Bupa Munsha'at, Choose the best options that fit your business
All New

We understand that each business requires various health insurance options and simple solutions to cover all it’s needs.
To understand SME owners and their needs better, we conducted more than 1000 interviews with decision makers like you from different enterprises that helped us to design a health insurance that suits SME needs. Presenting the all new health insurance that comes with wide variety of choices to choose the most convenient for your business

The All new Bupa Munsha’at Health Insurance comes with 3 different programs:

  • Health insurance at a competitive price that fits your budget
  • Health insurance with wide variety of network options that suits your needs
  • Health insurance with exceptional benefits to fit your expectations
Essential 1.0
Approved hospitals and clinics network
NWM
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Shared Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
20% up to:
MPN: SAR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 400
(For beneficiaries up to 14 years old)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation
with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
Not covered
Elective (non-emergency) treatment out of network – IN/OUT KSA
Not covered
Essential 2.0
Essential 2.1
Approved hospitals and clinics network
NWS
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Shared Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 400
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation
with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
Not covered
Elective (non-emergency) treatment out of network – IN/OUT KSA
Not covered
Essential 3.0
Essential 3.1
Approved hospitals and clinics network
NWR
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Shared Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 400
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation
with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
Not covered
Elective (non-emergency) treatment out of network – IN/OUT KSA
Not covered
Classic 1.0
Classic 1.1
Approved hospitals and clinics network
NW1
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Shared Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 400
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia (SR 50,000)
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Classic 2.0
Classic 2.1
Approved hospitals and clinics network
NW2
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Shared Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 400
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia (SR 50,000)
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Classic 3.0
Classic 3.1
Approved hospitals and clinics network
NW3
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 600
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia (SR 50,000)
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Classic 4.0
Classic 4.1
Approved hospitals and clinics network
NW4
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Paid in full
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication with no generic alternative available: 20% up to SAR 30
Branded medication with generic alternative available: 50% without CAP
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 600
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Not covered
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia (SR 50,000)
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Premium 1.0
Premium 1.1
Approved hospitals and clinics network
NW5
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Standard Suite
Maximum SAR 1,500 per night
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to:
Hospitals: SR 300 - Polyclinics & MPN: SR 75
%20 up to:
Hospitals: SR 100 - Polyclinics & MPN: SR 75
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication: 20% up to SAR 30
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 15,000
SAR 20,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,200 (Essential & Preventive, no deductible) SAR 800 (Treatment of root canals & Emergencies, with 20% deductible)
SAR 1,800 (Essential & Preventive, no deductible) SAR 1,200 (Treatment of root canals & Emergencies, with NIL deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400)
SAR 600
(For all beneficiaries)
SAR 800
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Covered up to the overall annual maximum limit.
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia SAR 50,000
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Premium 2.0
Premium 2.1
Premium 2.2
Approved hospitals and clinics network
NW6
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Standard Suite
Maximum SAR 1,500 per night
Standard Suite
Maximum SAR 1,500 per night
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to: Hospitals: SR 300
Polyclinics & MPN: SR 75
%20 up to: Hospitals: SR 100
Polyclinics & MPN: SR 75
NIL
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication: 20% up to SAR 30
Generic medication or Branded medication: 20% up to SAR 30
NIL
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 20,000
SAR 25,000
