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Policy Coverage for the Facility - PY01362 - Print Form Eligibility Verification Date - 25/10/2023
20.0% upto
Medical Copay O/P
AED 50
Medical Copay I/P NIL
Dental Copay NIL
Optical Copay NIL
Medical Coinsurance O/P 100%
Policy Number 4555800000 - HUNTSMAN (UAE) FZE Medical Coinsurance I/P 100%
Certificate No. 72 Dependent: 3 Pharmacy Copay NIL
Policy Name HUNTSMAN (UAE) FZE Dental Coinsurance 80.0%
Member Name KANISHKA VIJAYKUMAR Optical Coinsurance 80.0%
Mobile Number 971506501045 Maternity Coinsurance I/P 100%
Email Address K_VIJAYAKUMAR@HUNTSMAN.COM Maternity Copay I/P NIL
Coverage Status Active Maternity Coinsurance O/P 100%
Member Date Of Birth 30/09/2009 Maternity Copay O/P NIL
Member Gender Female Pharmacy Coinsurance 100%
VIP Status No Alternative Treatment IP Copay 100%
Active Medical 90.0
Medical / Dental / Optical / Maternity Alternative Treatment IP Coinsurance
Coverage
Alternative Treatment IP Deductible 100%
In Network Yes
Alternative Treatment OP Copay 100%
Card Expiry Date 31/12/2023
Alternative Treatment OP Coinsurance 90.0
Emirates/Country DUBAI
Alternative Treatment OP Deductible 100%
Pre-Existing
Conditions
Influenza vaccine Copay 100%
Influenza vaccine Coinsurance 100%
Influenza vaccine Deductible 100%
Mandatory Vaccination Copay 100%
Mandatory Vaccination Coinsurance 100%
Mandatory Vaccination Deductible 100%

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Additional
Information :
Day case will follow OP patient share"

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