Medical care insurance
Hereunder will show a shortly Suez Canal Insurance Company's medical insurance products
-
1 – Individual Medical insurancepolicy
- The individual healthcare product is applicable for each member separately or it can be offered as a family product. In any case, all applicants have to fill in the medical application
- If a family product is being offered, all applicants need to have the same plan, network and inception date
- The maximum applicable age at entry of the insured to the policy is 60 years
- (for any further info contact us on 16569)
2– SME Medical insurance policy
An SME is accompany, registered in Egypt, with a valid trade license which has the following characteristics
- It is a compulsory group which means that either all employees or employees and all their dependents are enrolled
- It consists of less than 250 insured members
- All insured members have the same benefits (no categorization of the insured members)
(for any further info contact us on 16569)
-
3– Group Medical insurance policy
- It is a compulsory group which means that either all employees or employees and all their dependents are enrolled
- It consists of less/more than 250 insured members
- categorization of the insured members is available
- (for any further info contact us on 16569)
Benefitsof Healthcare Products
In-Patient Benefits(including)
Accommodation
Intensive Care Unit
Specialist’s fees (Surgeon, anesthesiologist andattending physiciansLaboratory tests, X-Rays)
Physiotherapy as post-surgical treatment
Parent Accommodation (During hospitalization of insuredchild)
Nursing care at home (Instead of required hospitalization)
Organ Transplant (Covers only surgical procedureof the insured as a recipient andnot the organ donor)
Ambulance (If followed by an In-Patient case)
Out-Patient Limit(including)
Physician Consultation
Diagnostic test (Laboratory tests, X-Rays,electrocardiograms, scans)
Physiotherapy
Prescribed Medication
Maternity Benefit(including)
Covered only for new cases Hospitalization, day treatment and out-patient benefits
Dental Benefit(including)
Dentist consultations, X-ray, root canal treatments, teeth extractions, composite fillings, glass ionomer, amalgam,
medication and gum treatment
Optical Benefit(including)
Prescribed contact lenses or glasses for spectacles
Pre-Existing Conditions & Chronic Conditions(including)
Sub-limits are applicable for all In-Patient and Out-Patient services.
Cancer Treatment(including)
Surgery, chemotherapy, radiotherapy and out-of-hospital benefits
underwriting process needs
Individual Product
A filled-in Medical Application Form (MAF)
- - A copy of a national ID or of a passport for adults and a copy of birth certificate for children
- - The signed health offer/quotation
- - Personal photos of all applicants
- - A filled in Know Your Customer Forms
- - The list of exclusions and Policy Wording signed by the Policyholder as a sign of acceptance
SME Product
- - Filled-in Group Application Form
- - Census List including the above fields
- - Agreed Table of Benefits
- - Trade License
- - A filled in Medical Application Form for members above 60 years
- - The signed health offer/quotation
- - Personal photos of all applicants
- - A filled in Know Your Customer Form
Frequently Asked Questions
In order to pay your compensation for the accident, all you have to do is contact the customer service representative of "Suez Canal Insurance", and he will explain the steps to you in detail and facilitate the recovery process from the company while you are in your place.
Among the terms that we need to know well, what is the difference between the medical insurance program and the health care program, and this makes us ask about the company that offers the program, as only insurance companies are allowed to provide health insurance programs
The annual subscription price is calculated based on 3 main factors:
The age of the insured person
Coverage level and maximum annual coverage
Additional benefits
Group Product:
-Census list including the following information for each INSURED MEMBER:
Name, Date of Birth, Gender, Marital Status, Nationality, Plan, Country of residence
-
- Tables of benefits: required and expired
-
- Tender documents (if applicable)
-
- Past claim experience (applicable for Group business only and preferably last 3 years)
-
- Full name of the group
-
- Effective date of the group
-
- Nature of business
-
- COMPLUSORY or VOLUNTARY GROUP
-
- Since when the scheme/group is insured
-
- Geographical distribution of members (location and not distribution per nationality)
-
- Current insurer and previous insurers for the last 2 years
