COVERAGE DESCRIPTION

HEALTH CARE BENEFIT DETAILS

Printed On: September 16, 2020

Contract: Al Badia Cement

Beneficiary : Mohammad Deeb Daood

1- Limitations

Level Description Quantity Limit Used Balance

Service Optical Frames (Optical) 1 0 1

Optical Glasses/Lenses (Optical) 2 0 2

Level Description Nbr of Transactions Used Balance

Coverage Denba4 - Dental 90k Orthodontic- 99 0 99

Fix Pro
Optcb2 - Optic 30k Fram 1in 99 0 99
1year,Len 1
Ambbad - Amb 15 Trx Badieh 15 1 14
Cement
Pmbbad - Pm 15 Trx Badieh Phd- 15 4 11
Arop
Dvbad4 - Dv Bad 15 Trx 4000 15 6 9
Reim

Level Description Curr Financial Limit Used Balance

Sub Category In-Hospital SL 25,000,000 0 25,000,000

Sub Category Dental SL 90,000 0 90,000

Sub Category Optical SL 30,000 0 30,000

Benefit Burial Indemnity ( In-Hospital) SL 200,000 0 200,000

Mednet Baby Benefit ( In-Hospital) SL 350,000 0 350,000
Benefit Dental (Dental) SL 81,000 0 81,000

Service Stent - Al Razi ( In-Hospital) SL 900,000 0 900,000

Disease Related Combined DRC Limitation for: SL 250,000 0 250,000

Condition • Mental retardation related
conditions
• Short stature related conditions
• Pituitary related conditions
Neoplasm related conditions SL 15,000,000 0 15,000,000

1/1
The present coverage description is subject to all the legal and coverage terms and conditions of the underlying Healthcare Insurance Policy of the adherent. If for any reason, a
difference or discrepancy was found between the present Coverage Description and the underlying HealthCare Insurance Policy wording of the Beneficiary, the terms of the
underlying policy shall prevail.