Essential Care Health Insurance
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Area of Cover: Lebanon.
- Network of Hospitals: Limited Network (See Below - Subject to change without prior notice) on Direct Billing.
- Limit for In-Hospital Treatments: $150,000
- Emergency Room: Full Cover
- Maternity: For Couples and Single Mothers: Full cover after 365 days of enrollment.
- New Born Baby: Covered as of day 14, if eligible,
- Epidural: Covered
- Incubator and Nursery: Unlimited days, up to $10,000
- Screening test for baby: Up to $100
- Congenital Cases for babies born at Securite (Bebe Securite): All cases are covered up to the age of 12 and up to $10,000 per year.
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Home care: In hospital treatments administered at home are covered
- Prosthesis: (a device designed to replace a missing part of the body or to make a part of the body work better)
- Due to Accident: Up to $10,000 per year as per TPA's Tariff
- Due to Sickness: Up to $7,000 per year as per TPA's Tariff
- Coronary Stent / Valves: Covered up to sickness prosthesis limit
- Additional Inpatient Benefits:
- Dialysis for acute renal failure, excluding arteriovenostomy: Covers up to 3 sessions during first initial admission
- Sleep Disorder Disease: Polysomnography is covered.
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Epilepsy: Up to $2,000 (In & Out)
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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 $1,000 per year, as per TPA's Tariff.
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Cardiovascular disease: Limited to $100,000
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Bone Marrow Aspiration & Organ Transplant Surgery: Covered up to $10,000 lifetime, as per TPA's tariff. Cost of organ is excluded.
- Cancer Disease: Up to $100,000
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Morgue / burial expenses following a covered hospitalization: up to $1,000 for all adherents aged 64 and below.
- Epidemic / Pandemic Diseases: Up to $10,000
- Out of hospital benefits / Ambulatory Services (Lab, X-RAY, MRI...): Direct billing as per limited network
- Coverage: Up to $2,000 per year, 85% coverage on direct billing basis
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Morphological Echography: once per pregnancy
- Triple test: covered once per pregnancy
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Dental panoramic: covered if due to a covered accident and up to 9 months after the accident occurrence date
- MRI: covered subject to a prior approval
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Pet scan: covered subject to a prior approval
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OCT: covered subject to a prior approval
- Osteodensitometry (for insured age 50 yrs and above): covered for a specific medical reason
- Physiotherapy and kinesitherapy: 15 sessions per year
- Additional Benefits:
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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.
Authorized Limited Network of Hospitals (Subject to change without prior notice)
Beirut | Rosary Sisters Hospital |
Beirut | Hopital Libanais Geitaoui - Centre Hospitalier Universitaire |
Beirut | Sahel General Hospital |
Beirut | Hotel Dieu de France - University Medical Center ( for major cases that cannot be conducted in other hospitals ad subject to pre-approval |
Beirut | Beirut Eye & Ent Specialist Hospital |
Beirut | Najjar Hospital - General Hospital Institute |
Bekaa | Rayak Hospital |
Bekaa | Al Tatari Hospital - Baalbeck |
Bekaa | Bekaa Hospital |
Bekaa | Khoury General Hospital |
Bekaa | Al Assy Hospital |
Bekaa | Al Rayan Hospital |
Bekaa | Chtoura Hospital |
Bekaa | Al Mayyas Hospital |
Bekaa | Dr. H. Farhat Hospital |
Bekaa | Hopital Universitaire Dal Al Amal |
Chouf | Ain Wazein |
Jbeil | Hopital Notre Dame Maritime |
Keserwan | Keserwan Medical Center |
Keserwan | Mgr. Cortbawi Institute and Rehabilitation Hospital - Adma |
Metn | St. George Hadath Hospital |
Metn | Middle East Institute of Health - Bsalim |
Metn | Clinique du Levant |
Metn | Hopital Hayeck |
Metn | Hopital St. Joseph |
Metn | Jopital Dr. Serhal |
North | Batroun Hospital |
North | Family Medical Center - FMC |
North | New Mazloum Hospital |
North | Sheikh Khalaf Hamad Al Habtoor - Medical Line |
North | Hopital Islamique de Bienfaisance - Tripoli |
North | Hopital Al Koura |
North | Hopital Albert Haykal |
South | Lebanese Italian Hospital |
South | Raee Hospital - Saida |
South | Alaaedine Hospital - Sarafand |
South | Kassab Hospital - El Hlaliye Saida |
South | Jezzine Governmental Hospital |
South | Nakib Hospital |
South | Secours Populaire Libanais |
South | Tebnin Governmental Hospital |
South | Fakih Hospital |
South | Hiram Hospital |
Authorized Limited Network of Laboratories & Diagnostic Centers (Subject to change without prior notice)
Aley | Aley Medical Laboratories |
Baabda | Al Saha Medical Lab & Poly Clinic |
Baabda | Laboratoires Rahhal d'Analyses Medicales |
Baabda | Aya Lab Diagnostic sarl |
Baabda | Hara Medical Center |
Beirut | B Positive Medical Services sarl |
Beirut | Centre Medical Mar Elias sarl |
Beirut | St. Marc Medical & Diagnostic Center |
Beirut | MEDEX Medical Center |
Beirut | Laboratoires Du Musee |
Beirut | American Diagnostic Center sarl |
Bekaa | Health Diagnostic Center |
Bekaa | Analysis and Diagnostic Center |
Bekaa | Laboratoire St Georges - Zahle |
Bekaa | Medical Care Laboratories - MCL |
Metn | Trust Medical Center sarl |
Metn | St. Marc Medical & Diagnostic Center |
Metn | Centre Medical Dora (C.M.D.) sarl |
Metn | Medzone sarl |
Metn | Laboratoire d'analyses medicales - Dr. Elie Hraoui |
Metn | Laboratoires Dr. Joseph Mrad d'analyses medicales sarl |
Keserwan | Centre de Biologie Moleculaire Polyvalente (BMP) |
Keserwan | Elite Medical Center |
Keserwam | Elite Diagnostic Center |
Keserwan | Dr. Chelala Laboratories |
Keserwan | USEM - Unite Specialisee d'exploration Medicale |
North | Al Koura Laboratories for Medical Analysis |
North | Trad Radiology Center |
North | Dagher Medical Laboratories sarl |
South | Al Mashrek Medical Diagnostic Center - Tyr |
South | Family Clinic sarl |
South | Family Medical Laboratories |
