Sehhati

Your healthcare benefits in detail:

a. Consultation Charges

1. Physician fees as either in-patient or out-patient
2. Pathology, X-ray, and diagnostic procedures, magnetic
   resonance imaging (MRI) and computerized axial
   tomography (CT) scans, radiotherapy, chemotherapy, as
   in-patient or out-patient
   
3. Illness or Injury that requires consultations, diagnostic
   procedures, physiotherapies, prescribed drugs, or other
   covered healthcare services, which are subject to a
   Deductible and/or Co-Insurance per visit as specified in
   the policy

b. Hospital Charges

1. Room and board charges according to the type of Room
2. Accommodation of selected plan option
3. Physician fees including theatre charges for the treatment of
   an Illness or Injury
4. Intensive Care Unit (ICU) charges
   

c.  Prescribed Drugs as an in-patient or out-patient

d. Treatment for Emergency (the sudden, unexpected onset of
a non-excluded Illness or Injury, raising a legitimate professional concern that there may be a significant medical problem necessitating a treatment which cannot be delayed and requires immediate confinement to a Hospital)

* Subject to your selected Plan's Limits, Co-Insurance, Deductible, Pre-Authorization requirement, and other conditions in the policy,

e. Emergency Local Ambulance Charges, including transportation
costs to and from the Hospital by the most appropriate transport
method, only when considered medically necessary by a Physician

f. Cash Indemnity for in-patient treatments for Hospitalizations
within the Designated Network Providers that are not submitted
to us for Claim

g. Physiotherapy treatment which is referred by a specialist
Physician and deemed to be medically necessary for continued
recovery from an Illness or Injury

h. Chiropractic treatment and Osteopathy

i. Organ transplant but as recipient of heart, liver, and kidneys
only, excluding all costs associated with the acquisition of the
required organ to be transplanted including administrative and
transportation costs

j. Accidental damage to teeth provided treatment is received in
a Hospital’s Emergency room within forty-eight (48) hours
following the accident, and provided that the damage is caused
to sound, natural teeth and for the initial relief of pain and any
treatment necessary to preserve the dental structure

k. Home Nursing Care (the skilled nursing services given by a
registered nurse at home immediately after an in-patient
treatment which is deemed to be medically necessary)

l. Parent Accommodation - Charges for a parent staying with
a covered person who is less than 16 years old

m. International Medical Emergency Assistance (Available for
Platinum and Diamond Plans)

1. Emergency Evacuation -arrangement and payment for the appropriate mode of transport, equipment and personnel necessary to evacuate covered person to nearest capable medical facility in the event of an emergency Injury or Illness while traveling outside the country of residence or employment and if adequate facilities are not available
2. Emergency Message Transmission
   
3. Emergency Family Member Visit - transportation of a relative
to the place of Hospitalization when covered person is traveling alone and has been hospitalized for a specific number of days

4. Medically Supervised Repatriation - transportation back home for continuation of Hospitalization when covered person is in stable condition and if medically required
   
5. Care and Transportation of unattended Minor Children
   
6. Repatriation of Mortal Remains of a deceased covered person to his country of residence or employment, or costs for local burial at place of death
   
7. Legal Assistance and Emergency Cash Advances

Within the Medical Network Providers in Bahrain	100% of actual costs
Within the territorial scope / Outside the Medical Network Providers /With our prior approval	80% of actual costs
Within the territorial scope / Outside the Medical Network Providers/ With no prior approval	80% of actual costs,maximum of 80% of the Usual, Customary and Reasonable (UCR) Charges

What are Usual, Customary and Reasonable (UCR) Charges ? UCR Charges refer to charges or expenses for necessary healthcare which, in our sole opinion and experience, does not exceed the general level of charges being made by other healthcare providers of similar standing in the Kingdom of Bahrain, when providing like or comparable treatments or healthcare services.

Within the Medical Network Providers in Bahrain	100% of actual costs minus the Deductible
Within the territorial scope / Outside theMedical Network Providers	80% of actual costs, maximum of 80% of the UCR charges, minus the Deductible

Within Bahrain	100% emergency treatment
Outside Bahrain	100% of eligible inpatient and out-patient emergency treatment; for Gold I Plan-100% of the UCR charges; and for Gold II Plan - Not applicable