SAR 30,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,800 (Essential & Preventive, no deductible) SAR 1,200 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 1,800 (Essential & Preventive, no deductible) SAR 1,200 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 2,400 (Essential & Preventive, no deductible) SAR 1,600 (Treatment of root canals & Emergencies, with NIL deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400)
SAR 800
(For all beneficiaries)
SAR 1,000
(For all beneficiaries)
SAR 1,000
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Covered up to the overall annual maximum limit.
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia SAR 50,000
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Premium 3.0
Premium 3.1
Premium 3.2
Approved hospitals and clinics network
NW7
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Standard Suite
Maximum SAR 1,500 per night
Standard Suite
Maximum SAR 1,500 per night
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to: Hospitals: SR 300
Polyclinics & MPN: SR 75
%20 up to: Hospitals: SR 100
Polyclinics & MPN: SR 75
NIL
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication: 20% up to SAR 30
Generic medication or Branded medication: 20% up to SAR 30
NIL
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 20,000
SAR 25,000
SAR 30,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,800 (Essential & Preventive, no deductible) SAR 1,200 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 2,400 (Essential & Preventive, no deductible) SAR 1,600 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 3,000 (Essential & Preventive, no deductible) SAR 2,000 (Treatment of root canals & Emergencies, with NIL deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 1,000
(For all beneficiaries)
SAR 1,000
(For all beneficiaries)
SAR 2,000
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Covered up to the overall annual maximum limit.
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia SAR 75,000
Elective (non-emergency) treatment out of network –IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
Premium 4.0
Premium 4.1
Premium 4.2
Approved hospitals and clinics network
NW7+
Maximum level for each insured person for the term of the policy. This includes the sub-limit which appears in this document (Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand)
SAR 500,000
Hospitalization costs and same-day cases.
Covered
Level of accommodation within the network
Single Room
Standard Suite
Maximum SAR 1,500 per night
Standard Suite
Maximum SAR 1,500 per night
Companion charges when medically necessary.
Covered
Co-pay (contribution to payment)
- In the case of hospitalization only
NIL
- Out-patient department costs. Percentage paid by the beneficiary in the event of treatment at an out-patient department. It covers everything the doctor carries out including consultations, laboratory tests, scans, medications, and other treatments as well as a follow-up visit and referral for the same condition and not for each procedure separately
%20 up to: Hospitals: SR 300
Polyclinics & MPN: SR 75
%20 up to: Hospitals: SR 100
Polyclinics & MPN: SR 75
NIL
Out-patient department costs.
Covered
Medication Co-pay: Deductible for all Drug services and is separate from medical visits to outpatient clinics and applied according to the Insurance Drug formulary (IDF), with the adoption of generic drugs as an alternative to innovative drugs according to the unified CHI Policy.
Generic medication or Branded medication: 20% up to SAR 30
Generic medication or Branded medication: 20% up to SAR 30
NIL
Pregnancy and childbirth limit
- (Natural childbirth, prenatal and postnatal care).
SAR 20,000
SAR 25,000
SAR 30,000
- Pregnancy and childbirth-related complications including Caesarean delivery, ectopic pregnancy, bleeding associated with childbirth, pregnancy loss and legal abortion.
Covered up to the overall annual maximum limit.
- Premature children’s treatment.
Covered up to the overall annual maximum limit.
- Neonatal cover newborn babies are covered under the mother's policy up to 30 days from the date of birth until added in the policy retroactively form the date of birth
Covered up to the annual maximum limit.
Costs of circumcision (males)
Covered up to a maximum of SAR 500
Costs relating to the national program for early testing of newborn children to prevent disability
Covered up to SAR 100,000 during the policy term.
Dental Treatment: All essential dental procedures and Root Canals and Emergencies
SAR 1,800 (Essential & Preventive, no deductible) SAR 1,200 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 2,400 (Essential & Preventive, no deductible) SAR 1,600 (Treatment of root canals & Emergencies, with NIL deductible)
SAR 3,000 (Essential & Preventive, no deductible) SAR 2,000 (Treatment of root canals & Emergencies, with NIL deductible)
Optical: Basic medical frame and lenses without any add-ons. (Rate limit for framework is SAR 400).
SAR 800
(For all beneficiaries)
SAR 1,000
(For all beneficiaries)
SAR 2,000
(For all beneficiaries)
Pre-existing conditions & chronic diseases
Covered up to the maximum annual benefit limit
Hearing aid costs
