Amman Chamber of Commerce
Medical Insurance Coverage for Merchants In a professional partnership, the Amman Chamber of Commerce and Gulf Insurance Group – Jordan is pleased to offer comprehensive medical insurance coverage to merchants, their families, and their employees.
This insurance program provides extensive benefits for both inpatient and outpatient services. The coverage includes a wide network of healthcare providers, such as physicians, pharmacies, laboratories, and centers for radiology and physical therapy. Additionally, the plan includes various levels of hospital accommodation, along with related medical examinations and treatments.
- In & out hospital medical insurance for merchants, their families, and their employees. In & out of Jordan taking into consideration the conditions as stipulated in the medical insurance policy pertaining to medical coverage outside Jordan.
- Well distributed medical network inside Jordan (more than 3620 providers).
- Reimbursement claims settlement within 7 working days.
- Companion coverage for patients up to 13 years old.
Option 1: In & Out of Hospital Coverage
| Class | Class X | Class A | Class B | Class C |
|---|---|---|---|---|
| Region | Inside & Outside Jordan | |||
| Maximum Annual Limit / Person (JOD) | 100,000 | 75,000 | 50,000 | 25,000 |
| Maximum Annual Case Limit / Person (JOD) | 15,000 | 13,000 | 10,000 | 7,500 |
| In-Hospital Coverage | ||||
| Room & Board | Full Coverage 100% | |||
| ICU; CCU | Full Coverage 100% | |||
| Surgery & Surgeon Fees & Anesthesia | Full Coverage 100% | |||
| MRI, CT Scan & Other Diagnostic Tests | Full Coverage 100% | |||
| Accompanied Parent Coverage (for children less than 13 years old) | Full Coverage 100% | |||
| Doctor Fees & Consultation | Full Coverage 100% | |||
| Ambulance | Full Coverage 100% | |||
| Medical Devices & Stents | Full Coverage 100% | |||
| Maternity Coverage (Not Including Maternity Visits, IVF) | ||||
| Annual Limits (Normal Delivery, Cesarean Delivery or Legal Abortion) (JOD) | 1,500 | 1,250 | 1,000 | 850 |
| Out-Hospital Coverage (Including Maternity Visits) | ||||
| Number of Out-Hospital Visits / Person / Year | 16 Electronic Visits | 14 Electronic Visits | 10 Electronic Visits | 8 Electronic Visits |
| Physiotherapy (80% Coverage) | 20 Sessions | 15 Sessions | 12 Sessions | 10 Sessions |
| Specialized Dr. & G.P. | 100% | |||
| Medications | 80% | |||
| Laboratory Tests & Diagnostic Tests | 80% | |||
| X-Rays & Radiology | 80% | |||
| Approved Medical Network | ||||
| Medical Network | Full | Full | Full | Full Excluding Abdali Hospital |
Normal Maternity and Delivery Coverage
- Coverage of pregnancy (excluding IVF) test.
- Coverage of all maternity related vitamins & mineral supplements (including medications subject to 16% sales tax).
- Coverage of calcium supplements for maternity cases.
- Grant 7 extra visits for pregnant females for maternity (excluding IVF) visits only.
Newborn Coverage (within 15 days of birth)
New born babies coverage subject to adding them to the medical insurance policy within a maximum period of 15 days from birth date (in case the delivery case is covered) as follows:
- Coverage of newborn babies from day one.
- Coverage of congenital & hereditary diseases for newborn babies only with an annual limit of JOD 1,500 / case / year.
- Coverage of neonates' incubator for maternity (excluding IVF) cases with an annual limit of JOD 2,000 / case / year.
- Coverage of newborn circumcision within maternity limits.
Hormones and Vitamins
- Coverage of Hormones (tests & medications) not related to fertility.
- Coverage of vitamin B12 (tests & medications).
- Coverage of Vitamin D (tests & medications).
Vaccines Coverage
- Coverage of children vaccines according to the Ministry of Health National Program.
Chronic Diseases Coverage
- Coverage of chronic cases arise after policy inception within the case limit for In-Hospital cases and according to each case's needs for chronic medications (*this clause subject to GIG - Jordan terms).
Additional Benefits
- Coverage of hepatitis (A, B & C).
- Coverage of osteoporosis cases (tests and treatments excluding medications subject to 16% sales tax).
- Coverage of laser lithotripsy.
- Coverage of mammogram test related to covered cases.
- Coverage of benign tumor cases and the related treatments.
