International healthcare for you and your family
Powered by Table of Benefits Plans for Dubai and Northern Emirates Sphera International healthcare for you and your family Valid from 1st January 2026
Sphera plans Our Sphera plans cover you for in-patient, out-patient and standard maternity benefits. Our mandatory Dental Plans are displayed further in this document. You can also purchase our optional Enhanced Maternity Plan (appearing further in this document) to extend your cover. Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Overall maximum plan limit US$ 250,000 US$ 1,000,000 US$ 2,000,000 US$ 5,000,000 Out-of-network co-payment in the UAE 20% 20% 20% Core Plan benefits Hospital accommodation Private room Private room Private room Private room Intensive care Prescribed drugs and dressings In-patient and day-care treatment only Surgical fees, including anaesthesia and theatre charges Physician and therapist fees In-patient and day-care treatment only Surgical appliances and materials Diagnostic tests In-patient and day-care treatment only Organ transplant In-patient treatment only US$ 35,000 Psychiatry and psychotherapy In-patient and day-care treatment only Policy terms and conditions This Table of Benefits was designed for promotional purpose and offers an overview of the cover we provide under each plan. All limits are per member, per Insurance Year, unless otherwise stated. Cover is subject to product availability and to our policy terms and conditions, as detailed in our Benefit Guide, which is available on our website www.allianzcare.com/en/dubai-indi . Key to Table of Benefits Covered in full, up to the maximum plan limit. Not available. Waiting period applies. Treatments/costs require pre- authorisation through submission of a Pre-authorisation Form. Details of our Pre-authorisation process can also be found in the Individual Benefit Guide.
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Accommodation costs for one parent staying in hospital with an insured child under 18 per night US$ 28 US$ 135 Accommodation costs for one person accompanying an insured person in cases of medical necessity per night US$ 28 US$ 28 US$ 56 US$ 56 Emergency in-patient dental treatment Reconstructive surgery To restore natural function or appearance after a disfiguring accident or surgery for cancer Where treatment for the accident or initial surgery is covered by this policy US$ 43,000 Emergency in-patient treatment Other benefits Day-care treatment Kidney dialysis In-patient, day-care and out-patient treatment US$ 18,000 Out-patient surgery Nursing at home or in a convalescent home Immediately after or instead of hospitalisation US$ 1,500 US$ 2,500 US$ 5,000 Rehabilitation treatment In-patient, day-care and out-patient treatment; must commence within 14 days of discharge after the acute medical and/or surgical treatment ceases US$ 1,500 US$ 2,500 US$ 5,000 Local ambulance Congenital conditions In the event of non-emergency treatment In-patient and day-care treatment only US$ 10,000 US$ 20,000 US$ 40,000 Congenital conditions In the event of emergency treatment In-patient, day-care and out-patient treatment US$ 43,000 US$ 43,000 US$ 43,000 US$ 43,000 Post-hospitalisation treatment Covered when it is needed in the 90 days following discharge from in-patient or day-care treatment for the same acute medical condition Emergency treatment outside area of cover For trips of a maximum period of six weeks US$ 15,000 US$ 75,000 US$ 75,000 US$ 135,000
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Medical evacuation and repatriation Where necessary treatment is not available locally, we will evacuate the insured person to the nearest appropriate medical centre (or if the insured person’s home country is within their area of cover, they can choose to be medically repatriated to their home country). Where ongoing treatment is required, we will cover hotel accommodation costs. Evacuation in the event of unavailability of adequately screened blood. If medical necessity prevents an immediate return trip following discharge from an in-patient episode of care, we will cover hotel accommodation costs. Max. 7 days Max. 7 days Max. 7 days Max. 7 days Travel costs for one person accompanying an evacuated/repatriated person US$ 2,800 US$ 2,800 US$ 4,050 US$ 4,050 Travel costs of insured family members in the event of an evacuation/repatriation US$ 2,800 per event US$ 2,800 per event Repatriation of mortal remains or burial expenses US$1,500 Travel costs of insured family members in the event of the repatriation of mortal remains US$ 2,800 Travel costs of insured