Medical Insurance

Who this cover is for

We arrange schemes for individuals, families and companies of every size.

• Families wanting cover for hospitals, clinics and medication
• Companies seeking a group scheme at a lower cost than individual cover
• Self employed professionals with no employer scheme
• Anyone with a chronic condition who needs the wording read carefully

What the policy covers

The core covers we request in every quotation. Some are optional and carry an additional premium.

• In patient treatmentAdmission, surgery and investigations within a defined annual limit.
• Out patient treatmentClinic visits, laboratory tests and radiology.
• MedicationAccording to an approved list, with a co payment that varies by scheme.
• Emergency and accidentEmergency room attendance and ambulance cases as per policy terms.
• MaternityCovered after a defined waiting period, usually under a separate sub limit.
• Dental and opticalOptional cover added for an extra premium with its own limit.
• Treatment outside JordanEmergency treatment while travelling, and sometimes planned treatment with prior approval.

What it usually does not cover

These are common exclusions in this line of business. Actual exclusions differ between insurers, and we set them out in writing with every offer.

• Conditions existing before cover started unless written cover is confirmed
• Cosmetic procedures not arising from an accident or medical necessity
• Experimental and medically unapproved treatment
• Companion costs and non medical hotel style services
• Injuries from hazardous sports or military activity
• Elective routine check ups unless the scheme states otherwise

Figures and clauses worth asking about

Before you sign, these are the clauses that decide what the policy is really worth.

Claim documents

We prepare them with you and review them before submission so the file is not delayed on a procedural point.

• A medical report setting out diagnosis and treatment
• Original invoices and prescriptions
• Prior approval for cases where the policy requires it
• The insurance card and proof of identity
• The claim form completed and stamped by the provider

Questions we put to the insurer on your behalf

These questions are the difference between a cheap offer and a suitable one.

• Which hospitals and centres are in the network, and are any of them restricted?
• What is the annual limit, and is it per person or shared across the family?
• How long are the waiting periods for maternity and elective surgery?
• How does the policy treat chronic conditions that existed before enrolment?
• What is the co payment inside and outside the network?
• What is the prior approval process and how long does it usually take?

Common questions about Medical Insurance