal Cancer Screening
100% covered 50% covered
(applicable for males and females> 40 years) 2,6
Maternity Network Non-Network
Inpatient Maternity (Maximum annual limit per person)1,2
Within UAE: 100% Covered
100% covered 50% covered
Outside UAE: AED 8,000
(Deductible AED 500 Per delivery)
Outpatient Maternity
100% covered 50% covered
(Deductible physician consultation AED 50)

National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
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 Schedule of Benefits (Core Bronze without Dental)

(Deductible not applicable for follow up within 7 days)

Dental Not Covered Network Non-network
Other Services covered (Through Service Providers Only)
Teleconsultation healthcare services
(Deductible Nil)
International Assistance Service through service provider only
Second Medical Opinion through service provider only

*As defined by Daman

1
Please note: (1) A single holiday or business trip may not exceed 90 days. (2) Coverage outside UAE is limited to 90 days
per treatment. Exception: For Maternity benefit, coverage is extended up to 180 days.
2
Pre-authorization required to avail this benefit. All Emergency cases do not require pre-authorization but should be notified
to Daman within 24 hours
3
Available on reimbursement only. Non-network Providers covered on re-imbursement only
4
Includes: a) Clinical Examination b) Mammogram c) Pelvic Sonogram (if medically indicated) d) CA 15.3 (if medically
indicated)
5
Includes: a) Clinical Examination b) PSA c) Rectal sonogram
6
Includes: a) FIT (Fecal Immunochemical Test) every 2 years; b) Colonoscopy every 10 years
7
Exception: For inpatient maternity treatment at Non Network Provider, 50% covered outside UAE

Subject to DOH Approval.

SOB REF NO: SOB-US-6479-R1-170820 | DOH Ref : 39602

SC Package NO: 26539 & 26540

National Health Insurance Company – Daman (PJSC) (P.O. Box 128888, Abu Dhabi, U.A.E. Tel No. +97126149555 Fax No. +97126149550)
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