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Million
GWP in 2020

Health Insurance Plans for Individuals and Families

Our Health Insurance policy offer flexible insurance plans to secure your health, as well as the health of your family.

Today’s sedentary lifestyle along with unhealthy eating habits, not getting enough sleep and lack of physical activity has increased the risk of a wide range of health problems. Medical treatments are costly and can lead to financial stress.

In such cases, a good medical insurance plan will help you get the medical treatment you need and avoid financial burden.

GET A FREE INDIVIDUAL HEALTH INSURANCE QUOTE

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A health insurance plan that helps you deal with any sudden health adversity and high medical cost burden, Sahatuna helps you live a worry-free life without compromising on your good health needs.

PLAN INFORMATION

Differential Benefit Options
Bronze
Silver
Gold
Platinum
Annual Limit per person (Multiple options) OMR 3000 OMR 3000

OMR 5000

OMR 3000

OMR 5000

OMR 5000

OMR 10000

Hospital Network* NLGIC Designated Medical Network Bronze Network Band B Band A,

Band B

Band A+,

Band A,

Band B

Pre Existing / Chronic Condition Not covered for first 6 months. After 6 months upto OMR 250 Not Covered for 1st year Not Covered for 1st year Not Covered for 1st year
Deductible / Coinsurance For each and every claim / visit OMR 2 10% 10% 10%

Key Benefits – Insurance Policy

Benefits
Inpatient and Out Patient
Remark
Territorial Limit- Elective Treatment Oman, India, Sri Lanka, Bangladesh,
Thailand and Other Countries
Territorial limit – Emergency Treatment Worldwide excluding USA and Canada
Hospital Accommodation & Services Coverage for single Private Room
ICU Direct Billing at agreed rates at Designated
Medical Provider Network
Consultant’s, Physician’s, Surgeon’s,
Anesthetist’s Fee
Direct Billing at agreed rates at Designated
Medical Provider Network
Diagnostics (X-ray, MRI,CT Scan, Ultra
Sound etc)
Direct Billing at agreed rates at Designated
Medical Provider Network
Laboratory Direct Billing at agreed rates at Designated
Medical Provider Network
Medication Direct Billing at agreed rates at Designated
Medical Provider Network
Physiotherapy Charges
Nursing at home for recovery and in lieu
of hospital stay
upto 14 days per admission or procedure
Transportation expense for inpatient
treatment abroad
Amount per person per annum
Ambulance Maximum of 50 per trip

Our Medical Providers

Your health is integral to your quality of life. Our flexible insurance plans are supplemented by a vast medical network to bring you and your family affordable, high-quality healthcare. Check Sahatuna enhanced network list here

Get coverage against a wide variety of medical expenses such as in-patient and out-patient hospitalization and pre and post hospitalization.

Our medical insurance card offers you cashless medical cover and treatment at the network medical centers based on your plan.

Table of Benefits:

Basic Cover
Plan A
Plan B
Plan C (For Domestic Helps)
In patient treatment Maximum limit of inpatient RO 3,000 per insured person during the policy period Maximum limit of inpatient RO 3,000 per insured person during the policy period Maximum limit of inpatient RO 4,000 for domestic workers during the policy period
Hospitalization for maximum of 30 days per admission Hospitalization for maximum of 30 days per admission Admission for maximum of 30 days per time
Sharing room accommodation Sharing room accommodation Public room accommodation except for cases requiring isolation
Insured person transportation to hospital for maximum RO 100 per transport trip Insured person transportation to hospital for maximum RO 100 per transport trip Injury transportation to hospital for maximum RO 100 per time.
Co-Insurance- Nil Co-Insurance- Nil Co-Insurance- Nil
Outpatient treatment
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: 15% in designated network providers maximum of RO 20 per visit
    • 30% in non-designated network providers
    • 10% for medication applicable for maximum of 5RO per visit
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: Nil
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: Nil
Remains transportation to home country Maximum limit for remains transportation RO 1000 Maximum limit for remains transportation RO 1000 Maximum limit for remains transportation RO 1000
Territorial Limit for Treatment of Emergency and Non-emergency medical condition/ailment/diagnosis covered under the policy This policy shall apply to eligible medical expenses incurred in the territorial borders of the Sultanate of Oman

 

