Patient Details

Card Number 097110330225435802

DHA Member ID I035-036-115875133-01

Mobile Number 566034423

Email

Identification Emirates ID :

L
First Name JUBAITHA

Last Name BEGUM ABDUL RASHEED

TIA
Date of Birth 16 Oct 1991

Gender Female

Start Date 31 Aug 2023

30 Aug 2024
EN
Expiry Date

Member Network Silver Premium

Policy Holder ELGROCER DMCC

Policy Issued From Dubai-DHA

ID

Member Benefits
NF

Payer's Name Islamic Arab Insurance Co. (P.S.C.)_33

Assist America Coverage NO

Package Default Network Silver Premium

CO

Approvals Classification Standard

HAAD/DHA Approval Number DHA-SIAC-MNG-410

Territory of Coverage Worldwide

Outpatient Plan Covered

Physicial Consultation Copayment 20%

Physician Consultation Copay

50 AED
Maximum Amount

Laboratory Services Copayment 0%

Radiology Services Copayment 0%

Outpatient Procedure Copayment 0%

Pharmaceutical Copayment 0%
Dental Coverage Covered

Dental Access 02 Reimbursement & Free Access

Dental Copayment 20%

Alternative Medicine Not Covered

Alternative Medicine Access 03 Not Covered

Alternative Medicine Copayment 0%

Optical Plan Not Covered

Optical Copayment 0%

Optical Access 03 Not Covered

Wellness Access 01 Reimbursement

L
Vaccination Plan Not Covered

Vaccination Access 03 Not Covered

TIA
Vaccination Copayment 0%

Out Mat Physician Consultation

10%
Copayment

Out Mat Laboratory Copayment 10%

EN
Out Mat Radiology Copayment 10%

Out Mat Pharmaceuticals Copayment 10%

Maternity IP Plan Covered

ID

Physiotherapy Services Copayment 0%

Inpatient Copay 0%

DHA Member Registration ID I035-036-115875133-01

NF

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DISCLAIMER:
25/Oct/2023 17:14 PM
ALL SERVICES OUTSIDE PRE-APPROVAL PROTOCOL ARE SUBJECT TO RESTROSPECTIVE MEDICAL EVALUATION
CO

UPON CLAIM SUBMISSION.

CLAIMS PROCESSING IS SUBJECT TO CONTRACTUAL TARIFF.