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Full Network of Hospitals
Area of Cover: Lebanon.
- Network of Hospitals: All hospitals on direct billing.
- Limit for In-Hospital Treatments: Unlimited
- Emergency Room: Full Cover, Exclusions covered up to $100
- Maternity: For couples and single mothers; full cover after 270 days of enrollment.
- New Born Baby: Covered as of day 1, free of charge
- Epidural: Covered
- Incubator and Nursery: Unlimited days, up to $30,000
- Screening test for baby: Up to $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
- 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: Unlimited, as per TPA's Tariff
- Due to Sickness: Up to $30,000 per year as per TPA's Tariff
- Coronary Stent Valves: Covered up to sickness prothesis limit
- Orthesis: (An orthopedic brace, splints, or appliance.)
- Due to Accident: Up to $500
- Due to Sickness: Up to $500
- Additional Inpatient Benefits:
- Dialysis for acute renal failure, excluding arteriovenostomy: covered for all needed sessions during first initial admission
- Sleep Disorder Disease: Covered up to $5,000
- Parkinson: Up to $5,000 (In & Out)
- Epilepsy: Up to $5,000 (In & Out)
- New treatments, Medical Techniques, Surgeries & Tests: Up to $5,000 (In & Out)
- Rehabilitation for a covered case: Up to $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 $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
- Work Related Accidents: Covered
- Bone Marrow Aspiration & Organ Transplant Surgery: covered up to $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 $7,500 lifetime, as per TPA'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 $15,000 per year.
- Psychiatric disorder: in-hospital treatment covered up to $10,000 per year after 12 months of enrolment with a maximum of 30 days of hospitalization.
- Hospital daily income: For entrepreneurs below 60 years of age $50 per day starting the second day and up to 7 days per year
- Morgue and burial expenses: up to $3,000
- Epidemic / Pandemic Diseases: Covered up to $30,000
- Out of hospital benefits / Ambulatory Services (Lab, X-RAY, MRI...): Direct billing as per NextCare preferred network
- Coverage: 85% or 100% on direct billing basis (depends on your choice of plan)
- Amniocentesis: Covered if delivery date occurs after the maternity waiting period.
Morphological Echography: Covered if delivery date occurs after the maternity waiting period.
- Triple test: Covered if delivery date occurs after the maternity waiting period.
- Maternity Lab tests: Covered if delivery date occurs after the maternity waiting period.
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 $1,000 per year
- OCT: covered subject to a prior approval
- Osteodensitometry (for insured age 50 and above): covered for a specific medical reason
Physiotherapy and kinesitherapy: 25 sessions per year
- Premarital test: covered
- Additional Benefits:
- 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.
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.
- Unknown Pre existing conditions in hospital: Covered after 6 month for new members.
- Tests related to pre-existing cases for new insured: up to $100 once per year from day 1
- Upgrades on renewal: Observation period of 270 days for maternity and preexisting conditions
- Extension of coverage at the expiry date and while in hospital: up to 30 days
- Claims outside of Lebanese territories or outside of network: claim processed on reimbursement basis as per NEXTCARE's Lebanese network rates and subject to 30% excess