SimpleCare

SimpleCare CORE

Our SimpleCare CORE medical insurance plan is designed for individuals that want access to high-quality private healthcare providers, but are on a tight budget. This plan offers coverage for all major in-patient treatment including hospitalization, surgery and cancer treatment, as well as medical evacuation and repatriation. 

Please note this plan does not include cover for any out-patient treatment. Customers looking for out-patient cover should view our SimpleCare 100 or SimpleCare 250 plans. 

*SimpleCare CORE is not available to insured persons with residence visas in the Emirates of Dubai and Abu Dhabi. 

SimpleCare 100

Our SimpleCare 100 medical insurance plan is designed for individuals looking for affordable health coverage for both in-patient and out-patient treatment. This plan provides comprehensive cover for major health events such as hospitalization, surgery and cancer treatment. It also offers low levels of cover for out-patient treatment, including GP visits, drugs and dressings, and physiotherapy.

*SimpleCare 100 is not available to insured persons with residence visas in the Emirate of Abu Dhabi.

Dubai Health Authority (DHA) Mandatory requirements Benefit

This Plan provides coverage up to USD 41,000 in aggregate per Insured Person, per Period of Cover for the following basic health services inclusive of Emergency services within the United Arab Emirates:

(i) Pre-existing Conditions including maintenance of Chronic Medical Conditions.

(ii) Examinations, diagnostic and Treatment services (including cost of medicine) received in clinics and health centers that are provided by general Medical Practitioners and Specialists. Follow up visits are exempted from fees if made within a week from the date of the first examination.

(iii) Laboratory tests, Xñray diagnostic services, diagnostic procedures including MRI, CT scans and endoscopies.

(iv) Out-Patient physiotherapy - Maximum 10 sessions per year.

(v) The costs of accommodation of an accompanying person as an In-Patient in the same room in cases that are Medically Necessary at the recommendation of the Medical Practitioner or Specialist. Subject to Pre-Authorisation and up to a maximum of USD 28 (AED 100) per night.

(vi) Essential Vaccinations and inoculations for newborns and children as stipulated in the DHA policies and its updates, in assigned facilities covered up to a limit of USD 28 (AED 100).

(vii) Adult Pneumococcal Conjugate Vaccine as per DHA Adult Pneumococcal Vaccination guidelines.

(viii) Preventive screening for diabetes and other screening as stipulated by the DHA every three years for Insured Persons above the age of 30 and every year for 18 years and above for Insured Persons considered high risk.

(ix) Medically Necessary costs incurred during normal Pregnancy and childbirth, including the delivery costs, pre and post natal check-ups. Cover includes examinations, diagnostic and Treatment, and follow up visits for Pregnancy and gynaecology services provided by general Medical Practitioners and Specialists (subject to referral by the general Medical Practitioner) and received in authorised health centers and clinics.

• Cover is provided for eight visits to a Primary Healthcare (PHC) obstetrician for low-risk patients or Specialist obstetrician for high-risk patients referrals.
• Visits to include reviews and checks and tests in accordance with the DHA antenatal Protocols. Initial investigations to include: FBC and platelets, blood group, rhesus status and antibodies, VDRL, MSU, urinalysis, rubella serology, HIV, FBS, randoms or A1C and for high-risk patients GTT and Hepatitis C.
• The cost of three antenatal ultrasound scans.
• In-Patient maternity is limited to a maximum of USD 2,750 for normal Pregnancy and USD 2,750 for C-section per Insured Person, per Period of Cover.

(x) Cover is provided for a New Born baby of an Insured Person for a period of 30 days from birth within the existing aggregate limit of the Mother. This includes BCG, Hepatitis B and neo-natal screening tests (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening, congenital adrenal hyperplasia).

(xi) Psychiatry and Mental Health: Outpatient counselling covered up to USD 218 (AED 800) per year subject to a 30% coinsurance payable by the insured per visit.

(xii) Influenza Vaccine covered once a year. Unless otherwise indicated these Benefits will not be payable for Treatment outside the United Arab Emirates.

(xiii) Organ transplantation: Coverage up to limit of USD 27,226 (AED 100,000) for recipient only. 20% coinsurance payable by the insured per visit for outpatient visits.

(xiv) Dialysis: Covered to a limit of USD 16,336 (AED 60,000). 20% coinsurance payable by the insured per visit for outpatient visits.

(xv) Dental Benefits: Dental consultation, extraction, fillings, root canal treatment, scaling, x-rays, antibiotics and prophylaxis covered up to USD 137 (AED 500). 30% coinsurance payable by the insured per visit for outpatient visits. No coinsurance applicable if a follow-up visit is made within 7 days.

(xvi) Repatriation costs for the transport of mortal remains to the country of origin: Coverage up to limit of USD 1,362 (AED 5,000)

(xvii) Hearing and vision aids, and vision correction by surgeries and laser: Excluded healthcare services except in cases of medical emergencies. Subject to 20% coinsurance.

Unless otherwise indicated these Benefits will not be payable for Treatment outside the United Arab Emirates.

No maternity Waiting Period applies on the Dubai Health Authority (DHA) Mandatory requirements Benefit.

**Note: Above mentioned benefits are the minimum required DHA benefits however if client has opted for the upgraded plan (enhanced benefits) he/she will avail the benefits under the enhanced coverage.

BASMAH Initiative:

Dubai Health Authority (DHA), as part of UAE 2021 vision and in alignment with Dubai Standards of Care has launched a Cancer Patient Support Program (Cancer PSP) and a Hepatitis C Patient Support Program (HCV PSP).

Screening, healthcare services, investigations and Treatments related to and associated complications related to Cancer shall be extended to the fund ONLY for members enrolled under the Patient Support Program (PSP) as per terms and conditions of the Program.

Screening, healthcare services, investigations and Treatments related to viral hepatitis and associated complications related to Hepatitis C shall be available ONLY for members enrolled under the Patient Support Program (PSP) as per terms and conditions of the Program.