Medical Insurance

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

 QLM Life & Medical Insurance Company

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

 Scope of Coverage

Qatar
&
Country of Origin

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE SPIE, sharing a vision for the future
 Mode of Coverage
• Direct Billing
From the appointed Clinics/Hospitals within the Network.

• Reimbursement
All eligible claims incurred outside the designed network shall be settled at 80% based
on reasonable and customary charges of appointed network in Qatar.

Note: Al Ahli Hospital is excluded from the network and as such, not eligible for cash
reimbursement as well.

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

 Where Can I Use My Card?

You can present the e-card or insurance card in those health care facilities where QLM has an agreement.

Included Hospitals in Qatar are:

• Al Emadi Hospital
• American Hospital
• Doha Clinic Hospital
• Turkish Hospital
• Aster Hospital
• Hamad Hospital & Primary Health Care Centers

Please check the network list for the detailed list of health care facilities where direct billing is permitted.

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

Claim Process

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

 How to contact QLM?

QLM Website
QLM Mobile App.
www.qlm-online.com

Qatar Toll Free:

How to each QLM? 8000 880

Outside Qatar:
+974 4453 3666

The above contact details are

indicated on the back side of your
insurance card.

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

 QLM Mobile App
You can use QLM Mobile Application for:

• Claim Submission
• Claim Tracking
• Pre-Approval Tracking
• Table of Benefits under the plan
• Hospitals/Clinics (search by country ,city etc.)

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

Claim Process
Reimbursement (How to claim outside QLM network)
How to be reimbursed?

• You will have to pay the full amount upfront.

• The following original supporting documents (written in English) are required for each claim:

 A completed Medical Expenses Claim Form.

 Doctor's report/ Medical report
 Original invoice
 Prescriptions
 Discharge summary
 Pharmacy bill, detailing drugs and cost of prescribed drug.
 Diagnostic investigations (Laboratory investigation, X-Ray etc..) reports and invoices.
 Surgeon's Report for inpatient cases.
 In Hospital detailed invoice, in case of Hospitalization.

Continuation in next slide

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

Claim Process
Reimbursement (How to claim outside QLM network)

• For claims less than 1500 QAR, submission to be through QLM mobile App.

• For claims equal or more than 1500 QAR, original documents are to be submitted to the HR focal point in Doha
for completing the claim process.

• In case of substantial amount to pay or elective IP cases (where the cost will be higher than the OP), it is
strongly recommended to avail pre-certification (prior approval ) from QLM.

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

My Benefits

 25 QAR only deductible for every consultation visit.

 100% coverage for In-patient and Out-patient Hospitalization.
 100% for diagnosis (lab test, X-ray, MRI)
 100% coverage on prescription drugs.
 80% coverage outside the network
 Outpatient physiotherapy.
 Herbal medicines and vitamins on deficiency
 Enhanced network
 Toll free number (24/7 service)
 Local provider.

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE

Not Covered

× Vision: consultation, eye test, refraction and optical expenses

× Dental: preventive and surgical treatment

SPIE OIL & GAS SERVICES EQUATION FOR PERFORMANCE