Comprehensive Medical

CMC provides extensive health insurance coverage to individuals and families.

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Medical-insurance

Aptic Comprehensive Medical Cover

This insurance ensures individuals and families receive quality medical care and financial protection against healthcare costs

A. Inpatient Services

Hospital Accommodation:

  • Coverage for standard semi-private and private room accommodations during hospitalization.

Surgical Procedures and Theater Charges:

  • Includes costs associated with surgical procedures performed in the hospital.

Specialist Consultation Fees:

  • Covers fees for consultations with medical specialists as required.

ICU/HDU Charges:

  • Intensive Care Unit (ICU) and High Dependency Unit (HDU) fees for critical care.

Prescribed Medicines and Consumables:

  • Coverage for prescribed medications, medical consumables, and necessary supplies during hospitalization.

Diagnostic Services:

  • Includes laboratory tests, radiology, and other diagnostic services required for treatment.

Pre-existing Conditions:

  • Coverage for pre-existing conditions after a specified waiting period.

  B. Outpatient Services

Consultations:

  • Covers consultations with general practitioners and specialists.

Prescribed Medications:

  • Coverage for medications prescribed during outpatient visits.

Laboratory and Radiology Services:

  • Includes necessary diagnostic tests and imaging services.

Chronic Disease Management:

  • Management of chronic conditions after a specified waiting period, unless newly discovered.

Specialist Referrals:

  • Coverage for referrals to specialists as needed for further treatment.

Dental and Optical Care:

  • Limited coverage for dental and optical services.

Physiotherapy and Rehabilitation:

  • Coverage for physiotherapy sessions and rehabilitation services as prescribed.

 

  • Financial Protection: Protects members from high medical expenses and out-of-pocket costs.
  • Access to Quality Care: Ensures access to a network of quality healthcare providers and facilities.
  • Comprehensive Coverage: Provides a wide range of medical services, including inpatient, outpatient, maternity, and emergency services.
  • Peace of Mind: Members can focus on their health and well-being, knowing they are financially protected.

 A. Maternity Coverage

  • Antenatal Care:
    • Coverage for regular check-ups and necessary tests during pregnancy.
  • Delivery Costs:
    • Covers expenses related to childbirth, including hospital fees for labor and delivery.
  • Postnatal Care:
    • Essential care and support during the prenatal period.
  • Maternity Complications:
    • Coverage for complications arising during pregnancy and childbirth.
  • Congenital Conditions:
    • Coverage for referrals to specialists as needed for further treatment.

B. Emergency Services

  • Ambulance Services:
    • Coverage for emergency transportation to medical facilities.
  • Emergency Room Treatment:
    • Coverage for treatment received in the emergency room.
  • Overseas Emergency Treatment:
    • Coverage for necessary medical treatment while abroad.
  • Air Evacuation:
    • Coverage for air evacuation in emergencies where necessary.
  • Congenital Conditions:
    • Coverage for referrals to specialists as needed for further treatment.

Individuals and families seeking comprehensive health insurance.

Employers looking to provide health benefits to employees.

High-net-worth individuals who require extensive medical coverage.

General Exclusions

  • Cosmetic procedures and elective surgeries.
  • Treatment not medically necessasry or outside the scope of coverage.
  • Pre-existing conditions before the waiting period.
  • Experimental treatments and unapproved medications.

Operational Exclusions:

  • Willful negligence or non-compliance with prescribed treatment plans.
  • Self-inflicted injuries and conditions arising from substance abuse.
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