My Family Medical Insurance Guidance and Providers Network
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Medical Providers Network ﺷﺒﻜﺔ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ Medical Expenses Coverage This medical care program covers the medical expenses listed below during the period of insurance and subject to the following limits Per Person Per Year: My Family My Family My Family My Family Basic medical cover Silver Gold Platinum Diamond Maximum policy benefit limit SR. SR. SR. 100,000 SR. 250,000 Per Person Per Year 30,000 50,000 Room and board limit at Shared Shared Private Private Preferred Provider Network room room room room Room and board limit at non Preferred Provider Network SR. 350 SR. 350 SR. 600 SR. 600 (emergency only) Out-patient doctors fees at SR. 75 SR. 100 SR. 150 SR. 200 Preferred Provider Network Maximum pre-existing benefit sub-limit Per Person Per Year SR. 30,000 SR. 50,000 SR. 100,000 SR. 250,000 (no waiting period) Local ambulance services Covered Covered Covered Covered Circumcision for newborn male Covered Covered Covered Covered babies Ear piercing for newborn female Covered Covered Covered Covered babies Vaccinations for children as per Covered Covered Covered Covered MOH specification Covered Covered Covered Covered Physiotherapy treatment up to 12 up to 12 up to 12 up to 12 sessions sessions sessions sessions Hearing aids/other aids/ SR. 1,000 SR. 1,000 SR. 1,000 SR. 1,000 Equipments 1 My Family My Family My Family My Family Basic medical cover Silver Gold Platinum Diamond Geographical limits • in KSA Covered Covered Covered Covered • out KSA Not covered Not covered Not covered Covered* *Geographical Limits: for My Family Diamond In KSA, & out of KSA for emergency treatments whilst on vacations/business trips up to maximum 60 days PPPY & subject to 20% coinsurance. Deductible/coinsurance My Family My Family My Family My Family Deductible/coinsurance Silver Gold Platinum Diamond Each and every out-patient 20% 20% 