OTHER CONDITIONS
a Please refer to Policy terms and conditions for full list of General Exclusions and applicable to this policy
b For treatment availed outside the territorial limit   specified   in   (1)  above in  respect   of   Illness   or   injury   sustained   by   the Insured is not covered under this policy
c Direct Billing at Designated   Medical   provider   Network is   subject   to   annual   maximum   limit,   per   admission   limit   and   sub-limit   per   person applicable   under this policy and if incurred within the territorial limit specified above. Cost of eligible medical expenses will be reimbursed by insurance company after evaluation of the completed claim form along with any other documents to support the claim.
d Please refer to Annexure 5 of Terms and conditions for    services   warranting   pre-authorization   from   Insurance   Company.   If   services   are   availed   at   outside   the   Hospital Cost   Band   or   at   a   Non   designated   Medical   provider   network   applicable   to   this   policy,   it    is    the    Insured    member’s    responsibility    to    obtain pre-authorization before availing the treatment and failure to obtain such approval would result in denial of the claim.
e Treatment for emergency   conditions   shall   not   require   pre   authorization,   but   such   cases   are   to   be   notified   to   the   Insurer   or   its   administrators   within 48 hours of hospitalization or prior to his/discharge, whichever is earlier.
f Reimbursement of Claims arising out of Non-designated network providers- Insurer will reimburse the insured the cost of eligible expenses within fifteen (15) working days, provided completed claim form along with any other documents to support the claim, as specified in the notice of claim mentioned above are submitted to the insurer within a period of one hundred and twenty (120) days from incurring such expenses
g Insured member   shall   have   access   only   to   the   Designated   Medical   Provider (refer to Basic Network Provider List) for availing Direct   billing   Services.   All   other   Medical   providers   shall   be   construed   as Non-Designated Medical provider for this policy.
h Insurer shall not   be   responsible   for   the   non   availability   of   the   treatment   in   the   Designated   Medical   Provider   Network/Hospital   cost   band   chosen   by the   Insured.   If   the   treatment   facility   sought   is   based   on   the   advancement   of   technology   and   is   not   available   in   the   applicable   Hospital   Cost Band/designated   Medical   provider   network    applicable    to    this    policy,    then    cost    of    similar    treatment    in    more    conventional    methodology    would    be adopted to arrive the reasonable and customary charges of the applicable Hospital Cost Band/Designated Medical Provider network in Oman.

Our Medical Providers

Your health is integral to your quality of life. Our flexible insurance plans are supplemented by a vast medical network to bring you and your family affordable, high-quality healthcare. Check Sahatuna Basic network list here

Sahatuna Enhanced Plan

A health insurance plan that helps you deal with any sudden health adversity and high medical cost burden, Sahatuna helps you live a worry-free life without compromising on your good health needs.

PLAN INFORMATION

Differential Benefit Options
Bronze
Silver
Gold
Platinum
Annual Limit per person (Multiple options) OMR 3000 OMR 3000

OMR 5000

OMR 3000

OMR 5000

OMR 5000

OMR 10000

Hospital Network* NLGIC Designated Medical Network Bronze Network Band B Band A,

Band B

Band A+,

Band A,

Band B

Pre Existing / Chronic Condition Not covered for first 6 months. After 6 months upto OMR 250 Not Covered for 1st year Not Covered for 1st year Not Covered for 1st year
Deductible / Coinsurance For each and every claim / visit OMR 2 10% 10% 10%

Key Benefits – Insurance Policy

Benefits
Inpatient and Out Patient
Remark
Territorial Limit- Elective Treatment Oman, India, Sri Lanka, Bangladesh,
Thailand and Other Countries
Territorial limit – Emergency Treatment Worldwide excluding USA and Canada
Hospital Accommodation & Services Coverage for single Private Room
ICU Direct Billing at agreed rates at Designated
Medical Provider Network
Consultant’s, Physician’s, Surgeon’s,
Anesthetist’s Fee
Direct Billing at agreed rates at Designated
Medical Provider Network
Diagnostics (X-ray, MRI,CT Scan, Ultra
Sound etc)
Direct Billing at agreed rates at Designated
Medical Provider Network
Laboratory Direct Billing at agreed rates at Designated
Medical Provider Network
Medication Direct Billing at agreed rates at Designated
Medical Provider Network
Physiotherapy Charges
Nursing at home for recovery and in lieu
of hospital stay
upto 14 days per admission or procedure
Transportation expense for inpatient
treatment abroad
Amount per person per annum
Ambulance Maximum of 50 per trip

Our Medical Providers

Your health is integral to your quality of life. Our flexible insurance plans are supplemented by a vast medical network to bring you and your family affordable, high-quality healthcare. Check Sahatuna enhanced network list here

Sahatuna Basic Plan - Compliant to Unified Health Insurance Policy issued by CMA

Get coverage against a wide variety of medical expenses such as in-patient and out-patient hospitalization and pre and post hospitalization.

Our medical insurance card offers you cashless medical cover and treatment at the network medical centers based on your plan.

