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

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	✔

Refer to the Sahatuna Plan Individual Medical Insurance Policy – Terms and Conditions for further details

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 plan 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 RO 5 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.

Refer to the Sahatuna Basic Individual Medical Insurance Policy Wordings for further details

Our Medical Providers

Sahatuna 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	✔

Refer to the Sahatuna Plan Individual Medical Insurance Policy – Terms and Conditions for further details

Our Medical Providers

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 RO 5 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.

Refer to the Sahatuna Basic Individual Medical Insurance Policy Wordings for further details

Our Medical Providers

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:

CALL

+968 24730939 / +968 24730840

EMAIL

sahatuna@nlicgulf.com

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.