- Network
- NW5
- NW4
- NWS
- NW7
- Annual Limit
- SAR 1,000,000
- SAR 1,000,000
- SAR 1,000,000
- SAR 1,000,000
- Inpatient
- Room Type
- Single Room
- Standard Suite
- Standard Suite
- Standard Suite
- Companion Charges (When medically necessary)
- Inpatient Co-pay
- NIL
- NIL
- NIL
- NIL
- Outpatient
- Outpatient Co-pay
- 20% up to: ● MPN Providers: SAR 75 ● Hospitals out of MPN: SAR 300 ● Providers other than Hospitals out of the MPN: SAR 100
- 20% up to: ● MPN Providers: SAR 75 ● Hospitals out of MPN: SAR 300 ● Providers other than Hospitals out of the MPN: SAR 100
- 20% up to: ● MPN Providers: SAR 75 ● Hospitals out of MPN: SAR 300 ● Providers other than Hospitals out of the MPN: SAR 100
- 20% up to: ● MPN Providers: SAR 75 ● Hospitals out of MPN: SAR 300 ● Providers other than Hospitals out of the MPN: SAR 100
- Medication Co-pay
- ● Generic Medication or Branded Medication with no Generic Alternative Available: 20% up to SAR 30 ● Branded Medication with Generic Alternative Available: 20% without CAP
- ● Generic Medication or Branded Medication with no Generic Alternative Available: 20% up to SAR 30 ● Branded Medication with Generic Alternative Available: 20% without CAP
- ● Generic Medication or Branded Medication with no Generic Alternative Available: 20% up to SAR 30 ● Branded Medication with Generic Alternative Available: 20% without CAP
- ● Generic Medication or Branded Medication with no Generic Alternative Available: 20% up to SAR 30 ● Branded Medication with Generic Alternative Available: 20% without CAP
- Pregnancy & Childbirth
- SAR 15,000
- SAR 15,000
- SAR 15,000
- SAR 15,000
- Pregnancy & Childbirth-related Complications
- Premature Children’s Treatment
- Circumcision
- SAR 500
- SAR 500
- SAR 500
- SAR 500
- Neonatal
- Newborn Early Testing
- SAR 100,000
- SAR 100,000
- SAR 100,000
- SAR 100,000
- Dental Treatment
- ● Essential & Preventive dental treatment: Covered up to a maximum of SAR 1,200 without deductible. ● Treatment of root canals & Emergencies: Covered up to SAR 800 with 20% deductible.
- ● Essential & Preventive dental treatment: Covered up to a maximum of SAR 1,200 without deductible. ● Treatment of root canals & Emergencies: Covered up to SAR 800 with 20% deductible.
- ● Essential & Preventive dental treatment: Covered up to a maximum of SAR 1,200 without deductible. ● Treatment of root canals & Emergencies: Covered up to SAR 800 with 20% deductible.
- ● Essential & Preventive dental treatment: Covered up to a maximum of SAR 1,200 without deductible. ● Treatment of root canals & Emergencies: Covered up to SAR 800 with 20% deductible.
- Optical
- SAR 400 (For beneficiaries up to 14 years old)
- SAR 400 (For beneficiaries up to 14 years old)
- SAR 400 (For beneficiaries up to 14 years old)
- SAR 400 (For beneficiaries up to 14 years old)
- Pre-existing Conditions & Chronic Diseases
- Hearing Aids
- SAR 6,000
- SAR 6,000
- SAR 6,000
- SAR 6,000
- Vaccination & Inoculations
- Physiotherapy (When medically necessary)
- Congenital Illness
- Dialysis
- SAR 180,000
- SAR 180,000
- SAR 180,000
- SAR 180,000
- Psychiatric Treatment
- SAR 50,000
- SAR 50,000
- SAR 50,000
- SAR 50,000
- Rehabilitation (physiotherapy)
- Disability
- SAR 100,000
- SAR 100,000
- SAR 100,000
- SAR 100,000
- Obesity Treatment
- ● Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
- ● Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
- ● Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
- ● Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
- Acquired Heart Valve Diseases
- SAR 150,000
- SAR 150,000
- SAR 150,000
- SAR 150,000
- Alzheimer’s Treatment
- SAR 15,000
- SAR 15,000
- SAR 15,000
- SAR 15,000
- Autism Treatment
- SAR 50,000
- SAR 50,000
- SAR 50,000
- SAR 50,000
- Donor Part Collection
- SAR 50,000
- SAR 50,000
- SAR 50,000
- SAR 50,000
- Emergency Out-of-Network Treatment
- Transportation of the Deceased Beneficiary’s Body
- SAR 10,000
- SAR 10,000
- SAR 10,000
- SAR 10,000
- Consulting an In-Network Doctor
- Maximum Physician's Fees within the Network
- ● General Practitioner/ specialist (First Registrar Doctor): 100 - 150 SAR ● Specialist (Second Registrar Doctor)/ Consultant: 200 - 300 SAR ● Specializations with scarcity and the like: (Such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties) 400 SAR
- ● General Practitioner/ specialist (First Registrar Doctor): 100 - 150 SAR ● Specialist (Second Registrar Doctor)/ Consultant: 200 - 300 SAR ● Specializations with scarcity and the like: (Such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties) 400 SAR
- ● General Practitioner/ specialist (First Registrar Doctor): 100 - 150 SAR ● Specialist (Second Registrar Doctor)/ Consultant: 200 - 300 SAR ● Specializations with scarcity and the like: (Such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties) 400 SAR
- ● General Practitioner/ specialist (First Registrar Doctor): 100 - 150 SAR ● Specialist (Second Registrar Doctor)/ Consultant: 200 - 300 SAR ● Specializations with scarcity and the like: (Such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties) 400 SAR
- Family Planning
- SAR 1,500
- SAR 1,500
- SAR 1,500
- SAR 1,500
- Menopausal & Perimenopausal
- Sexually Transmitted Diseases
- Comprehensive Diabetic Program
- Kidney Transplant
- SAR 250,000
- SAR 250,000
- SAR 250,000
- SAR 250,000
- Preventive Screenings
- Local Ambulance
- Medical Devices
- Birth Defects
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