- Overall annual maximum limit per member (in SR)
- Customisable from SAR 500,000 / USD 133,000 up to SAR 37,500,500 / USD 10,000,000 million.
- Customisable from SAR 500,000 / USD 133,000 up to SAR 37,500,500 / USD 10,000,000 million.
- Hearing Aids
- Minimum: We pay up to SAR 6,000 / USD 1,700 each insurance period. Maximum: Paid in full up to the annual maximum limit.
- Minimum: We pay up to SAR 6,000 / USD 1,700 each insurance period. Maximum: Paid in full up to the annual maximum limit.
- Congenital Illness
- Up to annual maximum limit
- Up to annual maximum limit
- Dialysis
- Customisable from SAR 100,000 / USD 26,666 up to annual maximum limit
- Customisable from SAR 100,000 / USD 26,666 up to annual maximum limit
- Rehabilitation (physiotherapy)
- Rehabilitation and physiotherapy: up to annual maximum limit
- Rehabilitation and physiotherapy: up to annual maximum limit
- Emergency Treatment Network
- Up to annual maximum limit, inside and outside KSA
- Up to annual maximum limit, inside and outside KSA
- Healthline Services
- Included
- Included
- Neonatal cover
- Inside KSA: Covered from Day 1. Outside KSA: Minimum: Not covered. Maximum: up to 7 days following birth for routine care and up to SAR 560,000 / USD 150,000 for non-routine care.
- Inside KSA: Covered from Day 1. Outside KSA: Minimum: Not covered. Maximum: up to 7 days following birth for routine care and up to SAR 560,000 / USD 150,000 for non-routine care.
- OP Deductible
- Inside KSA: Choice between 20% of net amount up to SAR 100 per visit and nil. Outside KSA: Choice between up to SAR 100 per visit and nil.
- Inside KSA: Choice between 20% of net amount up to SAR 100 per visit and nil. Outside KSA: Choice between up to SAR 100 per visit and nil.
- VI Ministry Health
- -
- -
- Accommodation
- Inside KSA: Choice between shared room and standard suite. Outside KSA: Single room.
- Inside KSA: Choice between shared room and standard suite. Outside KSA: Single room.
- International emergency treatment
- -
- -
- Maternity cover with benefits
- Customisable from SAR 15,000 / USD 4,000 up to annual maximum limit
- Customisable from SAR 15,000 / USD 4,000 up to annual maximum limit
- Dental coverage
- Customisable from SAR 2,000 / USD 533 up to annual maximum limit
- Customisable from SAR 2,000 / USD 533 up to annual maximum limit
- Optical coverage
- Customisable from SAR 400 / USD 110 up to annual maximum limit
- Customisable from SAR 400 / USD 110 up to annual maximum limit
- Seniors over 64-year old annual limit
- -
- -
- In-patient / day-case coverage
- Up to annual maximum limit
- Up to annual maximum limit
- Companion charges
- Covered
- Covered
- In-patient deductible
- NIL
- NIL
- Out-patient coverage
- Minimum: Covered with limits per visit: GP – SAR 50 / USD 14. Specialist – SAR 100 to 200 / USD 25 to 50. Consultant – SAR 300 / USD 80. Other rare Specialists – SAR 500 / USD 130. Maximum: Paid in full up to annual maximum limit.
- Minimum: Covered with limits per visit: GP – SAR 50 / USD 14. Specialist – SAR 100 to 200 / USD 25 to 50. Consultant – SAR 300 / USD 80. Other rare Specialists – SAR 500 / USD 130. Maximum: Paid in full up to annual maximum limit.
- Preventative Test
- Customisable from not covering it or up to SAR 7,500 / USD 2,000
- Customisable from not covering it or up to SAR 7,500 / USD 2,000
- Treatment of premature babies
- Inside KSA: Up to annual maximum limit. Outside KSA: minimum not covered. Maximum: new-born care benefit, see above.
- Inside KSA: Up to annual maximum limit. Outside KSA: minimum not covered. Maximum: new-born care benefit, see above.
- Circumcision of new-born boys and ear piercing of new-born girls
- Minimum: We pay up to SAR 500/ USD 140 for circumcision and up to SAR 300/ USD 80 for ear piercing each insurance period. Maximum: Paid in full up to annual maximum limit.
- Minimum: We pay up to SAR 500/ USD 140 for circumcision and up to SAR 300/ USD 80 for ear piercing each insurance period. Maximum: Paid in full up to annual maximum limit.
- Pre-existing conditions and chronic disease
- -
- -
- Treatment for acquired heart valves diseases
- -
- -
- Seasonal vaccination including mother and child care as per the Ministry of Health (MOH) programme and schedule
- -
- -
- Physiotherapy when medically needed
- -
- -
- Cost of early screening for new-borns (National Program for Prevention of Disability)
- Inside KSA: Minimum up to SAR 100,000 / USD 27,000. Maximum: up to annual maximum limit. Outside KSA: Minimum: not covered. Maximum: up to annual maximum limit.
- Inside KSA: Minimum up to SAR 100,000 / USD 27,000. Maximum: up to annual maximum limit. Outside KSA: Minimum: not covered. Maximum: up to annual maximum limit.