Table of Benefits:

Basic Cover
Plan A
Plan B
Plan C (For Domestic Helps)
In patient treatment Maximum limit of inpatient RO 3,000 per insured person during the policy period Maximum limit of inpatient RO 3,000 per insured person during the policy period Maximum limit of inpatient RO 4,000 for domestic workers during the policy period
Hospitalization for maximum of 30 days per admission Hospitalization for maximum of 30 days per admission Admission for maximum of 30 days per time
Sharing room accommodation Sharing room accommodation Public room accommodation except for cases requiring isolation
Insured person transportation to hospital for maximum RO 100 per transport trip Insured person transportation to hospital for maximum RO 100 per transport trip Injury transportation to hospital for maximum RO 100 per time.
Co-Insurance- Nil Co-Insurance- Nil Co-Insurance- Nil
Outpatient treatment
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: 15% in designated network providers maximum of RO 20 per visit
    • 30% in non-designated network providers
    • 10% for medication applicable for maximum of 5RO per visit
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: Nil
  • Maximum limit of outpatient is RO 500 for the policy period
  • Co-Insurance: Nil
Remains transportation to home country Maximum limit for remains transportation RO 1000 Maximum limit for remains transportation RO 1000 Maximum limit for remains transportation RO 1000
Territorial Limit for Treatment of Emergency and Non-emergency medical condition/ailment/diagnosis covered under the policy This policy shall apply to eligible medical expenses incurred in the territorial borders of the Sultanate of Oman

 

OTHER CONDITIONS
a Please refer to Policy terms and conditions for full list of General Exclusions and applicable to this policy
b For treatment availed outside the territorial limit   specified   in   (1)  above in  respect   of   Illness   or   injury   sustained   by   the Insured is not covered under this policy
c Direct Billing at Designated   Medical   provider   Network is   subject   to   annual   maximum   limit,   per   admission   limit   and   sub-limit   per   person applicable   under this policy and if incurred within the territorial limit specified above. Cost of eligible medical expenses will be reimbursed by insurance company after evaluation of the completed claim form along with any other documents to support the claim.
d Please refer to Annexure 5 of Terms and conditions for    services   warranting   pre-authorization   from   Insurance   Company.   If   services   are   availed   at   outside   the   Hospital Cost   Band   or   at   a   Non   designated   Medical   provider   network   applicable   to   this   policy,   it    is    the    Insured    member’s    responsibility    to    obtain pre-authorization before availing the treatment and failure to obtain such approval would result in denial of the claim.
e Treatment for emergency   conditions   shall   not   require   pre   authorization,   but   such   cases   are   to   be   notified   to   the   Insurer   or   its   administrators   within 48 hours of hospitalization or prior to his/discharge, whichever is earlier.
f Reimbursement of Claims arising out of Non-designated network providers- Insurer will reimburse the insured the cost of eligible expenses within fifteen (15) working days, provided completed claim form along with any other documents to support the claim, as specified in the notice of claim mentioned above are submitted to the insurer within a period of one hundred and twenty (120) days from incurring such expenses
g Insured member   shall   have   access   only   to   the   Designated   Medical   Provider (refer to Basic Network Provider List) for availing Direct   billing   Services.   All   other   Medical   providers   shall   be   construed   as Non-Designated Medical provider for this policy.
h Insurer shall not   be   responsible   for   the   non   availability   of   the   treatment   in   the   Designated   Medical   Provider   Network/Hospital   cost   band   chosen   by the   Insured.   If   the   treatment   facility   sought   is   based   on   the   advancement   of   technology   and   is   not   available   in   the   applicable   Hospital   Cost Band/designated   Medical   provider   network    applicable    to    this    policy,    then    cost    of    similar    treatment    in    more    conventional    methodology    would    be adopted to arrive the reasonable and customary charges of the applicable Hospital Cost Band/Designated Medical Provider network in Oman.

Our Medical Providers

Your health is integral to your quality of life. Our flexible insurance plans are supplemented by a vast medical network to bring you and your family affordable, high-quality healthcare. Check Sahatuna Basic network list here

Who can buy Sahatuna Individual Medical Insurance?

    • Citizens/Residents with valid Visa for stay in Oman
    • Age 14 days to 60 years

How to Buy or Renew:

CONTACT YOUR NEAREST BRANCH

NLG INSURANCE APP – REGISTER AND VIEW YOUR E-MEDICAL CARD

Why National Life & General Insurance Co. SAOG (NLG)

No.1 health insurers in Oman

Easy and worry-free claims settlement

Wide network of sales/service touch points

24 x 7 Call Center to assist you with your medical

In-house claims management

How to Submit your Claim

Our dedicated health insurance claims department is always available to help whenever you require assistance, we also offer an easy claims submission process for a smooth and time-saving experience. Check NLG Claims process here.

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