Proposal on health insurance detailed; 39 services not covered for expats above 60

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KUWAIT CITY, Dec 13: The Kuwait Insurance Federation has submitted a proposal to the Minister of Commerce and Industry, Dr. Abdullah Al-Salman, detailing the health insurance policy for residents 60 years and above which shows that the value of an annual insurance premium for one individual is set at 500 dinars, in addition to a host of other health services throughout the entire insurance year whose cost is expected not exceed 10,000 dinars, reports Al-Rai daily. The value of the specific extra package per person is distributed as 8,000 dinars for various services and treatments including a stay at the hospital, while the package for treatment at outpatient and personal clinics, including chronic diseases, is 1,500 dinars, and 500 dinars for regular dental treatment.

Al-Ittihad indicated the insurance period is linked to the length of residence permit and a maximum of two years, and the insurance companies have the right to review the insurance premium after one year of its implementation, in light of profit or loss ratio, pointing to 39 services not covered by the 500 dinars premium insurance policy, and they include the following cases and activities:

  1. Personal services provided to the insured person inside the hospital, such as phone calls, newspapers and magazines, service and meals for guests, barber or cosmetics and any other personal expenses.
  2. Pregnancy and childbirth expenses.
  3. Dental implants, installation of crowns, bridges, dentures and periodic dental examination.
  4. Physiotherapy.
  5. Pain treatment: It means medical procedures intended to alleviate or reduce the pain and symptoms associated with a specific disease for a temporary period and not intended as a complete cure for the disease. It includes, for example: local injections for joints, local injections of tissues, tendons and muscle knots, and injections of peripheral nerves, nerve block, vertebrae and facet joints of the vertebrae, nerve channels and nerve roots with cortisone or narcotic drugs and nerve radiofrequency, and others, except for oral analgesic drugs, intravenous and intramuscular injections, and injections of albumin, which remain covered in cases Covered pathology.
  6. Radiation, biological and chemical treatment of tumors and cancer and its complications.
  7. Hemodialysis.
  8. Alzheimer’s disease, memory loss and senile dementia.
  9. Care for the infirm and private nursing, whether at home or in the hospital, and care for the sake of comfort (the care of the infirm means: services not related to a specific disease such as assistance in activities of daily living that do not aim at recovery, or services provided during periods when the patient’s health status does not change, or services which does not require continuous management by qualified or medically trained persons).
  10. Sexually transmitted diseases, including syphilis, gonorrhea, venereal viruses, acquired immunodeficiency diseases such as AIDS and related diseases, communicable diseases such as TB and hepatitis, and any other infectious diseases or epidemics that the Ministry of Health specializes in treating.
  11. Convalescence, home medical and nursing care, and any bodies or clinics that do not meet the description of a hospital, center or clinic.
  12. Therapeutic feeding unless it is for a medical necessity related to a case covered by the document and prescribed by the attending physician
  13. Congenital/hereditary cases.
  14. Health services and expenses related to cosmetic procedures that aim to improve the appearance of the body, including all cosmetics, cosmetic medicines, cosmetic dental services such as bleaching, as well as medicines for fixing and transplanting hair, and plastic surgeries of all kinds unless they are an essential part of treatment following an accident.
  15. Health services and expenses related to surgical or non-surgical treatment, pharmacological treatment of obesity, and any other program or equipment for weight control.
  16. Orthodontic
  17. Preventive treatment such as all types of vaccinations, all preventive treatments and procedures, in addition to general examinations not related to a specific disease or symptom.
  18. Difficulties and disorders of sleep.
  19. Hereditary (not pathological) hair loss.
  20. Palliative care.
  21. Vitamins, nutritional supplements or mineral substances unless prescribed by the attending physician based on medical necessity, sexual stimulants, hormones and sports tonics, all kinds of perfumes, soaps, dental products, and all medicines not registered by the Ministry of Health.
  22. Cases resulting from environmental, nuclear, radiological and biological pollution, atomic reactors, remnants of military equipment or nuclear waste, as well as natural disasters such as earthquakes, volcanoes and floods, as well as sick cases resulting from participation in wars, riots, armed insurrection, resistance of prisoners and treatment of injury or disease as a result of participation in service military or police.
  23. Addiction to alcohol, drugs, narcotics or any other addiction, misuse of drugs, solvents or adhesives, or any disorders resulting from them.
  24. Attempts to commit suicide or intentionally harm a person based on a medical report or a police report.
  25. Expenses of medical equipment and devices used outside the hospital, such as any artificial devices, such as blood pressure and glucose meters, orthotics and correction devices, and prosthetic devices.
  26. Expenses of supportive medical supplies, including, but not limited to, wheelchairs, crutches and medical watches.
  27. Prescription lenses, contact lenses, eyeglass frames and sunglasses.
  28. Any expenses related to organ transplantation and transfer.
  29. Mental and psychological disorders (anxiety, depression, obsessive- compulsive disorder…).
  30. Health services and expenses related to experimental or non-approved services for therapies, devices, drug treatment regimens, gene therapy and alternative medicine (acupuncture, Chinese therapy….).
  31. Medical expenses resulting directly or indirectly from complications as a result of the insured’s undergoing any treatment or surgery that is not covered by the insurance coverage.
  32. Medical entities or unaccredited physicians within the network of health service providers approved by the insured.
  33. Brain, lung and nerve surgeries, with the exception of spine surgeries and all related supplies directly related to the operation, where they remain covered.
  34. All cardiac surgery procedures, such as open-heart surgeries, arterial change, valve replacement and pacemaker, with the exception of personal and therapeutic coronary angioplasty including stents (a maximum of 3 stents per year), where they remain covered.
  35. Tests and treatments related to infertility, contraceptive drugs, devices, tests, and test-tube babies.
  36. Weakness, impotence, dysfunction and sexual transformation processes.
  37. Operations and procedures for correcting vision to dispense with glasses such as LASIK.
  38. Eyeglasses or contact lenses, corneal operations and transplantation, and lens implants.
  39. Removal of cataracts from the eye using laser technology, provided that the normal surgical technique remains covered.

General Terms:

  1. The insurance company must be listed, noting that there are 6 insurance companies on the Kuwait Stock Exchange: “Kuwait Insurance”, “Gulf Insurance Group”, “Al-Ahlia Insurance”, “Warba Insurance”, “Al-Oula for Takaful Insurance” and “Wethaq” for Takaful Insurance.
  2. The company must issue a healthcare card and insurance form with a guiding booklet that includes items covered by the insurance cover, conditions and exceptions, delivered upon issuance.
  3. Provide the insured with a health care network of hospitals, clinics and pharmacies within a unified list.
  4. Provide a customer service center 24 hours a day to respond to the insured’s inquiries and complaints.
  5. Issuance of insurance through the company’s websites, while providing the delivery of health cards to the customer by the delivery system.
  6. In the event of cancellation of the residence permit during the validity period of the policy and the existence of claims, there will be no refund of the premium.
  7. The document remains valid as long as the residency is valid.

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