- Alzheimer’s Disease
- Up to SAR 15,000 / USD 4,000
- Up to SAR 15,000 / USD 4,000
- Autism
- Up to SAR 15,000 / USD 4,000
- Up to SAR 15,000 / USD 4,000
- Acute psychiatric
- -
- -
- Disability cases
- Minimum: We pay up to SAR 100,000 / USD 27,000 each insurance period. Maximum: Paid in full up to annual maximum limit.
- Minimum: We pay up to SAR 100,000 / USD 27,000 each insurance period. Maximum: Paid in full up to annual maximum limit.
- Treatment for damage to acquired heart valves
- Minimum: We pay up to SAR 70,000 / USD 18,920 each insurance period. Maximum: Paid in full up to annual maximum limit.
- Minimum: We pay up to SAR 70,000 / USD 18,920 each insurance period. Maximum: Paid in full up to annual maximum limit.
- Artificial limbs
- Up to annual maximum limit
- Up to annual maximum limit
- Cost of obtaining harvesting donor organs
- Up to SAR 50,000 / USD 13,333
- Up to SAR 50,000 / USD 13,333
- Local road ambulance for emergency cases only
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit
- Transportation of mortal remains to home country in case of death in KSA
- Minimum: We pay up to SAR 10,000 / USD 2,666 each insurance period. Maximum: Paid in full up to annual maximum limit.
- Minimum: We pay up to SAR 10,000 / USD 2,666 each insurance period. Maximum: Paid in full up to annual maximum limit.
- life threating emergency treatment out of network in KSA
- -
- -
- Physicians fees within the network
- -
- -
- Emergency evacuation through international SOS assistance
- -
- -
- Elective (non-emergency) treatment out of network in or out of KSA
- Inside KSA: Minimum: Not covered. Maximum: based on 100% of customary prices of Network hospitals in Network level NW7. Outside KSA: Subject to Reasonable and Customary charges.
- Inside KSA: Minimum: Not covered. Maximum: based on 100% of customary prices of Network hospitals in Network level NW7. Outside KSA: Subject to Reasonable and Customary charges.
- inpatient pre authorization approval
- As per standard protocol
- As per standard protocol
- out patient pre authorization approval
- As per standard protocol
- As per standard protocol
- Advanced Imaging (MRI, CT, PET)
- Up to annual maximum limit
- Up to annual maximum limit
- Cancer treatment
- Up to annual maximum limit
- Up to annual maximum limit
- Local air ambulance for emergency cases only
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit
- Maternity complications (Caesarean deliveries, legal abortion, miscarriage, hemorrhages …)
- Up to annual maximum limit <br>
- Up to annual maximum limit <br>
- Neonatal newborn cover
- Inside KSA: Covered from Day 1. Outside KSA: Minimum: Not covered. Maximum: up to 7 days following birth for routine care and up to SAR 560,000 / USD 150,000 for non-routine care.
- Inside KSA: Covered from Day 1. Outside KSA: Minimum: Not covered. Maximum: up to 7 days following birth for routine care and up to SAR 560,000 / USD 150,000 for non-routine care.
- Mental health conditions (acute psychiatric treatment)
- Minimum: We pay up to SAR 15,000 / USD 4,000 each insurance period. Maximum: We pay up to SAR 15,000 / USD 4,000 each insurance period.
- Minimum: We pay up to SAR 15,000 / USD 4,000 each insurance period. Maximum: We pay up to SAR 15,000 / USD 4,000 each insurance period.
- Non-emergency (elective) treatment outside the Bupa network
- -
- -
- Physiotherapy when medically necessary
- When medically necessary: Minimum: Paid in full up to annual maximum limit (out-patient co-payment applies). Maximum: Paid in full up to annual maximum limit.
- When medically necessary: Minimum: Paid in full up to annual maximum limit (out-patient co-payment applies). Maximum: Paid in full up to annual maximum limit.
- Preventive tests
- Minimum: Not covered. Maximum: We pay up to SAR 7,500 / USD 2,000 each insurance period.
- Minimum: Not covered. Maximum: We pay up to SAR 7,500 / USD 2,000 each insurance period.
- Circumcision of new born boys
- -
- -
- Ear piercing of new born girls
- -
- -
- transplant of organ or born marrow
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit.
- Minimum: Not covered. Maximum: Paid in full up to annual maximum limit.
- Treatment for contagious or endemic diseases
- Covered
- Covered
- Vaccinations and inoculations (up till age 6)
- Inside KSA: Covered. Outside KSA: Up to SAR 11,250 / USD 3,000.
- Inside KSA: Covered. Outside KSA: Up to SAR 11,250 / USD 3,000.
- Vaccinations and inoculations (after age 6)
- Minimum: not covered. Maximum: up to SAR 7,500 / USD 2,000.
- Minimum: not covered. Maximum: up to SAR 7,500 / USD 2,000.
- MOH vaccines
- Physiotherapy
- -
- -
- Emergency medical treatment in the US
- Minimum: Not covered. Maximum: up to SAR 187,500/ USD 50,000.
- Minimum: Not covered. Maximum: up to SAR 187,500/ USD 50,000.
- In patient day case treatment
- -
- -
- Emergency treatment outside of network in KSA
- -
- -