Covered up to SAR 6,000 for total claims for both ears over the policy term
Vaccination & inoculations as per the Ministry of Health (MOH) schedule
Covered based on MOH’s vaccination guidelines for children and adults
Physiotherapy when medically necessary.
Covered up to the overall annual maximum limit.
Dialysis
Covered up to SR 180,000 per insurance cover period.
Psychiatric Treatment
Covered up to SR 50,000 per insurance cover period.
Rehabilitation (physiotherapy)
Covered up to the overall annual maximum limit.
Disability costs
Covered up to a maximum of SAR 100,000 during the policy term.
Obesity treatment: The cost of covering obesity treatment based on (Bariatric Surgery Bundle) from the unified CHI policy
Covered up to SR 15,000 per insurance cover period, with 20% co-pay up to SAR 1,000. (Coverage is subject to the BMI mentioned as per (Bariatric Surgery Bundle) from the unified CHI policy
Cost of acquired heart valve
diseases management
Covered up to a maximum of SAR 150,000 during the policy term
Alzheimer’s treatment
Covered up to a maximum of SAR 15,000 during the policy term
Autism treatment
Covered up to SAR 50,000 per insurance cover period according
to the announced regulations
Cost of donor part collection
Covered up to a maximum of SAR 50,000 during the policy term
Transportation of the deceased beneficiary’s
body from the Kingdom to his country of origin
Covered up to a maximum of SAR 10,000 during the policy term
Consulting an in-network doctor
Covered
Local ambulance
Covered by ambulances of approved service providers in cases
of medical emergencies
Out-of-network treatment for life-threatening
emergency conditions inside the Kingdom:
Fully covered from the maximum annual benefit limit.
Maximum Physician's Fees within the Network: - General Practitioner - Specialist - Consultant - Rare medical specialties and the like, such as cardiology, brain and neurological surgery, vascular surgery, and other subspecialties as per standards of the Saudi Commission for Health Specialties. (The beneficiary shall be examined as per sequence of service provision procedures except when the service is unavailable in the Approved Provider Network
Covered General Practitioner/ specialist (First Registrar Doctor). 100 - 150 SAR -Specialist (Second Registrar Doctor)/ Consultant. 200 - 300 SAR - Specializations with scarcity and the like, such as cardiology, neurosurgery, vascular surgery and subspecialties according to the standards of the Saudi Commission for Health Specialties 400 SAR
Family Planning: Cost of birth control for females (Coverage for temporary contraception that includes hormonal contraceptives therapy and intrauterine devices according to the approved guideline)
Covered up to SR 1500 per insurance cover period
Menopausal & Perimenopausal
Covered including alternative hormone therapy
Sexually Transmitted Diseases (Insurance coverage for the treatment of sexually transmitted diseases (whatever the way the infection occurs) Include cover for Nongonococcal urethritis, Trichomoniasis, HIV, Syphilis, Human Papillomavirus (genetic warts), Neisseria gonorrhoeae, Genetic herpes, Chancroid)
Covered
Comprehensive Diabetic Program
Covered
Preventive Screenings
Covered based on national guidelines for periodic health examinations (1. Mammogram to detect breast cancer, 2. Pap smear to detect cervical cancer, 3. Fecal immunochemical test (FIT) or colonoscopy as per the medical necessity and best clinical practice to detect colon cancer. (Fecal immunochemical test) or colonoscopy according to medical need and best medical practices, 4. Behavioral or dietary consultations, or both, about healthy diet, and physical activity to prevent cardiovascular disease for adults with cardiovascular risk factors and have a Body Mass Index of more than 30 or those with two and more risk factors for heart Disease, 5. Diabetes screening by fasting blood sugar test or checking (HbA1C) test, 6. Lipid profile test, 7. Bone densitometry (DEXA) to Detect Osteoporosis)
Kidney Transplant
Covered up to SR 250,000 per insurance cover period
Medical Devices
Covered based on the Saudi clinical guide for diabetes
Birth defects
Covered up to the overall annual maximum limit

Additional Table of benefits

Emergency medical evacuation in cooperation with International SOS Assistance when the
illness occurs outside the KSA only
Covered up to the overall annual maximum limit.
Emergency life threating treatment –out KSA
The actual cost of covered medical services is limited to the amounts mentioned below.
Any cost exceeding this amount will be covered at reasonable and customary rates for the same
level of coverage in the approved network within Saudi Arabia SAR 100,000
Elective (non-emergency) treatment out of network – IN/OUT KSA
Covered as per accepted prices and approved for the same level of coverage in the network approved within
the Kingdom of Saudi Arabia through the principle of Reimbursements only for the cases covered in this
policy, based on the conditions of Reimbursements and the prior approval of Buba Arabia
SAMA product ID for Bupa Munsha'at:A-BUPA-2-C-19-002.

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