Thursday, 23 May 2019 | 17 Ramadan 1440
Health insurance: RO500 for outpatient treatment

Health insurance coverage: RO500 for outpatient treatment

It covers the wellness insurance coverage of workers, their wives and kids (not exceeding 21 years).

The insurance coverage period will be for 1 year initially and the tenure can be elevated as agreed on by the parties.

For outpatient treatment, CMA mentioned, that RO500 consists of the price of consultation, diagnostics, laboratory and medication. The maximum price of in-patient treatment can go up to RO3,000 inclusive of hospital remain, doctor’s costs and diagnosis, medicines, ambulance expenditures and patient care. Also, the maximum price of repatriating the physique of the deceased will be RO1,000.

H E Salmi mentioned, “It includes a number of optional benefits such as pregnancy, birth, child health, dental and eye care which the employer may include in the basic and compulsory coverage as agreed with the worker and the ability of the establishment.”

The choice also stipulates provisions not covered below the Dhamani scheme.

The fourth chapter of the choice states, “The following conditions are excluded from implementation of the mandate: Pre-meditated self-inflicted injuries, experimental treatment, pre-existing conditions, comprehensive check-ups that do not require treatment as per the law, or any check-ups that are for non-medical reasons such as travel, insurance, or getting a permit.”

Dhamani does not cover plastic surgery, unless needed due to an injury integrated in the law, dental care such as fitting new teeth or braces unless associated to a workplace injury, vision-correction, clearing of the nasal passages, treating baldness, weight manage and infertility treatment.

It also does not contain treatment of sexually-transmitted illnesses, HIV and substance abuse.

H E Salmi, “The policy will cover around 2.1mn workers in the private sector. CMA is cooperating with the Ministry of Manpower, the Ministry of Health, Oman Chamber of Commerce and Industry (OCCI) and the Public Authority for Social Insurance to implement it in Oman.”

CMA has held a number of meetings to seek views on Dhamani. It is cooperating with OCCI to organise meetings with company owners in North Batinah, Dakhliyah, South Sharqiyah and Buraimi to spread awareness about the wellness insurance coverage policy.

Information Source: Muscat Daily

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