Individual / Family / SME

Solutions for Individual Health Protection

Alliance has been looking after the health insurance needs of individuals, families and SMEs in the UAE for over 40 years, and in that time we have grown to become one of the nation’s premier insurers. We offer a full range of health insurance protection, exceptional customer service, security, reliability and a commitment to excellence. Choose from our flexible insurance options including local, regional or international policies.

Multiple Choice Programs

We offer an extensive range of advanced health insurance products, which can be tailored to suit your specific needs. Benefit from our experience and choose which one is right for you.

Guaranteed Renewability

Alliance guarantees that all individual, family and SME medical insurance policies are fully renewable (terms and conditions apply) at the end of each policy term.

Corporate Health Insurance Plans

All proposed plans shall be governed by the provisions of Law No. 23 of 2005 regarding Health Insurance in the Emirate of Abu Dhabi and its executive regulations and the provisions of Health Insurance Law 11 of 2013 in the Emirate of Dubai and its executive regulation

Cover Type	Universal Plus	Universal	Basic	Local	Limited	Enhanced Economy
Territorial Scope of Coverage	Worldwide	Worldwide Excluding USA/Canada	UAE, Arab World, Indian Sub-Continent, Sri Lanka, Korea & Philippines	UAE only	UAE, Arab World, Indian Sub-Continent, Sri Lanka, Korea & Philippines	UAE only
Aggregate Annual Limit	AED 500,000/-	AED 500,000/-	AED 300,000/- For Basic Plan GN / AED 250,000/- for Basic Plan RN	AED 150,000/-	AED 150,000/-	AED 150,000/-
Network	General Network	General Network	General Network & Restricted Network	General Network & Restricted Network	Restricted Network 2	Restricted Network 3 For In-Patient & PCP For Out-Patient.
Room Type	Private	Private	Private / Semi-Private	Private / Semi-Private	Semi-Private	Ward
Pre-existing & Chronic Conditions	Covered
Claims Settlement	Direct Billing
Maternity	Covered

Health Insurance Plans for SME’S

Plan for SME’s

Benefits

Other Features

Optional Benefits

Deductible / Limitation / Settlement

Plan for SME’s

Benefits

Other Features

Optional Benefits

Deductible / Limitation / Settlement

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For feedback / complaint to DHA, you may follow the link below.

http://ipromes.eclaimlink.ae/

Plan	Optimum	Grand	Comprehensive	General	Basic	Limited
Salient Features
Aggregate Limit PPPA	AED 1,000,000/-	AED 500,000/-	AED 500,000/-	AED 500,000/-	AED 500,000/-	AED 250,000/-
Network	General Network	General Network	Restricted Network	Restricted Network 2	NEXTCARE RN3 ( Out-patient is restricted to Clinics Only)	NEXTCARE RN3 ( Out-patient is restricted to Clinics Only)
Territorial Limit	Worldwide	Worldwide Excluding USA/ Canada	UAE, Arab Countries, Sub-Asia Countries, Philippines, Korea, Sri Lanka	UAE, Arab Countries, Sub-Asia Countries, Philippines, Korea, Sri Lanka	UAE, Arab Countries, Sub-Asia Countries, Philippines, Korea, Sri Lanka	UAE only
Preexisting and Chronic Conditions	Covered up to Annual Limit after 6 months waiting perio	Covered up to Annual Limit after 6 months waiting period	Covered up to Annual Limit after 6 months waiting period	Covered up to Annual Limit after 6 months waiting period	Covered up to Annual Limit after 6 months waiting period	Covered up to Annual Limit after 6 months waiting period

