NEED HELP?
Frequently Asked Questions
What is Pacis Amani Medical Cover?
Pacis Amani Medical Cover is a comprehensive medical insurance product that covers you and your family against the financial burden of unexpected medical expenses.
What benefits are covered by Pacis Amani Medical Cover?
Our medical cover protects you against costs related to inpatient hospitalization, optional outpatient, optional maternity, hospital accommodation, theatre charges, doctors’ fees, accident cover, pre-existing conditions, chronic conditions, and congenital conditions.
What are the waiting periods for claims?
Pacis Amani Medical Cover has waiting periods for claims such as a 30-day waiting period for acute illness claims and a 90-day waiting period for surgical cases not specified on the benefit schedule. Maternity benefit, if purchased, will have a waiting period of one year.
What is not covered under Pacis Amani Medical Cover?
Pacis Amani Medical Cover does not cover expenses related to alcoholism, drug abuse, experimental treatment, cosmetic surgery, infertility treatment, impotence treatment, professional and hazardous sports activities, and other treatments not specified in the brochure and policy document.
Can I choose my own doctor?
Pacis Amani Medical Cover has a panel of certified medical practitioners. Members who utilize doctors outside the panel will be required to settle the whole bill, and reimbursement will be subject to pre-authorization up to 80% of reasonable and customary rates.
Is outpatient benefit available separately?
No, the outpatient benefit cannot be purchased alone or for specific family members. It is only available if the inpatient benefit is purchased and covers all family members.
Can I purchase outpatient dental and optical benefits separately?
No, the outpatient dental and optical benefits can only be purchased if the outpatient benefit is purchased and for all family members.
What is the eligibility for Pacis Amani Medical Cover?
Adults between the ages of 18 years and 64 years are eligible, and dependents include one spouse, own, or legally adopted children. Children over the age of 21 but below 25 years will be covered by their families with proof of full-time schooling.
Is there a maximum joining age?
Yes, the maximum joining age for Pacis Amani Medical Cover is 64 years.
Are medical examination reports required?
Yes, medical examination reports will be required for persons who attain 55 years and above.
