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Corporate medical insurance

5 August 2023

All sectors are currently keen to provide medical insurance to private and government companies, in order to provide medical benefits to their employees according to the agreed insurance systems, as this ensures reducing the material cost of the medical service provided to the employee and facilitating his access to it, which benefits the work and gains the loyalty of the employee to provide his best efforts to improve the performance of the company to which he belongs.

What is medical insurance?

Medical insurance provides a range of services to care for individuals or a group of employees working in private or government companies against the health risks associated with some diseases, as the insurance guarantees the diagnosis of the disease and the cost of treatment, in addition to providing an interruption allowance for work when exposed to critical medical conditions, whether for specific periods or in the event of a permanent disability that hinders the completion of work.

What is the difference between insurance companies and health care companies?

Each of them differs in the programs provided to the customer, so you should pay attention before subscribing to these systems and knowing the advantages of each of them, where:

Healthcare Companies

These companies work through the coordination of contracts between hospitals and medical service centers for the purpose of providing organized medical service to customers, and these services can be provided directly to individuals or through one of the insurance companies.

Insurance Companies

Companies that provide medical services, provided that they are affiliated with the Financial Regulatory Authority, which guarantees the beneficiary access to the medical service agreed upon through the terms of the agreement, in addition to the possibility of receiving complaints in the event of a defect in the provision of the service.

How the owner of the company obtains corporate medical insurance?

This system depends on providing multiple medical services to employees working in companies in exchange for paying an agreed financial value, and this requires the availability of at least 50 employees within the company to obtain group insurance benefits.

What is the difference between having individual insurance or corporate medical insurance?

Individual insurance differs from group insurance (corporate insurance) in several points, as:

Individual insurance: It is done through a direct agreement between the individual and the insurance company, and it needs to submit many papers and the beneficiary meets the conditions of the insurance company, in addition to the high cost of receiving the service due to the high volume of annual coverage, which sometimes reaches one million pounds annually.

Corporate Insurance: This system is applied through the participation of a group of employees to pay a fixed and unified value in a monthly premium determined through the insurance policy, as it is characterized by easy subscription procedures and low cost value, in addition to the possibility of dispensing medicines for chronic diseases that were previously diagnosed before subscribing to a corporate medical insurance policy.

Advantages of having corporate medical insurance

Health insurance companies offer multiple benefits to employees of private or government companies, the most important of which are:

Providing material and moral support to the employees of companies.

Providing low-cost medical services.

Providing medical services to the employee and his family members as well.

Facilitate access to medical service providers through the insurance system.

What are the conditions for providing medical insurance for companies?

There are several restrictions set by medical insurance companies through the agreement document between the two parties, as it stipulates the need to adhere to them to ensure access to the insurance service, the most important of which are:

  • The employee exceeded the proposed internship period within the company.

  • The need to ensure that the employee is not insured by any other party.

  • The employee's commitment to the conditions agreed upon with the insurance company.

  • Not to misuse any of the medical services provided.

How to subscribe TO insurance for facilities?

Subscribe to this service by following these steps:

  • Signing an employment contract between the employee and the insured company.

  • Part of the employee's salary is deducted in exchange for obtaining medical insurance service.

The necessity of providing the required papers within the subscription, including:

  • A copy of the employee's national ID card.

  • A copy of the wife's national ID card and the birth certificates of the children if they join the insurance.

Conditions for the participation of the wife and children in medical insurance

Most insurance systems allow the wife and children to participate to enjoy the medical benefits provided, and this is done through the following steps:

Pay additional costs for the wife's participation in receiving medical services.

Deducting part of the employee's monthly salary to pay the cost of insurance.

Submit a copy of the wife's and children's card, provided that the age of males is less than 25 years, and unmarried females.

What is the role of insurance for facilities in treating employees?

Medical insurance includes the provision of many medical services to the employee and his family members, provided that the costs of the services are borne according to the following rules:

  • The cost of visiting a doctor for detection and virtual examination.

  • The cost of conducting a medical radiology examination determined by the treating doctor, including (CT scan and magnetic resonance).

  • Coverage of radiation and chemotherapy.

  • The cost of dispensing the treatment prescribed by the doctor in full, or through a rate exceeding 70%.

  • Coverage of surgical procedures in therapeutic, not cosmetic cases.

  • The cost of accommodation in intensive care units.

  • The cost of anesthesiologists and surgeons.

  • Cover the costs of the insured's stay in the hospital, in addition to the costs of one companion as well.

  • The cost of dental examination and oral and maxillofacial surgery.

  • If the wife and children participate in medical insurance, the costs of medical services provided to them, such as pregnancy and childbirth follow-up, are also incurred.

Does the insurance cover the cost of treating chronic diseases?

Medical insurance agreements for companies provide for covering the costs of treating chronic diseases, whether new or prior to signing the insurance policy, in addition to covering outgoing diseases such as cancers, hepatitis C and others.

Conclusion of Corporate medical insurance

Due to the high costs of medical care needed by the employee and his family members, many resort to joining a legal system that ensures access to medical services at reduced costs, so the government and private sectors allow the provision of health services to their employees through the application of medical insurance systems for companies with agreed contracts that ensure the provision of good service to all their employees and their families.