Health Insurance Plan for SME

Insurance experts at Tawuniya, the Saudi insurance pioneer, will help you to identify, analyze and manage such risks and suggest appropriate insurance solutions. Therefore, Tawuniya designed this Health Insurance Plan to provide the best The success of your business requires proper planning to face potential risks. healthcare services for your employees and their family members and it is compatible with the CCHI requirements.
Dedicate to grow your business~ and leave us the responsibility to protect it.

From 1 - 10
Employees

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From 11 - 250
Employees

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Integrated programs for Health insurance clients

Tawuniya Vitality Program

Tawuniya Vitality program helps you understanding your health status and works with you to have health lifestyle and be more active. Move more to get health improved, and you will have more rewards.

Taj Program

This program provides integrated health services for your employees and enables them to take advantages of the health insurance program and have the best healthcare they deserve.

Check 360° Categories

Select category to view benefits

VIP A/B

NETWORK Golden/+1
ANNUAL MAXIMUM LIMIT PER PERSON 1,000,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI None
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT None
DOCTOR CONSULTANCY FEES Covered
OUT-PATIENT PRE-AUTHORIZATION 1,000 SR
IN-PATIENT DEDUCTIBLE None
ROOM Normal Suite up to 1,500SR
DENTAL BENEFIT 5,000 SR
OPTICAL BENEFIT 2,000 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 30,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Covered subject to reasonable and customary charges
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Covered
EMERGENCY TREATMENT OUT OF KSA 100,000 SR
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 15,000 SR

Platinum A/B

NETWORK Golden/+1
ANNUAL MAXIMUM LIMIT PER PERSON 800,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI 10%
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT

- UMPN providers maximum limit "Hospital&Polyclinic" (75 SR)

- Out UMPN providers maximum limit "Hospitals" (100 SR)

- In/Out of UMPN providers maximum limit "Other provider " (100 SR)

DOCTOR CONSULTANCY FEES Covered
OUT-PATIENT PRE-AUTHORIZATION 1,000 SR
IN-PATIENT DEDUCTIBLE None
ROOM Normal Suite up to 1,500SR
DENTAL BENEFIT 4,000 SR
OPTICAL BENEFIT 1,500 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 25,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Covered subject to reasonable and customary charges
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Covered
EMERGENCY TREATMENT OUT OF KSA 75,000 SR
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 10,000 SR

Gold A/B/C

NETWORK Golden/+1
ANNUAL MAXIMUM LIMIT PER PERSON 700,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI 20%
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT

- UMPN providers maximum limit "Hospital&Polyclinic" (75 SR)

- Out UMPN providers maximum limit "Hospitals" (100 SR)

- In/Out of UMPN providers maximum limit "Other provider " (100 SR)

DOCTOR CONSULTANCY FEES Covered
OUT-PATIENT PRE-AUTHORIZATION 1,000 SR
IN-PATIENT DEDUCTIBLE None
ROOM Private Room
DENTAL BENEFIT 3,000 SR
OPTICAL BENEFIT 1,000 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 20,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Covered subject to reasonable and customary charges
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Covered
EMERGENCY TREATMENT OUT OF KSA 50,000 SR
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 10,000 SR

Silver A/B

NETWORK 1/+2
ANNUAL MAXIMUM LIMIT PER PERSON 600,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI 20%
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT

- UMPN providers maximum limit "Hospital&Polyclinic" (75 SR)

- Out UMPN providers maximum limit "Hospitals" (100 SR)

- In/Out of UMPN providers maximum limit "Other provider " (100 SR)

DOCTOR CONSULTANCY FEES Covered
OUT-PATIENT PRE-AUTHORIZATION 1,000 SR
IN-PATIENT DEDUCTIBLE None
ROOM Private Room
DENTAL BENEFIT 2,000 SR
OPTICAL BENEFIT 800 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 15,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Covered subject to reasonable and customary charges
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Covered
EMERGENCY TREATMENT OUT OF KSA 50,000 SR
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 10,000 SR

Bronze A/B

NETWORK 2/3
ANNUAL MAXIMUM LIMIT PER PERSON 500,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI 20%
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT

- UMPN providers maximum limit "Hospital&Polyclinic" (75 SR)

- Out UMPN providers maximum limit "Hospitals" (100 SR)

- In/Out of UMPN providers maximum limit "Other provider " (100 SR)

DOCTOR CONSULTANCY FEES Covered
OUT-PATIENT PRE-AUTHORIZATION 500 SR
IN-PATIENT DEDUCTIBLE None
ROOM Shared Room
DENTAL BENEFIT 2,000 SR
OPTICAL BENEFIT 400 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 15,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Covered subject to reasonable and customary charges
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Covered
EMERGENCY TREATMENT OUT OF KSA 50,000 SR
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 10,000 SR

Basic A/B

NETWORK 4/6
ANNUAL MAXIMUM LIMIT PER PERSON 500,000 SR
THE PERCENTAGE OF OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISI 20%
THE MAXIMUM LIMIT FOR OUT-PATIENT DEDUCTIBLE/CO-INSURANCE FOR EACH VISIT

- UMPN providers maximum limit "Hospital&Polyclinic" (75 SR)

- Out UMPN providers maximum limit "Hospitals" (100 SR)

- In/Out of UMPN providers maximum limit "Other provider " (100 SR)

DOCTOR CONSULTANCY FEES Covered
OUTPATIENT PRE-AUTHORIZATION 500 SR
INPATIENT DEDUCTIBLE None
ROOM Shared Room
DENTAL BENEFIT 2,000 SR
OPTICAL BENEFIT 400 SR
HEARING AID BENEFIT 6,000 SR
MATERNITY BENEFIT 15,000 SR
NEWBORN COVERAGE Covered on: The mother’s policy up to a maximum of 30 days from the date of birth until they are added in the policy on retroactive basis from the date of birth.
PREMATURE BORN BABIES Covered
COMPLICATIONS OF DELIVERY / PREGNANCY Covered
EMERGENCY CASES IN KSA Covered
ELECTIVE (NON-EMERGENCY) TREATMENT OUT OF NETWORK IN OR OUT OF KSA Not covered
EMERGENCY EVACUATION THROUGH UNITEDHEALTHCARE GLOBAL Not covered
EMERGENCY TREATMENT OUT OF KSA Not covered
REPATRIATION OF MORTAL REMAINS TO HOME COUNTRY 10,000 SR

The Common Benefits (for all categories)

Dialysis 100,000 SR
Severe Psychiatric Illnesses 15,000 SR
Acquired Damage in Heart Valves 70,000 SR
Operation on an Organ Donor (for the donor) 50,000 SR
Alzheimer Patients 15,000 SR
Autism Cases 15,000 SR
National Program for Early Diagnosis in Newborns 100,000 SR
Disability 100,000 SR
Newborn Circumcision (males) 500 SR
Ears piercing (Females) 300 SR
Infant vaccines according to the schedule of the Ministry of Health Covered
Intensive Care Unit Covered
Pre-existing and chronic diseases prior to the insurance policy Covered
Natural Treatment Covered
Caregivers of children under 12 years old Covered
Ambulance service on local roads Covered
Life-threatening congenital diseases Covered
Treatment of allergy-triggered illnesses Covered

From 1 - 10
Employees

Buy Now

From 11 - 250
Employees

Get Quote

Send An Enquiry

Related Documents

You can download documents for more details

360° Medical SME Application Form

Medical Service Provider Networks

Unified Medical Declaration Form

360° Medical SME Brochure

Insurance Consumer Protection Principles

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