20% 20% claim Each and every in-patient claim 20% 20% 20% 20% 2 Maternity/Obstetrical Benefits This benefit is covered with no waiting period for all spouses reported for coverage. This benefit is subject to the following limits: Maternity/obstetrical My Family My Family My Family My Family cover Silver Gold Platinum Diamond Maximum maternity benefit limit per spouse per year (PSPY) • Normal delivery SR. 5,000 SR. 7,000 SR. 10,000 SR. 15,000 • Ceaserean section/complications SR. 5,000 SR. 7,000 SR. 10,000 SR. 15,000 • Legal Abortion/Miscarriage SR. 5,000 SR. 7,000 SR. 10,000 SR. 15,000 ( Pre and post natal care covered under basic limit) Dental Treatment This benefit is subject to the following limits: My Family My Family My Family My Family Dental cover benefits limit Silver Gold Platinum Diamond Maximum dental benefit limit SR. 1,000 SR. 1,500 SR. 2,000 SR. 3,000 PPPY (basic cover only) Dental cover benefit limit to: - Dental consultation Covered Covered Covered Covered - Extraction non-surgical/ Covered Covered Covered Covered surgical - Amalgam/composite (non- Covered Covered Covered Covered cosmetic) filling - Root canal treatment Covered Covered Covered Covered - Gum treatment Covered Covered Covered Covered - X-rays & prescribed medication Covered Covered Covered Covered in respect of above covers 3 Optical Treatment The coverage extends to include charge for optical examination PPPY when conducted for the purpose of obtaining eye glasses and/or upgrading existing optical lenses. This extension excludes the cost of contact lenses, all optical appliances and frames and any kind of sight correction procedures. My Family My Family My Family My Family Optical cover benefits limit Silver Gold Platinum Diamond Maximum optical benefit limit SR. 200 SR. 300 SR. 500 SR. 1,000 Per Person Per Year Optical cover benefit limit to: - Optical examination Covered Covered Covered Covered - lenses once per person per Covered Covered Covered Covered year To Obtain Assistance Tawuniya