Aamali Program
A bundled insurance package designed specifically for small companies, combining medical insurance, personal accident coverage, Health and Wellness Benefit, and Funeral Expenses benefit, all under one plan and one invoice.
Benefits
- A complete insurance solution in one package and one invoice.
- Medical insurance with flexible and comprehensive coverage.
- Access to a wide medical network.
- Health & wellness program to support employee well-being.
- Additional personal accident and condolence benefits.
- Free HR platform (Menaitech) for companies with 5 to 100 employees.
Coverage Table
| Class | Class (X) | Class (A) |
|---|---|---|
| Region | Inside & Outside Jordan | |
| Maximum Annual Limit / Person (JOD) | 100,000 | 75,000 |
| Maximum Annual Case Limit / Person (JOD) | 13,000 | 10,000 |
| 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 under 13 years) | Full Coverage 100% | |
| Doctor Fees & Consultation | Full Coverage 100% | |
| Ambulance | Full Coverage 100% | |
| Medical Devices | Full Coverage 100% | |
| Cardiovascular Stent Network | Full Coverage 100% | |
| Maternity Coverage (Not Including Maternity Visits, IVF) | ||
| Annual Limit (JOD) | 2,000 | 1,500 |
| Out-Hospital Coverage (Including Maternity Visits) | ||
| Number of Out-Hospital Visits / Person / Year | 12 Electronic Visits | 10 Electronic Visits |
| Physiotherapy (80% Coverage) | 15 Sessions | 10 Sessions |
| Specialized Dr. & G.P. | 100% | |
| Medications | 80% | |
| Laboratory Tests & Diagnostic Tests | 80% | |
| X-Rays & Radiology | 80% | |
| Medical Network | Full | |
20% co-payment will be applied for all inpatient treatments at Abdali and Istishari Hospitals.
Normal Maternity and Delivery Coverage
Newborn babies coverage is subject to adding them to the medical insurance policy within a maximum period of 15 days from the birth date (in case the delivery case is covered).
- 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 of 9 extra visits for pregnant females for maternity (excluding IVF) visits only.
- Coverage of newborn babies from day one.
- Coverage of congenital & hereditary diseases for newborn babies only, with an annual limit of JOD 3,000 per case per year.
- Coverage of neonates' incubator for maternity (excluding IVF) cases, with an annual limit of JOD 3,000 per case per year.
- Coverage of newborn circumcision within the maternity limits.
Hormones and Vitamins Coverage
- Coverage of hormones (tests & medications) not related to fertility.
- Coverage of vitamins (tests & medications) not subject to 16% sales tax.
Chronic Diseases Coverage
- Coverage of chronic cases within the case limit for in-hospital cases and according to each case's needs for chronic medication (*subject to GIG - Jordan terms).
Additional Benefits
- 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 tests, except for comprehensive allergy testing.
- Coverage of eye diseases not related to visual acuity, refractive errors, keratoconus, or age-related visual disorders.
- Coverage of moisturizing eye drops for insurance-covered cases.
- Coverage of back pain, spine, and disc surgeries after applying the waiting period.
- Coverage of fibroids, myomectomy, and hysterectomy after applying the waiting period.
- Coverage of cardiovascular disorders after applying the waiting period.
- Coverage of stroke and its complications.
- Coverage of more than one box of medicine, up to 3 boxes, for a maximum period of one month.
- Coverage of medical devices (stent, pacemaker, heart valves, artificial knee).
- Coverage of pre-existing (declared and covered) cases after review by GIG – Jordan to determine a specific and appropriate sub-limit for coverage.
- Coverage of Hepatitis (A & B) for cases occurring after the policy inception date.
Health and Wellness Benefits which characterize the Aamali Program
- The plan includes coverage for an annual check-up for all insured members under the medical insurance contract. This check-up consists of a comprehensive set of laboratory tests provided in collaboration with designated laboratories through a voucher system, with a co-payment of JOD 30 instead of JOD 140. The included tests are: CRP Levels, CBC, Kidney Function Test, ALT, Ferritin Levels, HBA1C, Blood Sugar, Cholesterol, Triglyceride, LDL, HDL, Uric Acid, Vitamin B12, Vitamin D, and CPK.
- A specialized health assessment, including an InBody test to analyze body composition and a nutrition consultation, provided through a voucher system to improve overall health and promote a healthy lifestyle.
- Mental health benefit covering treatment for anxiety, depression, psychiatric and mental illnesses, epilepsy, and speech disorders, and sedatives, reimbursed via cash-payment receipts up to a limit of JOD 200.
- Coverage for Vitamin B12 tests and treatments.
- Coverage for Vitamin D tests and treatments.
- Coverage for children's vaccinations according to the national program of the Ministry of Health.
- Coverage for the influenza vaccine by coordination.
Funeral Expenses Benefit
Coverage of funeral expenses with an amount of five thousand (5,000) JOD in the event of death of the insured included in the medical insurance contract, from the age of 3 years and before reaching 65 years. This benefit can only be granted for accounts with a number of members not less than 5 insured members.
Personal Accidents Benefit
Coverage of personal accidents with an amount of five thousand (5,000) JOD for the insured members covered under the medical insurance contract, within the age band of 18 to 65 years old. This benefit is subject to the total number of members being no less than 5 insured members (subject to the terms and conditions of Gulf Insurance Group – Jordan).
Free HR Platform
Offering a free human resources management system subscription, provided in cooperation with Menaitech, during the insurance period, for insured employees in the contract, for companies whose number of employees ranges from 2 to 100, provided that they have no current dealing with Menaitech (subject to the terms of Gulf Insurance Group - Jordan).