individual-family
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.

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.

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.

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 Economy
Territorial Scope of Coverage Worldwide Worldwide Excluding USA/Canada UAE, Arab World, Sub Asian Continent, Sri Lanka, Korea & Philippines UAE only UAE only
Aggregate Annual Limit AED 1,000,000/- AED 1,000,000/- AED 500,000/- AED 150,000/- AED 150,000/-
Network

 

General Network Plus General Network Restricted Network Restricted Network 2 Restricted Network 3
Room Type

 

Private Private Private Semi Private Ward
Pre-existing & Chronic Conditions Covered
Claims Settlement

 

Direct Billing
Maternity

 

Covered

Health Insurance Plans for SME’s

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

Plan Optimum Grand Comprehensive General Basic Limited
Salient Features
Cover type Inpatient and outpatient Inpatient and outpatient Inpatient and outpatient Inpatient and outpatient Inpatient and outpatient Inpatient and outpatient
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 Plus 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 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 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.

LOOKING FOR A QUOTE ?

We are happy to serve you, please share your requirement with us on-

For Individual Schemes :- health.insurance@alliance-uae.com or medical.individual@alliance-uae.com

For Group / SME Schemes :- medical1@alliance-uae.com or health@alliance-uae.com

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