US$ US$ Transaction Standard Recovery

Code Plan Financial Financial Number of Excess Financing

limitation limitation transactions Deductible % Excess %
IH In Hospital for basic health plan Unlimited 0.00
PM Prescription Medicine Unlimited 15% 0.00
MG Medi guide Unlimited 2 0.00
AM Ambulatory Unlimited 15% 0.00
DM Dental care limited 600 20% 0.00
DC Doctor Visit limited 240 20 12 0.00

Network:
Open Network as per Best Assistance list of providers at the time of claim. For an up-todate list of
providers, please visit www.bestassistance.com, or download Best Assistance mobile application.

Compulsory Cover:
In Hospital – No annual financial limitation

Observation Period:
An Observation period (OP) of 180 days to set the final underwriting decision is applied for new enrolled
adherents. Such OP is waived for adherents enrolled with continuity.

Out Patient Cover:

Ambulatory:
Annual financial limitation. Unlimited
Excess Deductible: 15%
Benefits:
o Radiology, C.T. Scan, MRI, Ultrasonography, Electroencephalogram, Audiogram,
Electromyogram, Stress test, Evoked response, Ocular angiography, Thallium myocadiac
scintigraphy, Echocardiography, Holter monitoring, Electrocardiogram, Laboratory test, Nuclear
medicine tests.
o Scintigraphy & Abdomin-pelvic Ultrasound. OCT. Osteodensitometry.
o Pet Scan, VCT64 (Multi channel).
o HIV & sexually transmitted diseases tests are covered once per year per insured
o Genetic tests are covered once per year / insured up to US Dollar 1,000 if medically indicated
o Premarital tests: thalassemia is covered on reimbursement basis.
o Laser therapy, Physiotherapy, Kinesitherapy.is covered up to 20 transactions.
Prescription Medicine:
Annual Financial Limitation Unlimited
Excess Deductible 15 % for acute drugs and 35 % for Chronic
Benefits:
Under the Prescription Medicine Benefit Plan the medicines duly registered and approved by the
Lebanese Ministry of Health, and as per the tariffs set by the latter, prescribed by the Insured's attending
physician
All the benefits of the Prescription Medicine Benefit Plan are limited to products dispensed exclusively
through a Bankers Assistance Healthcare Provider in Lebanon.
Coverage Includes Acute Drugs & chronic Drugs.
The eligibility for chronic medications will be as follows:

o Chronic medications are covered with excess 35 %.

o Acne medication is covered as well as medications for the treatment of infectious disease or
allergic reactions or consequences of accidents.
o All medicines used for the treatment of the chronic diseases (e.g., Hypertension, Cholesterol,
Diabetes, Cardio - Vascular, Cancer ...)
o Medicines available without prescription (i.e., over the counter drugs, cosmetic and the like,
vitamin, mineral, hair treatment products, personal and household hygiene and similar
products) are excluded.
o For Chronic Drugs: Participants will have to submit the unified prescription prior policy issuance
to the insurance company in order to prepare the chronic medications for on line retrieval from
providers Chronic drugs period is prepared based on the unified prescription provided.
o For Acute Drugs: Participants will have to submit the unified prescription & their insurance card
to the provider in order to retrieve their medication.
o Vaccination schedule is as per the registered and approved medicines by the ministry of Health
(MOH).
o In all instances, medicines & drugs, even if prescribed according to the followed rules and
conditions, will not be covered if they don't match the sex or age of the Insured or if they have
any contradiction to any other prescribed medicine or any other medical contra - indication that
is known internationally and that is captured by the expert system used by the Administrator.
Such medicine & drugs will be subject to the Administrator prior approval needed to specify
whether these drugs are totally or partially covered, or rejected according to the applicable rules
and regulations related to prior approval.
Doctor Visits:
Annual financial Limitation
Limited to 240 USD per person per year, 12 transaction per person per year 20 USD per visit.
Benefits:
o The Insurance Company covers, cumulatively the following as Medical Consultations Healthcare
Benefits:
o Doctors Consultations includes visits to Family Medicine, Specialist, Generalist, Surgeon and
psychiatrist
o Benefit is only payable for recognized, necessary, infant / child vaccinations as per MOH or
similar local authorities Note: Pre - approval is required
o The full fees and expenses related to the medical services and procedures listed hereunder,
rendered by a physician:
o The normal, usual and customary consultation.
o The following diagnostic services: Cardiac Echo Doppler, Arterial Doppler, Ultrasonography,
electroencephalogram, electrocardiogram, electromyogram, audiogram, Spirometry, cardiac
stress test, evoked response.
o Small surgery and endoscopic procedures not requiring an operating room or emergency room
or hospital services.

Dental Care:
Annual Limitation - USD 600 per person / year on reimbursement basis.
Excess Deductibles 20 % per claim
Coverage includes
o Dental consultation
o Extraction Composite
o and amalgam fillings
o Root canal treatment
o Scaling,
o Bridgework,
o Crowns and the treatment of gum disease,
o Oral and maxillofacial surgery.

Basis of Coverage:
 24-hour protection, 365 days, for all classes of hospitalization, as per Bankers Assurance Group
Medical Policy.
 Access by personalized card and Direct Billing within a wide network of healthcare providers
 Medical Insurance plan is consistent with generally accepted standards of medical practice,
procedures, and surgeries in the country, in accordance with the Ministry of Health and the
National Social Security for normal, usual & customary procedure and the standard market
practice.
 Accidents and emergency outside Lebanon are covered on reimbursement basis, based on the
Lebanese tariff.
 All the offered covers are subject to the standard general terms and conditions of the respective
policy
Upgrade Conditions:
12 months following the renewal

Additional Benefit:
This cover, should you retain it, will enable your employees and dependents, after one year of waiting
period, to secure a lifetime Guaranteed Renewability, whereby no exclusions and/or limitations may be
applied.

Claims Process:
You need urgent healthcare.? While going into the Emergency Room just make sure you submit your
medical insurance card and identity document. The hospital registers the case and informs Best
Assistance hostesses on +961 1 425 426. The terms and conditions of the coverage are then determined,
and you will only be responsible for the settlement of any Excess, where applicable.

You need hospitalization?

Best Assistance teams will assist you in filling and submitting the pre-admission formalities at the
hospital, or you can go directly to the hospital admission desk, which will register the case and inform
Best Assistance hostesses accordingly. Just make sure to submit:
o Your identity document.
o Your medical insurance cards.
o Your Medical Report for Admission
Best Assistance will then immediately issue an approval, specifying the terms and conditions thereof
and you will only be Responsible for the settlement of any excess, where applicable.

You need Out-of-Hospital services?

If you need to carry out medical acts in diagnostic and physiotherapy centers, do not hesitate to call Best
Assistance team for help. Just make sure to submit:
o Your identity document.
o Your medical insurance cards.
o Your unified medical prescription.
The medical center will then register your case with Best Assistance and perform the act as prescribed.
The conditions of the coverage are determined, and you will only be responsible for the settlement of
any excess, where applicable.