- Coverage of non-cosmetic dermatological diseases (excluding medications subject to 16% sales tax).
- Coverage of allergy treatments, except for the comprehensive allergy test.
- Coverage of eye diseases not related to acuteness of vision, optical refractory errors, keratoconus and age-related visual disorders.
- Coverage of moisturizing eyedrops for Class X and A members and for cases covered by insurance.
- Coverage of Spinal Column pain & surgery, knee pain & surgery after applying waiting periods.
- Coverage of the treatment for uterine fibroids or hysterectomy after applying waiting periods.
- Coverage of Cardiovascular diseases after applying waiting periods.
- Coverage of strokes (tests and medications).
- Coverage of more than one medicine box, with a maximum of 3 boxes, and for a maximum period of one month.
- Coverage of sudden, episodic and non-chronic neurological diseases that are covered by insurance.
- Coverage of medical devices (e.g. Stent, heart valves, pacemaker, artificial knee).
- Coverage of pre-existing (declared and covered) cases after studying the cases by GIG – Jordan to determine a specific and appropriate sub-limit for coverage.
- Coverage of medications subjected to 16% sales tax for covered cases upon doctor prescription provided that they are not cosmetic or skin care products.
Option 2: In-Hospital Coverage Only
| Class | Class X | Class A | Class B | Class C |
|---|---|---|---|---|
| Region | Inside & Outside Jordan | |||
| Maximum Annual Limit / Person (JOD) | 100,000 | 75,000 | 50,000 | 25,000 |
| Maximum Annual Case Limit / Person (JOD) | 15,000 | 13,000 | 10,000 | 7,500 |
| In-Hospital Coverage | ||||
| Room & Board | Full Coverage 100% | |||
| ICU; CCU | Full Coverage 100% | |||
| Surgery & Surgeon Fees & Anesthesia | Full Coverage 100% | |||
| MRI, CT Scan & Other Diagnostic Tests | Full Coverage 100% | |||
| Accompanied Parent Coverage (for children less than 13 years old) | Full Coverage 100% | |||
| Doctor Fees & Consultation | Full Coverage 100% | |||
| Ambulance | Full Coverage 100% | |||
| Medical Devices & Stents | Full Coverage 100% | |||
| Approved Medical Network | ||||
| Medical Network | Full | Full | Full | Full Excluding Abdali Hospital |
Newborn Coverage (within 15 days of birth)
Newborn babies coverage subject to adding them within 15 days from birth:
- Coverage from day one, excluding congenital & hereditary diseases.
- Coverage of neonatal incubator (excluding IVF).
- Coverage of newborn circumcision within maternity limits.
Other Benefits
- Coverage of Hormones not related to fertility.
- Coverage of hepatitis (A, B & C).
- Coverage of strokes (tests & medications).
- Coverage of Osteoporosis cases.
- Coverage of benign tumor cases and related treatments.
- Coverage of spinal column pain & surgery, knee pain & surgery after applying waiting periods.
- Coverage of uterine & fibrous benign tumors, uterus lining & repairs, or hysterectomy after applying waiting periods.
- Coverage of cardiovascular diseases after waiting periods.
- Coverage of medical devices (Stent, heart valves, pacemaker, artificial knee).
- Coverage of sudden, episodic, non-chronic neurological diseases.
- Coverage of pre-existing (declared & covered) cases subject to GIG review for sub-limit.
Annual Premium (In & Out – Hospital)
| Age Band | Class X | Class A | Class B | Class C |
|---|---|---|---|---|
| 1 Day – 17 Years (JOD) | 345 | 315 | 300 | 285 |
| 18 Years – 45 Years (JOD) | 525 | 475 | 445 | 430 |
| 46 Years – 55 Years (JOD) | 765 | 620 | 590 | 555 |
| 56 Years – 65 Years (JOD) | 1150 | 1020 | 955 | 825 |
| 66 Years – 70 Years (JOD) | 2290 | 2160 | 2035 | 1905 |
Annual Premium In-Hospital
| Age Band | Class X | Class A | Class B | Class C |
|---|---|---|---|---|
| 1 Day – 17 Years (JOD) | 135 | 125 | 120 | 115 |
| 18 Years – 45 Years (JOD) | 215 | 190 | 180 | 175 |
| 46 Years – 55 Years (JOD) | 330 | 300 | 285 | 270 |
| 56 Years – 65 Years (JOD) | 460 | 415 | 400 | 370 |
| 66 Years – 70 Years (JOD) | 1020 | 890 | 765 | 635 |