Essential Care Health Insurance

• 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.
• 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.
• Epilepsy: Up to $2,000 (In & Out)
  
• 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.
• Cardiovascular disease: Limited to $100,000 
  
• 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
• 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
• 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 occurrence date
  
• MRI: covered subject to a prior approval
• Pet scan: covered subject to a prior approval
  
• 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:
• 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)

Authorized Limited Network of Laboratories & Diagnostic Centers (Subject to change without prior notice)