Prime Care Medical Plan - 1st CLASS - Yearly Price Starting at
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Area of Cover: Lebanon.
Network of Hospitals:All hospitals on direct billing.
Limit for In-Hospital Treatments:Unlimited
For Couples: Full cover after 180 days of enrollment.
For Single Mother: Full cover after 12 months of enrolment.
New Born Baby: Covered as of day 1, free of charge
Incubator and Nursery: Unlimited days, up to USD 30,000
Screening test for baby: Up to USD 200
Congenital Cases for babies born at Securite (Bebe Securite): All cases are covered up to the age of 12 and with no financial limit.
Parent Accommodation at hospital for children below age of 16: covered
Home care: In hospital treatments administered at home are covered
Due to Accident:Unlimited, as per TPA's Tariff
Due to Sickness:Up to USD 30,000 per year as per TPA's Tariff
Additional Inpatient Benefits:
Dialysis for acute renal failure, excluding arteriovenostomy: covered for all needed sessions during first initial admission
Sleep Disorder Disease: Polysomnography is covered.
Sleep Apnea Surgery: Up to USD 5,000
Parkinson:Up to USD 5,000 (In & Out)
Epilepsy:Up to USD 5,000 (In & Out)
New treatments, Medical Techniques, Surgeries & Tests:Up to USD 5,000 (In & Out)
Rehabilitation for a covered case:Up to USD 2,000
Breast Reconstruction: Covered if due to a covered partial or complete breast excision due to breast cancer within 6 months of the sickness
Infertility:Covered after 12 months of enrollment and up to USD 3,000 per year, for all classes, as per TPA's Tariff.
Cornea transplant: surgery is covered, cost of cornea is excluded.
Cardiovascular disease: unlimited
Coronary stent: covered up to sickness prothesis limit
Valves: covered up to sickness prothesis limit
Work Related Accidents:Covered
Bone Marrow Aspiration & Organ Transplant Surgery: covered up to USD 30,000 lifetime, as per TPA's tariff. Cost of organ is excluded.
Bariatric Surgery related to morbid obesity (e.g. Sleeve and Bypass): covered up to USD 7,500 lifetime, as per TPS's tariff.
Cancer Disease: unlimited
Chemotherapy and radiotherapy: covered
Tropical Disease:Specific diseases as per general conditions are covered.
Sexually Transmitted Diseases: covered up to USD 15,000 per year.
Psychiatric disorder: in-hospital treatment covered up to USD 1000 per year after 12 months of enrollment.
Hospital daily income: For entrepreneurs below 60 USD 50 a day starting the second day and up to 7 days a year
Morgue and burial expenses: up to USD 3000
Out of hospital benefits / Ambulatory Services (Lab, X-RAY, MRI...): Direct billing as per next care preferred network
Coverage:85% on direct billing basis
Morphological Echography: once per pregnancy
Triple test: covered once per pregnancy
Dental panoramic: covered if due to a covered accident and up to 9 months after the accident
MRI: covered subject to a prior approval
Thallium myocardial scintigraphy: covered subject to a prior approval
Pet scan: covered subject to a prior approval
VCT 64: covered subject to a prior approval
Genetic test: up to USD 1000 a year
OCT: covered subject to a prior approval
Osteodensitometry (for insured age 50 and above): covered for a specific medical reason in private diagnostic centers
Physiotherapy and kinesitherapy: 25 sessions per year
Premarital test: covered
Waiver of medical premium of family: Applicable for adherents aged below 65 years, for a period of the policy year and 1 additional year in case of death, terminal illness, or total disability of the bread winner.
Family discount: applicable for 3+ (for every year)
Rental of medical supplies: up to 1 month rental
Guaranteed Renewability: 720 days, lifetime subject to an observation period of 180 days for new members.
Pre existing conditions in hospital: Covered after 1 year for new members.
Tests related to pre existing cases for new insured: up to USD 100 one a year from day 1
Upgrades on renewal: Observation period of 180 days for maternity and preexisting conditions
Extension of coverage at the expiry date and while in hospital: up to 120 days
Claims outside of Lebanese territories or outside of network: claim processed on reimbursement basis as per NEXtCARE's Lebanese network rtes and subject to 20% excess
Travel insurance up to 65 years of age:Covers 24/7 help desk. Covers death abroad, repatriation of mortal remains, up to USD 10,000. Covers accidental and acute sickness not due to any Pre-Existing condition, up to €30,000 per trip and up to 90 days per year. Card should be requested at least 48 hours before traveling.
Travel insurance 66 and above: covers 24/7 help desk, death abroad, repatriation of mortal remains up to USD 10000