Frequently Asked Questions _FAQ's_ by shitingting

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									                             HEALTH INSURANCE PROVIDER
                                       DAMAN

                                 FREQUENTLY ASKED QUESTIONS



1. What health insurance plan is provided by the HCT?

    The HCT provides health insurance benefit to all its employees and their eligible dependents through the
    Insurance Provider Daman – National Health Insurance Company.


2. Where can I access information about the plan?

    Visit the DAMAN website at http://www.damanhealth.ae



3. The health insurance plan provided by Daman:

    Daman provides both Regional and International coverage to the HCT employees. The Regional coverage is at
    no cost to the employee and the eligible dependents. International coverage is optional and difference in cost
    shall be borne by the employee.

    In their endeavor to enhance the medical coverage to their clients, Daman has included Annual Medical Check-
    up and Annual Screening for Breast Cancer and Prostrate Cancer for the HCT employees at a minimum cost
    detailed in the HR Procedure http://portal.hct.ac.ae/sites/pnp/hr/Pages/RH024.1.aspx


4. What is the difference between the Regional and International Plan?

    The International Plan has more in network providers within UAE (e.g. Tawam, SKMC and American Hospital,
    Dubai). Europe is covered on a 100% reimbursement basis (in network) and 80% (out-of-network).

    Under the Regional Plan, Europe is covered on an 80% reimbursement basis based on the American Hospital,
    Dubai rates.

    The annual benefit limit is Dhs 2,5 million while Regional benefit limit is Dhs 1 million.


5. Can I upgrade my cover to the International Plan?

    Yes, but only upon annual renewal of membership – normally in November & December for the next
    membership year commencing 1 January. The cover selected will apply to the primary member and
    dependents.


6. Can I downgrade my cover during the year?

    No, only during the renewal of membership period as mentioned above.




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                            HEALTH INSURANCE PROVIDER
                                      DAMAN

                                FREQUENTLY ASKED QUESTIONS



7. Which areas or countries are covered by Daman under the Regional Plan?

       Worldwide, including countries such as UAE, Australia, Singapore, Thailand, Pakistan, Philippines,
        Bangladesh, India, Sri Lanka, Namibia, South Africa, Morocco, Sudan, Yemen, Bahrain, Kingdom of Saudi
        Arabia, Oman, Jordan, Kuwait, Qatar, Lebanon, Syria and Egypt where Daman currently has networks.

        Visit the DAMAN website at http://www.damanhealth.ae

       In countries where no network exists, Daman will cover on 80% reimbursement basis.

       Treatment in Europe, USA and Canada are covered on 80% reimbursement basis as per the American
        Hospital (Dubai) rates.

       Worldwide life-threatening emergency cover


8. What does DAMAN consider an “emergency?”

    A serious medical condition or symptom resulting from Injury or sickness and requires immediate care and
    treatment, generally received within 24 hours of onset, to avoid jeopardy to the life of the individual. The
    following examples are covered under the policy: broken bones, sprain, high fever, kidney stones, injury resulting
    from a trip/fall etc. While these injuries and/or illnesses may not initially jeopardize the members’ life, if left
    untreated, it may result in a life threatening condition.


9. Where is emergency medical treatment covered?

    Emergency treatment is covered on a worldwide basis. Treatment does not need to be obtained from a DAMAN
    network provider. If treatment is from an out of network provider, you will pay for the treatment and submit a
    request to DAMAN for reimbursement.


10. When I am traveling, who can I call for assistance when there is an emergency?

    The DAMAN policy includes a global emergency services program from Assist America. This program is
    available when traveling 150 kilometers or more away from your permanent residence, or to another country.
    You can contact them at:
                                 In UAE Call                      :        800-4-32626
                               In USA Call                    :           877 488 9857
                               Worldwide (call collect)               :     +1 609 275 4999

11. Are pre-existing conditions covered?

    Yes. Pre-existing conditions, including maternity, are covered based on the policy terms and conditions.




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                           HEALTH INSURANCE PROVIDER
                                     DAMAN

                               FREQUENTLY ASKED QUESTIONS



12. Do I have dental coverage?

    No coverage is provided for dental expenses.


13. Do I need to get pre-authorization for long-term medications?

    Yes. Long-term medications that exceed 60 days need to be pre-authorized.

14. How do I get reimbursed for treatment and/or medications?

    Submit a Reimbursement form with receipts/documents attached to DAMAN via your HR Officer.
    The claim needs to be submitted within 90 days in the UAE and 90 days outside UAE after
    receiving the treatment/medication.

    Daman has introduced an online claim process ‘My Daman’ whereby you can submit and track your
    claims.https://www.damanhealth.ae/eDamanApp/loadDamanLoginForm.action?request_locale=en


15. How long will it take DAMAN to process a reimbursement claim?

    On average, it will take DAMAN 14 working days to process a claim, provided all required details and documents
    are submitted along with the Claim Form.


16. My children hold resident visas and attend school overseas. Are they covered by DAMAN while they are
    overseas?

    No, they are only covered whilst in the UAE. The cover will continue for a maximum period of 90 days from the
    date they exit the UAE. This applies to any member who holds a resident permit but is absent from the UAE for
    more than 90 days.


17. Can I make a request to have a service provider (hospital, clinic, doctor, etc.) added to the DAMAN
    network?

    Send an e-mail to Tes Dizon at HR/CS, tdizon@hct.ac.ae , with the provider’s name, address, and telephone
    number. Central Services HR will forward the request to DAMAN who will determine if the provider meets both
    GAHS & DAMAN requirements.


18. When I visit a hospital, do I need to make sure the doctor is part of DAMAN’s network?

    No. If a hospital is included in DAMAN’s network, all doctors employed at the hospital are considered network
    providers.



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                            HEALTH INSURANCE PROVIDER
                                      DAMAN

                                FREQUENTLY ASKED QUESTIONS



19. What if I have lost my DAMAN card?

    Notify your Human Resource Officer (HRO) and request a new card to be issued. DAMAN charges Dhs. 25/- to
    issue a replacement card. This amount will be deducted from you next paycheck.


20. Is physiotherapy covered?

    Yes, Physiotherapy should be pre-authorized. Physiotherapy is covered 100% within network and 80% out of
    network.


21. Are chiropractic and osteopathic treatments covered?

    Yes, up to an annual limit of AED1,800 per member.


22. What hazardous activities does DAMAN exclude from being covered?

    DAMAN, like many health insurance providers in the UAE, excludes hazardous activities. All costs relating to
    the following activities are excluded:
          Any form of aerial flight (including light aircraft, monoplanes, ballooning, hang-gliding, parachuting)
          Participation in any kind of power-vehicle race, rally or competition
          Water sports (powerboats, water skiing, jet skiing, diving)
          Horse riding activities (hunting, jumping, polo, racing)
          Climbing activities (mountaineering, rock-climbing, pot holing, abseiling)
          Judo, boxing, karate, wrestling and other martial arts of any kind
          Bungee jumping
          Any professional sports activities
         Please also refer to the General Exclusions list on our website
        http://damanhealth.ae/eDamanApp/opencms/eDaman/en/Products/Plans/Regional_Exclusion.h
        tml?div=Plans&subdiv=submenu4


23. How do I obtain medical insurance for my dependent who is not eligible for coverage under the HCT
    plan?

    For dependent children over 18 years of age and who have valid UAE residence visa, can be added to the HCT
    policy. The annual premium for such dependents will be borne by the employee. Or, you can obtain medical
    insurance coverage direct from DAMAN or any of the other approved insurance providers.

    For visiting / relocating parents, you have to contact DAMAN or any other health provider directly to obtain health
    coverage.




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