Call Center provides continuous services for 24 hours daily to give help, advice, guidance, approved medical providers details and assistance to insured persons on no.: 9200 19990 Dear our valued customer, To get the best medical services with Tawuniya, you may: • Show your ID/Iqama when visiting the providers to ensure the privacy and accuracy of your medical data. • Notify Tawuniya immediately for any fraud or abuse intended by any part of the service to avoid misuse of the medical services. • Make sure the provider forwarded the approval request to Tawuniya without any delay. Note The appointed medical providers list may be updated without prior notifications, please visit our website to see the updated list. اﺳﻢ ﻣﻘﺪم اﻟﺨﺪﻣﺔ .Provider Name Tel اﻟﺮﻳﺎض Riyadh اﻟﻤﺴﺘﺸﻔﻰ اﻟﺴﻌﻮدي اﻻﻟﻤﺎﻧﻲ - Saudi German Hospital اﻟﻤﺴﺘﺸﻔﻰ اﻟﺴﻌﻮدي اﻟﺒﺮﻳﻄﺎﻧﻲ - British Saudi Hospital ﻣﺠﻤﻮﻋﺔ د. ﺳﻠﻴﻤﺎن اﻟﺤﺒﻴﺐ اﻟﻄﺒﻲ، Dr. Sulaiman Al Habib Medical - اﻟﺘﺨﺼﺼﻲ Group ﻣﺠﻤﻮﻋﺔ د. ﺳﻠﻴﻤﺎن اﻟﺤﺒﻴﺐ اﻟﻄﺒﻲ، Dr. Sulaiman Al Habib Medical - اﻟﺮﻳﺎن Group, Al Rayan ﻣﺠﻤﻮﻋﺔ د. ﺳﻠﻴﻤﺎن اﻟﺤﺒﻴﺐ اﻟﻄﺒﻲ، Dr. Sulaiman Al Habib Medical - اﻟﻌﻠﻴﺎ Group ﻣﺪﻳﻨﺔ ﺳﻠﻄﺎن ﺑﻦ ﻋﺒﺪاﻟﻌﺰﻳﺰ ﻟﻠﺨﺪﻣﺎت Sultan Bin Abdulaziz - اﻧﺴﺎﻧﻴﺔ Humanitarian City Hospital ﻣﺴﺘﺸﻔﻰ ازﻫﺎر - Al Azhar Hospital ﻣﺴﺘﺸﻔﻰ اﻻﺳﺮة اﻟﺪوﻟﻲ - Al Osrah International Hospital ﻣﺴﺘﺸﻔﻰ اﻟﺠﺎﻓﻞ اﻟﺪوﻟﻲ - Al Jafel International Hospital ﻣﺴﺘﺸﻔﻰ اﻟﺠﺰﻳﺮة اﻟﻄﺒﻲ - Al Jazeera Hospital ﻣﺴﺘﺸﻔﻰ اﻟﺤﻤﺎدي - Al Hammadi Hospital ﻣﺴﺘﺸﻔﻰ اﻟﺮﻳﺎض اﻟﻮﻃﻨﻲ - Riyadh National Hospital ﻣﺴﺘﺸﻔﻰ اﻟﺼﻔﻮة - Al Safwa Hospital ﻣﺴﺘﺸﻔﻰ اﻟﻔﻼح اﻟﺪوﻟﻲ - Al Falah International Hospital ﻣﺴﺘﺸﻔﻰ اﻟﻤﺒﺎرك - Al Mobarak Hospital Specialized Medical Center ﻣﺴﺘﺸﻔﻰ اﻟﻤﺮﻛﺰ اﻟﺘﺨﺼﺼﻲ اﻟﻄﺒﻲ - Hospital ﻣﺴﺘﺸﻔﻰ اﻟﻤﻤﻠﻜﺔ - Kingdom Hospital ﻣﺴﺘﺸﻔﻰ اﻟﻬﻼل اﻻﺧﻀﺮ - Green Crescent Hospital ﻣﺴﺘﺸﻔﻰ د. أﺣﻤﺪ أﺑﺎﻧﻤﻲ - Dr. Ahmed Abanamy Hospital Dr. Abdulrahman Al Mishari ﻣﺴﺘﺸﻔﻰ د. ﻋﺒﺪاﻟﺮﺣﻤﻦ اﻟﻤﺸﺎري - Hospital ﻣﺴﺘﺸﻔﻰ دار اﻟﺸﻔﺎ - Dar Al Shifa Hospital ﻣﺴﺘﺸﻔﻰ دﻟﻪ - Dallah Hospital اﺳﻢ ﻣﻘﺪم اﻟﺨﺪﻣﺔ .Provider Name Tel اﻟﺮﻳﺎض Riyadh ﻣﺴﺘﺸﻔﻰ راﺑﻴﺔ اﻟﻄﺒﻲ - Rabiah Hospital ﻣﺴﺘﺸﻔﻰ رﻋﺎﻳﺔ اﻟﺮﻳﺎض - Riyadh Care Hospital ﻣﺴﺘﺸﻔﻰ ﻋﺒﻴﺪ - Obeid Hospital ﻣﺴﺘﺸﻔﻰ ﻣﻐﺮﺑﻲ ﻟﻠﻌﻴﻮن واﻧﻒ - ,Magrabi Hospital - Eye, ENT واذن واﻟﺤﻨﺠﺮة واﺳﻨﺎن - Dental ﻣﺴﺘﺸﻔﻰ ﻧﺠﺪ اﺳﺘﺸﺎري - Najd Consulting Hospital اﻟﻤﺮﻛﺰ اﻟﻄﺒﻲ ﻟ³ﻧﻒ واذن واﻟﺤﻨﺠﺮة - ENT Medical Center ﻣﺮﻛﺰ آﺑﺎد اﻟﻄﺒﻲ - Abad Medical Center ﻣﺮﻛﺰ ارام اﻟﻄﺒﻲ - Aram Medical Complex ﻣﺮﻛﺰ اﻛﺴﻴﺮ اﻟﻄﺒﻲ - Elixir International Polyclinic ﻣﺮﻛﺰ اﺑﺪاع اﻟﻄﺒﻲ - Al Ebda›a Medical Clinic & Center ﻣﺮﻛﺰ اﻃﺒﺎء اﻟﻤﺘﻤﻴﺰون اﻟﻄﺒﻲ - Motamayzoon Medical Center ﻣﺮﻛﺰ اﻻﻃﺒﺎء اﻻﺳﺘﺸﺎرﻳﻮن - Medical Consultants Polyclinic ﻣﺮﻛﺰ اﻟﺘﺪاوي اﻟﻄﺒﻲ - Al Tadawe Medical Clinic ﻣﺮﻛﺰ اﻟﺮﺑﻴﻊ اﻟﻄﺒﻲ - Al Rabe›a Medical Center ﻣﺮﻛﺰ اﻟﺮﺛﻮﻳﺔ اﻟﻄﺒﻲ - Rathawia Medical Specialized ﻣﺮﻛﺰ اﻟﺮﻳﺎض اﻟﻄﺒﻲ - Riyadh Medical Center ﻣﺮﻛﺰ اﻟﺼﺒﺤﻲ اﻟﺘﺨﺼﺼﻲ - Al Subhi Specialized Center ﻣﺮﻛﺰ اﻟﻄﺎﺋﻒ اﻟﻄﺒﻲ - Taif Medical Center ﻣﺮﻛﺰ اﻟﻄﺐ اﻟﻤﺘﻘﺪم - Advanced Medicine Center Al Orouba Medical Group ( ﻣﺮﻛﺰ اﻟﻌﺮوﺑﺔ اﻟﻄﺒﻲ - branches) ﻣﺮﻛﺰ اﻟﻌﺮوﺑﺔ اﻟﻄﺒﻲ 2- Al Orouba Medical Clinic ﻣﺮﻛﺰ اﻟﻌﺰﻳﺰﻳﺔ اﻟﻄﺒﻲ - Al Azizia Medical Center ﻣﺮﻛﺰ اﻟﻌﻼج اﻟﻄﺒﻴﻌﻲ - Physical Therapists Center ﻣﺮﻛﺰ اﻟﻌﻠﻴﺎ اﻟﻄﺒﻲ - Olaya Medical Center ﻣﺮﻛﺰ اﻟﻤﺴﺘﻘﺒﻞ اﻟﻄﺒﻲ - Future Medical Center اﺳﻢ ﻣﻘﺪم اﻟﺨﺪﻣﺔ .Provider Name Tel اﻟﺮﻳﺎض Riyadh ﻣﺮﻛﺰ اﻟﻤﺸﻔﻰ اﻟﻄﺒﻲ - Al Mashfa Medical Center ﻣﺮﻛﺰ اﻟﻨﺨﺒﺔ اﻟﻄﺒﻲ واﻟﺠﺮاﺣﻲ - Elite Medical & Surgical Center ﻣﺮﻛﺰ اﻟﻨﺰﻫﺔ اﻟﻄﺒﻲ - Al Nozha Medical Center ﻣﺮﻛﺰ اﻟﻮدام اﻟﻄﺒﻲ - Al Wedam Medical Center ﻣﺮﻛﺰ اﻟﻮرود اﻟﻄﺒﻲ - Al Warood Medical Center ﻣﺮﻛﺰ اﻟﻮﻃﻦ اﻟﻄﺒﻲ، اﻟﺮواﺑﻲ - Al Watan Medical Center, Rawabi ﻣﺮﻛﺰ اﻳﺎن اﻻﺳﺘﺸﺎري - 1 Ayan Consultative Center ﻣﺮﻛﺰ اﻳﻤﺎ اﻻﺳﺘﺸﺎري - 1 Ayma Consultative Center ﻣﺮﻛﺰ ﺑﻦ رﺷﺪ اﻟﻄﺒﻲ - Bin Rushd Medical Center ﻣﺮﻛﺰ ﺗﺮاﻧﺴﺎد ﻟﻠﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ - Transad Clinic ﻣﺮﻛﺰ ﺣﺮاء اﻟﻄﺒﻲ - Heraa Medical Clinic ﻣﺮﻛﺰ ﺧﺎﻟﺪ اﻟﻄﺒﻲ - Khalid Medical Clinic ﻣﺮﻛﺰ د. ﻣﺴﺎﻋﺪ اﻟﺰﻻل اﻟﻄﺒﻲ - Dr. Azallal Medical Center ﻣﺮﻛﺰ دوﻓﻦ اﻟﻄﺒﻲ - Douvin Medical Center ﻣﺮﻛﺰ ﺳﻴﻤﺎي اﻟﻄﺒﻲ - Cmai Medical Center ﻣﺮﻛﺰ ﺷﻌﺎع اﻟﻄﺒﻲ - Shoaa Medical Center ﻣﺮﻛﺰ ﺻﺤﺔ اﻣﻢ اﻟﺘﺨﺼﺼﻲ - Sheat Al Omam Al Takhasusi ﻣﺮﻛﺰ ﻋﻤﺮ اﻟﻌﺠﺎﺟﻲ اﻟﻄﺒﻲ - Omar Al Ajaji Medical Center ﻣﺮﻛﺰ ﻋﻤﺮ اﻟﻌﺠﺎﺟﻲ اﻟﻄﺒﻲ Omar Al Ajaji Medical Center , ،2 - اﻟﺼﻨﺎﻋﻴﺔ Industrial Area ﻣﺮﻛﺰ ﻣﺎﻳﺰ اﻟﻄﺒﻲ - Mayiez Medical Center Al Mursalaat Medical & Center ﻣﺮﻛﺰ ﻣﺴﺘﻮﺻﻒ اﻟﻤﺮﺳﻼت - Clinic ﻣﺮﻛﺰ ﻣﻐﺮﺑﻲ ﻟﻠﻌﻴﻮن واﻧﻒ واذن - Magrabi Center - Eye, ENT, Dental واﻟﺤﻨﺠﺮة واﺳﻨﺎن - اﻟﻤﺴﺘﻮﺻﻒ اﻟﺨﻠﻴﺠﻲ اﻟﻄﺒﻲ، ﺷﺒﺮا - Al Khaleejy Medical Clinic, Shobra اﻟﻤﺴﺘﻮﺻﻒ اﻟﺨﻠﻴﺠﻲ اﻟﻌﺎم، اﻟﻤﻌﺬر - Al Khaleejy Medical Clinic اﺳﻢ ﻣﻘﺪم اﻟﺨﺪﻣﺔ .Provider Name Tel اﻟﺮﻳﺎض Riyadh اﻟﻤﺴﺘﻮﺻﻒ اﻟﻄﺒﻲ اﻟﺤﺪﻳﺚ - Modern Medical Center اﻟﻤﺴﺘﻮﺻﻒ اﻟﻨﻤﻮذﺟﻲ - Typical Medical Clinic ﻣﺴﺘﻮﺻﻒ إﺑﺘﺴﺎﻣﺔ اﻟﻌﺎﺋﻠﺔ - Family Smile Polyclinic ﻣﺴﺘﻮﺻﻒ أﺟﻴﺎل اﻟﻄﺒﻲ - Ajial Medical Polyclinic ﻣﺴﺘﻮﺻﻒ أﺿﻮاء اﻟﻌﺎﻟﻤﻲ اﻟﻄﺒﻲ، ,Adwaa Al Alami Polyclinic - اﻟﻌﺰﻳﺰﻳﺔ Aziziyah ﻣﺴﺘﻮﺻﻒ آل ﻣﺘﺮك اﻟﻄﺒﻲ 2، ﻇﻬﺮة , Al Metrek Medical Dispensary - ﻟﺒﻦ Wadi Laban Al Metrek Medical Dispensary , ﻣﺴﺘﻮﺻﻒ آل ﻣﺘﺮك اﻟﻄﺒﻲ 3، اﻟﺤﺎﺋﺮ - Al Hayer ﻣﺴﺘﻮﺻﻒ اﺷﺒﻴﻠﻴﺎ - Ashbelia Medical Clinic ﻣﺴﺘﻮﺻﻒ اﻋﻤﺎل اﻟﻌﻨﺎﻳﺔ اﻟﻄﺒﻲ - Amal Medical Care Clinic ﻣﺴﺘﻮﺻﻒ اﺳﺮة اﻟﻄﺒﻲ 1- Al Osra Medical Center ﻣﺴﺘﻮﺻﻒ اﺳﺮة اﻟﻄﺒﻲ 2، اﻟﺒﻄﺤﺎء - Al Osra Medical Clinic , Batha ﻣﺴﺘﻮﺻﻒ اﻣﻞ - Al Amal Clinic ﻣﺴﺘﻮﺻﻒ اﻻﺧﻼص اﻟﻄﺒﻲ - Al Ekhlass Medical Clinic ﻣﺴﺘﻮﺻﻒ اﻻﻣﻴﻦ اﻟﻄﺒﻲ - Al Amin Medical Clinic ﻣﺴﺘﻮﺻﻒ اﻻﻳﻤﺎن اﻟﻄﺒﻲ - Al Eman Medical Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺒﺪري اﻟﻄﺒﻲ - Al Badri Medical Center ﻣﺴﺘﻮﺻﻒ اﻟﺒﺮاك اﻫﻠﻲ - Al-Barrak Medical Center ﻣﺴﺘﻮﺻﻒ اﻟﺒﺴﺘﺎن - Al Bustan Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺒﻼد اﻟﻄﺒﻲ - Al-Belad Medical Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺒﻴﺎن اﻟﻄﺒﻲ - Al Bayan Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺜﻤﻴﺮي اﻫﻠﻲ 1- Al Thomairy National Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺜﻤﻴﺮي اﻫﻠﻲ 2- Al Thomairy National Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺜﻮﻳﻨﻲ اﻟﻄﺒﻲ - Al Thowaini Clinic ﻣﺴﺘﻮﺻﻒ اﻟﺠﺰﻳﺮة اﻟﻄﺒﻲ - Al Jazeraa Medical Clinic اﺳﻢ ﻣﻘﺪم اﻟﺨﺪﻣﺔ .Provider Name Tel اﻟﺮﻳﺎض Riyadh ﻣﺴﺘﻮﺻﻒ اﻟﺤﺮﻣﻴﻦ