members to be with a close relative who is at peril of death or who has died One round trip per insured member per Insurance Year US$ 2,125 US$ 2,125 US$ 2,125 CT and MRI scans In-patient and day-care treatment only Pre-authorisation is required for MRI scans PET and CT-PET scans In-patient and day-care treatment only Oncology In-patient, day-care and out-patient treatment Purchase of a wig, prosthetic bra or other external prosthetic device for cosmetic purposes US$ 270 US$ 270 US$ 270 US$ 675 Preventive surgery In-patient, day-care and out-patient treatment US$ 10,000 US$ 20,000 US$ 40,000 In-patient cash benefit (per night) Where treatment has been received free of charge US$ 100, max. 25 nights US$ 100, max. 25 nights US$ 150, max. 25 nights US$ 250, max. 25 nights Newborn care In-patient and out-patient treatment Max. 30 days Max. 30 days Max. 30 days Max. 30 days
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Palliative care In-patient, day-care and out-patient treatment US$ 50,000 Long term care In-patient, day-care and out-patient treatment US$ 100,000 Max. 90 days per lifetime Max. 90 days per lifetime Max. 90 days per lifetime Home delivery US$ 270 US$ 500 US$ 1,000 Pre-existing conditions Including pre-existing chronic conditions In-patient, day-care and out-patient treatment Pre-authorisation is required only for in-patient and day-care treatments US$ 43,000 US$ 43,000 US$ 43,000 US$ 43,000 Standard Maternity Antenatal care Within the limits outlined by the Dubai Health Authority protocols 90% refund 90% refund 90% refund 90% refund Routine maternity Includes medically necessary caesarean section 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy Complications of pregnancy and childbirth In the event of non-emergency treatment 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy 90% refund, up to US$ 2,750 per pregnancy Complications of pregnancy and childbirth In the event of emergency treatment US$ 43,000 US$ 43,000
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Additional Core Plan services Expat Assistance Programme** Offers access to a range of 24/7 multilingual support services as follows: • Confidential and professional counselling up to five sessions per issue, per calendar year (in-person, phone and video) • Legal and financial referral services • Wellness website access Travel Security Services** Offers 24/7 access to personal security information and advice for all your travel safety queries. This includes: • Emergency Security Assistance Hotline (not a free phone number) • Country intelligence and security advice • Daily security news and travel safety alerts Olive** Our Health & Wellness support program includes, for example: • Fitness app • Access to wellness resources MyHealth Digital Services • Manage your cover online with our app or portal anytime, anywhere • Submit and track progress of claims • Access your policy documents, health services, payment details and more Second Medical Opinion Service** Offers access to expert help on the best treatment options available, if you have been diagnosed with a serious illness or had surgery recommended
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Out-patient Plan benefits Maximum plan limit Subject to the overall maximum plan limit US$ 43,000 US$ 63,000 No limit No limit Pre-hospitalisation tests Covered when they are needed in the 72 hours before in-patient or day-care treatment Video consultation services** Medical practitioner fees Specialist fees Prescribed drugs and dressings 70% refund, up to US$ 1,000 70% refund, up to US$ 1,400 US$ 10,000 Diagnostic tests MRI scans CT scans PET scans and CT-PET scans Emergency out-patient treatment Emergency out-patient dental treatment Can also be reimbursed within the terms of any separate Dental Plan Chiropractic treatment, osteopathy, and podiatry After every 4 sessions, your therapist needs to provide a progress report and a treatment plan for your condition 10 visits 15 visits Homeopathy, Chinese herbal medicine, acupuncture and ayurvedic treatment After every 4 sessions, your therapist needs to provide a progress report and a treatment plan for your condition US$ 500 US$ 2,000 US$ 5,000 Prescribed physiotherapy Referral from doctor required Initially limited to 8 sessions ; limit also applies to prescribed and non-prescribed physiotherapy sessions, where combined 8 sessions 12 sessions 20 sessions 30 sessions - Non-prescribed physiotherapy 5 sessions 5 sessions
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Prescribed speech therapy and occupational therapy Pre-authorisation is required for occupational therapy only US$ 1,000 US$ 1,400 US$ 5,000 Vaccinations Up to and including 17 years of age Vaccinations From 18 years of age and older US$ 300 US$ 500 US$ 2,000 Health and wellbeing checks including screening for the early detection of illness or disease Checks are limited to: • Physical examination • Chest X-ray • Blood tests (full blood count, biochemistry, lipid profile, thyroid function test, liver function test, kidney function test) • Cardiovascular examination (physical examination, electrocardiogram, blood pressure) • Neurological examination (physical examination) • Bone densitometry (every five years for women aged 50+) US$ 150 US$ 250 US$ 750 US$ 1,000 Well child test 8 visits Up to and including 6 years of age 15 visits Up to and including 6 years of age 15 visits Up to and including 15 years of age Up to and including 15 years of age Cancer screening Checks are limited to: • Annual gynaecological exam • Mammogram (every two years for women aged 40+, or younger where a family history exists) • Annual prostate screening (yearly for men aged 50+, or younger where a family history exists) • Colonoscopy (every five years for members aged 50+, or 40+ where a family history exists) • Annual faecal occult blood test • BRCA1 and BRCA2 genetic test (where a direct family history exists) with exclusion of BRCA1 and BRCA2 that are not covered with exclusion of BRCA1 and BRCA2 that are not covered with exclusion of BRCA1 and BRCA2 that are not covered Preventive services Checks are limited to: • Diabetes tests (every three years for members aged 30+, or yearly for members aged 18+ if there is a high risk of diabetes developing) • Annual pap smear • Hepatitis B & C Virus screening Psychiatry and psychotherapy Referral from doctor required for psychotherapy, and initially limited to 10 sessions US$ 1,000 US$ 1,500 20 visits 30 visits Prescribed medical aids US$ 500 US$ 1,000 US$ 5,000
Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Dietician fees 1 visit 4 visits Hormone Replacement Therapy US$ 500 Sleep apnoea US$ 2,500 Prescribed glasses and contact lenses US$ 280 US$ 280 US$ 500 Annual eye examination To reduce your Out-patient Plan premium, please note that it is mandatory to select a co-payment from the options below, based on your selected plan. Two co-payment options are available with the Essence and Base Plans and four co-payment options are available with the Enhanced and Signature Plans. Once you’ve selected a co-payment option, please read across to find the relevant premium discount. The co-payment selected is payable per insured person, per visit on Out-patient services and applies to all benefits with the exception of 'Video consultation services’, ‘Cancer screening’, ‘Preventive services’ and ‘Vaccinations’. Also, our premiums are expressed in whole numbers (i.e. without any cents), therefore, percentages may be slightly higher or lower than those stated below. Out-patient Plan co-payments Sphera Essence Sphera Base Sphera Enhanced Sphera Signature Premium discount 10%, up to max. US$ 14 per visit on out-patient services 15% 20%, up to max. US$ 28 per visit on out-patient services 25% 10% per visit on out-patient services 20% 20% per visit on out-patient services 30%
Our optional plan Sphera Enhanced Maternity Plan The Sphera Enhanced Maternity Plan extends the maternity cover already offered within the Core Plan. You can only purchase the Sphera Enhanced Maternity Plan with either the Sphera Enhanced or Sphera Signature Plans. You can’t buy them separately or in conjunction with the Sphera Essence or Sphera Base Plans. This optional plan is subject to the overall maximum plan limit. Sphera Enhanced Maternity Maternity Plan benefits Enhanced routine maternity In-patient and out-patient treatment Includes medically necessary caesarean section Cover starts 12 months after the benefit was first introduced to your plan 90% refund, up to US$ 7,250 Enhanced complications of pregnancy and childbirth In the event of non- emergency treatment Cover starts 12 months after the benefit was first introduced to your plan 90% refund, up to US$ 50,000 Elective circumcision for newborn males Cover starts 12 months after the benefit was first introduced to your plan 90% refund, up to US$ 500 Dental Plans Please note that it is mandatory to select one of the following Dental Plans. They can’t be bought separately. The Sphera Dental 1 Plan can be selected with any of the four Sphera Plans. The Sphera Dental 2 and Sphera Dental 3 Plans can only be selected with either the Sphera Enhanced or Sphera Signature Plans. You can’t buy them