Group Medical

Our Group Medical Insurance plan offers the flexibility to choose the level of coverage you want—from a cost-efficient Essential Benefit Plan (EBP), to a comprehensive VIP programme.

In Patient

• Daily hospitalization expenses
• Ambulance costs
• Emergency accident cover
• Surgical expenses
• Diagnostic X-ray and laboratory expenses
• Intensive care expenses
• Doctor’s visits
• Maternity services

Out Patient

• Clinical examination expenses
• Investigative procedure expenses
• Medicines, and follow-up treatments
• Minor surgeries and day-care
• Doctor’s visits (GP, specialist and consultant)
• Maternity services
• Vaccinations

With our exceptional network of medical providers in the region, your employees will be able to access the best possible medical care through:

• Nearly 3,000 medical providers across the Gulf
• Over 3,200 medical providers in India, through Paramount Healthcare Management

We work hard to create ongoing partnerships. With the Group Medical package, we’ll provide you with constant support and the necessary expertise—guiding you at every step of the way.

Our service promise includes:

• A clear explanation of policy terms and a pledge to adjudicate all claims fairly
• Welcome package and a full on-boarding experience including orientation presentations and continuous education programs
• Direct billing facility when using nearly 3,000 medical providers
• Prompt and efficient payment of claims to employees and providers
• Competitive pricing, to ensure risk and premiums are properly balanced
• Profit-sharing arrangements for large accounts through multi-national or regional pooling solutions
• Managed care focused on providing the best available care at the most reasonable prices, using the latest technology
• Case management for large cases

Through MetLife Preferred Providers Organization Network (PPO), your employees and their eligible dependents will enjoy high levels of service together with efficient claim settlements that will minimize cash outlays. When they simply present their medical insurance card at any of our MetLife PPO Network premises and pay the deductible/co-insurance amount, MetLife will take care of the rest.

You can further personalise your policy to fit the special requirements of your employees—while staying within your company’s budget.

• Hospital Cash: A cash reimbursement benefit to cover eligible expenses that arise while any of your employees is in hospital.
• Dental Benefits: Choose between four options to enhance your employees’ medical coverage:
  • Plan 1 Preventative Procedures (examinations, emergency treatment and more)
  • Plan 2 Basic Procedures
  • Plan 3 Major Procedures (crowns, dentures and more)
• Optical coverage: A high-value, and cost-effective way to enhance your employees’ Group medical insurance.
• Maternity Benefits: A valued addition to your employees’ medical cover, helping to relieve the stress of welcoming a new life into their home.
• Additional assistance benefits: A special benefit that includes access to a second expert opinion, arrangement of hospital admission, evacuation and repatriation costs.

Eligibility

All full-time employees in active employment the policyholder’s offices in the country of coverage

Participation Requirements

The Group Medical Plan is designed to cover employers with a minimum of 10 employees. Dependents are eligible for coverage under the comprehensive major medical only. All eligible employees must be enrolled.

Payment Modes

Flexible payment modes are available, ranging from quarterly to annual.