Plan	Optimum	Grand	Comprehensive	General	Basic	Limited
Hospital Accommodation Room and Board Class	Private Room
Hospital Accommodation Intensive Care Unit (ICU)	Covered 100%
Parent Hospital Accommodation When staying with an Insured patient under 18 years of age	Covered up to max AED 350/- per day
Companion accommodation The cost of accommodation of a person accompanying an in-patient in the same room in cases of medical necessity at the recommendation of the treating doctor and after the prior approval of the insurance company providing coverage	Maximum 350 AED per night
Psychiatric Treatment in a registered psychiatric unit of a Hospital and with a registered psychiatrist	Out Patient Covered up to Maximum AED 1,500/- per person per annum IN Patient Covered up to Maximum AED 7,500/- per person per annum
Home nursing post Hospitalization	Covered up to Maximum AED 10,000 per person per annum
Medical emergency cases – Hearing & Vision aid and Vision correction by surgeries and laser	Covered 100%
Medical emergency cases – Diagnostic and treatment services for dental and gum treatments	Covered 100%
Organ Transplant	Covered as recipient, only for Heart, Kidney and Liver, excluding organ donation, expenses of the donor and acquisition cost of the organ.
Emergency road ambulance services to and from hospital by registered ambulance services provider	Covered
Cash Indemnity for In-Patient Treatment post hospitalization up to max of 15 days	AED 200 night up to 180 days for all inpatient hospitalizations that are not submitted to the Insurance Company
Physiotherapy subject to prior approval	Covered 100% for Inpatient Limited to 20 session for Outpatient
Prescribed Drugs & Medicines	Covered
Basic Vaccination for child up to 6 years	Covered as per MOH list of vaccines
Diagnostics ( X-ray, MRI, CT-Scan, Ultra Sound& Endoscopy diagnostic services )	Covered
Repatriation of Mortal Remains to the Country of Domicile:	Covered up to Maximum AED 10,000 per person per annum

Plan	Optimum	Grand	Comprehensive	General	Basic	Limited
Maternity Services Note:- Maternity benefits are applicable for ALL Married females aged 18 and above	Outpatient Services (10% coinsurance) (ante-natal services-require prior approval) 8 visits to PHC; All care provided by PHC obstetrician for low risk or specialist obstetrician for high risk referrals Initial investigations to include: – FBC and Platelets – Blood group, Rhesus status and antibodies – VDRL – MSU & urinalysis – Rubella serology – HIV – Hep C offered to high risk patients – GTT if high risk – FBS , random s or A1c for all due to high prevalence of diabetes in UAE Visits to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols 3 ante-natal ultrasound scans In-patient Services (10% coinsurance) Required period approval from the insurance company or within 24 hours of emergency treatment) Maximum benefit 7,000 AED per normal delivery & 10,000 AED for medically necessary C-section, complications and for medically necessary termination
New Born Cover	Cover for 30 days from birth BCG, Hepatitis B and neo-natal screening test (Phenylketonuria (PKU), Congenital Hypothyroidism, sickle cell screening ,congenital adrenal hyperplasia)
Preventive services, vaccines and immunizations	Essential vaccinations and inoculations for newborns and children as stipulated in the DHA’s policies and its updates in the assigned facilities
Emergency medical evacuation provided by Mondial Assistance	Covered

Plan	Optimum	Grand	Comprehensive	General	Basic	Limited
Dental benefit Covers the following: Teeth Extraction, Amalgam fillings, Temporary and/or permanent composite, fillings and root canal treatment only.	Covered up to AED 2,000/- PPPA subject to 20% Co-pay
Optical benefit: Covers the following: Optical examinations conducted for the purpose of obtaining eye glasses or upgrading existing lenses	Covered up to AED 1,000/- PPPA subject to 20% Co-pay
Alternative Medicines/ therapies ( subject to additional premium) covers the following: Chiropractic/ Osteopathy/ Homeopathy and Ayurvedic	Covered up to AED 1,600/- PPPA

Deductible / Co participation / Limitation / Settlement
Plan	Optimum	Grand	Comprehensive	General	Basic	Limited
OP Consultation Deductible	Opt 1: 20% up to AED 25 Opt 2: 20% up to AED 50
Prescribed Drugs & Medicines	Option 1: NIL Co-pay Option 2: 10% Co-pay Option 3: 20% Co-pay
Settlement Basis	Direct Billing within Network
Within Network	100% on Direct Billing basis
Out of Network Treatment	Treatment taken outside the Network is subject to 20% Co-Payment. Reimbursement will be up to Reasonable & Customary Charges applicable in the UAE Network.
Outside UAE within Territory Limit	100% Reimbursement subject to Reasonable & Customary Charges applicable in the UAE Network.