in conjunction with the Sphera Essence or Sphera Base Plans. Sphera Dental 1 Sphera Dental 2 Sphera Dental 3 Maximum plan limit Subject to the overall maximum plan limit US$ 150 US$ 1,500 US$ 3,000 Dental Plan benefits Dental treatment 70% refund 80% refund 80% refund Dental surgery 70% refund 80% refund 80% refund Periodontics 70% refund 80% refund 80% refund Orthodontic treatment Please contact us and submit the details we will require before starting treatment, so we can verify if you are covered Cover starts 12 months after the benefit was first introduced to your plan 50% refund 50% refund Dental prostheses Cover starts 12 months after the benefit was first introduced to your plan 50% refund 50% refund
Area of cover We offer a choice of two different geographical areas of cover: Worldwide, which provides cover anywhere in the world (this area of cover can only be selected with the Sphera Signature Plan) Worldwide excluding USA The area of cover is subject to full terms and conditions as stated in the Benefit Guide. Choice of medical provider networks inside the UAE We offer a choice of medical provider networks you can select depending on your requirements: Comprehensive Network: includes all medical facilities within our UAE provider network (only available with the Sphera Enhanced and Sphera Signature plans). General Plus Network: excludes premium healthcare providers (American Hospital Group, Mediclinic Group, Cleveland Clinic Abu Dhabi, King's College Hospital, and Dr. Sulaiman Al Habib) (available with the Sphera Base, Sphera Enhanced and Sphera Signature plans). General Network: features additional exclusions of high-cost providers beyond those excluded from Comprehensive and General Plus networks (only available with the Sphera Base and Sphera Essence plans). Restricted Enhanced Network: includes selected cost-effective providers delivering a complete range of medical services throughout the UAE (only available with the Sphera Essence plan). Please contact us for the list of providers available under each of the above network. We have contractual arrangements in place with the UAE clinics/hospitals and pharmacies included in our networks. Upon presentation of the Access Card, each of these clinics/hospitals and pharmacies will provide their services and products without seeking immediate payment from members (unless the prescribed treatment is specifically excluded under your policy). Please note that where provided under the following benefits, cover is available on a reimbursement basis only, i.e. the member will have to pay for eligible treatment and then complete and submit a claim for: - Health and wellbeing checks including screening for the early detection of illness or disease - Preventive services - Prescribed medical aids - Complementary treatment - Well child test ** Certain services that may be included in your plan are provided by third party providers. If included in your plan, these services will show in your Table of Benefits. These services are made available to you subject to your acceptance of your policy’s terms and conditions, as well as the service’s terms and conditions as set out by the relevant third party service provider. By accepting the third party service providers’ terms and conditions, you enter a separate contractual relationship directly with them. Their services may be subject to geographical restrictions. Full details of the third party service providers’ terms and conditions are available in their websites and in the relevant application and/or platform where services may be hosted. The third party service providers are independent data controllers, and we recommend that you review their privacy notices to understand how they process your personal data. The third party service providers offer non-insurance services that are not intended to be a substitute for in-person medical consultations, diagnosis, treatment, assessment or care. You understand and agree that the insurer, its reinsurer and their administrators are not responsible or liable for any claim, loss or damage, directly or indirectly resulting from your use of any of these third party services.
Talk to us, we love to help! If you have any queries, please do not hesitate to contact us: Carl Downham Tel: +971 56 5228622 Email: carl.downham@international-healthcare.com Mohamad Hamadeh Tel: +971 54 5867267 Email: mohamad.hamadeh@international-healthcare.com Orient Insurance PJSC, Allianz Designed Products, 02a Orient Building, Al Badia Business Park, Dubai Festival City, P.O. Box 27966, Dubai, United Arab Emirates. DOC-DUBAI-IND-TOB-EN-1225