Local SME Life & Healthcare

A plan offering small and medium enterprises – between 20 and 300 employees – the opportunity to provide their teams with high quality healthcare benefits and life protection services in Egypt; allowing them to focus on growing their business and moving from one success to another. The plan includes six packages to choose from, meeting your and your team’s needs for life protection and medical services.

Key Benefits:

✓ Pre-underwritten plans, easy issuance with no medical tests needed
✓ Access to inpatient and outpatient treatments
✓ Access to a network of more than 3,000 healthcare provider
✓ 24/7 customer service, claims processors and production staff to ensure best services
✓ Coverage for new chronic conditions, pre-existent conditions, dental, optical and maternity
✓ Coverage for work related injuries
✓ Life coverage includes Group life insurance, accidental death, total and partial permanent disability

Key Benefits Table
Plan Name
Prestige Plus Elite Plus Diamond Plus Elite Diamond Standard Diamond
Life Benefits

Group Life Insurance (GLI)

EGP 100,000K

Total Permanent Disability (TPD)

EGP 100,000K

Accidental Death Insurance (ADI)

EGP 100,000K Not covered

Partial Permanent Disability (PPD)

EGP 100,000K
Health Benefits

Referral Letter


Area of cover

Inside Egypt only

Medcial Network Class

Elite (golden card) Elite (golden card) Diamond (silver card) Elite (golden card) Diamond (silver card) Diamond (silver card)

Yearly maximum per insured member

EGP 150,000 EGP 100,000 EGP 50,000 EGP 30,000

Direct billing inside network

Inpatient and outpatient treatment as applicable
Inpatient Treatment

Inpatient and day care including surgeon, anesthetists, and consultation charge, diagnostic procedures, and physiotherapy

coverage on direct billing basis 100%

Daily room and board

Standard private room

Parent accommodation in the same room when the insured is under 18 years old

coverage on direct billing basis 100%
Outpatient Treatment

Doctor’s consultation

coverage on direct billing basis 100% coverage on direct billing basis 80% coverage on direct billing basis 70%

Prescribed labs and diagnostic tests


Prescribed drugs

coverage on direct billing basis 80%
Other Benefits

Pre-existing cases

EGP 15,000 EGP 10,000 EGP 5,000 EGP 3,000

New Chronic


Organ transplant


Ground ambulance


Accidental damage to natural teeth


Passive war and terrorism risk


Work related injuries


Pregnancy (Including antenatal care and childbirth)

EGP 7,500 EGP 5,500 EGP 3,000 Not covered
Two cases per twenty insured One case per twenty insured
coverage on direct billing basis 100%

New-born cover

Covered with maximum limit of 3,000 EGP from the annual mother ceiling Not covered

Dental care

EGP 1,500 EGP 1,000 EGP 500 EGP 350
coverage on direct billing basis 80%

Optical care

EGP 1,000 EGP 600 EGP 400 Not Covered
Two cases per twenty insured One cases per twenty insured
80% coverage on reimbursement basis