Provider Network level
Inside the KSA:Minimum: NWM
Maximum: NW7
Outside the KSA: Access to over 1.2 millions medical facilities
around the world
Annual Maximum Limit- Minimum:
500,000 / $ 266,666
Maximum: 37,500,000 / $ 10,000,000
- Coverage
Worldwide (USA Optional)
Hospital Accommodation- Inside the KSA:Shared Room or Standard Suite Outside the KSA: Single room
Out-patient co-insurance/co-payment (Deductible)- Inside KSA: Minimum: 20% up to 75.
Option 1: 20% up to 100 per visit
Options 2: Nil
Outside KSA: Option 1: 20% up to 100 per visit
Options 2: Nil
Dental treatment- 2,000 / $ 533 up to annual maximum limit
Optical treatment- 400 / $ 110 up to annual maximum limit
- Out-patient coverage
- Minimum:Covered with limits per visit Maximum: Covered up to annual maximum limit.
Out-patient pre-authorization approval- Covered
Maternity cover with benefits- 15,000 / $ 4,000 up to annual maximum limit
Preventive tests
- Customizable starting from covering only Periodic Health Examination as per CHI or up to 7,500 / $ 2,000
In-patient / day-case coverage- Up to annual maximum limit
In-patient pre-authorization approvalCovered
- In-patient deductible
Nil
Companion chargesCovered
Advanced imagingCovered
Artificial limbsCovered
Cancer treatment- Covered
Congenital illness- Covered
- Dialysis
- Covered up to 180,000 / $ 48,000 per insurance cover period
Emergency treatment received at a healthcare provider that is not in the Bupa Network. Emergency.- Up to annual maximum limit, inside and outside KSA
- Emergency medical treatment in the USA
- Optional Coverages
Healthline servicesCovered
Hearing aids- Minimum: We pay up to 6,000/$ 1,700
each insurance period
Maximum: Covered up to the annual
maximum limit
Local air ambulance for emergency cases only- Optional Coverages
Local road ambulance for emergency cases only.- Covered
- Maternity complications
- Covered
Neonatal / Newborn cover- Inside KSA: Covered from Day 1. Outside KSA: Minimum: Not covered. Maximum: up to 7 days following birth for routine care and up to 560,000 / $ 150,000 for non-routine care.
- Treatment of premature babies,
- Inside KSA: Up to annual maximum limit Outside KSA: minimum not covered. Maximum: new-born care benefit, see above.
Mental health conditionsInside KSA: Up to Max of 50,000 during the policy period. Outside KSA: Non-acute: We pay up to 30 visits each insurance period. Acute:We pay up to
15,000 / $ 4,000 each insurance period.
Non-emergency (elective) treatment outside the Bupa network- Inside KSA: Minimum: Not covered. Maximum: based on 100% of customary prices of Network hospitals in Network level NW7. Outside KSA: Subject to Reasonable and Customary charges.
Physiotherapy when medically necessary.- Covered
Pre-existing and chronic conditions- Covered
Rehabilitation (physiotherapy only)- Covered
- Transportation of mortal remains to home country in case of death in KSA
- Minimum: 10,000/$ 2,666
Maximum: Covered up to the annual
maximum limit
Treatment for damage to acquired (non-congenital) heart valves- Inside KSA: We pay up to to 150,000
Outside KSA: Coverad up to annual maximum limit.
- Alzheimer’s treatment
- 15,000 /$ 4,100
- Autism treatment
- Inside KSA: Covered up to 50,000
Out
Outside KSA:Up to 15,000 / $ 4,000
Disability cases:- Minimum: 100,000/$
27,000
Maximum: Covered up to annual maximum limit
Cost of obtaining / harvesting donor organs- 50,000/$
13,333
- Transplant of organ or bone marrow
- Inside KSA: Covered up to a maximum of 250,000
Outside KSA: Covered up to annual maximum limit
- Treatment for contagious or endemic diseases
- Covered
Vaccinations and inoculations (up till age 6)- Inside KSA: Covered. Outside KSA: Up to 11,250 / $ 3,000.
- Vaccinations and inoculations (after age 6)
- Minimum: Covered based on MoH vaccination schedule Maximum: up to 7,500 / $ 2,000.
- Cost of circumcision (for males)
- Minimum: 500/$ 140
Maximum: Covered up to annual maximum limit
- Cost of ear piercing (for females)
Minimum: Not covered Maximum: Covered up to annual maximum limit