Membership Guide

8003010030

sa.enaya @saudi_enaya www.saudienaya.com

 Welcome Valued Saudi Enaya Customer
It is our pleasure to have you become a valued member of Saudi Enaya. We consider it an honor that you
have chosen us to be your health care partner. Our aim is to provide you with the best services and
products that meet with your needs.
We invite you to read this membership guide carefully. It contains information that will help you to each a
better understanding of your membership health care benefits. This guide will help you to make use of all
quality services from Saudi Enaya and to understand your full range of benefits.
 Phone In KSA 800 30 100 30 - Outside KSA +966 92 000 41 22
www.saudienaya.com care@saudienaya.com sa.enaya @saudi_enaya
Mail P. O. Box 3528 Jeddah 21481 - Kingdom of Saudi Arabia | Fax +966 12 59 237 41
Address Prince Sultan St. AR Rawdah District, Jeddah, Saudi Arabia 23435
Note we kindly advise you to save these contacts on your mobile phone for our instant assistance to be
available at your fingertips.

Insured/Member:
The person (employee or dependent) included
under the scheme.
Card Number:
A unique number provided to each Saudi Enaya
insured member as an identification.
Insurer:
Your health insurance company Saudi Enaya
Cooperative Insurance Co.
Policyholder:
The employer or person in whose name the
policy is issued.
CCHI (Council for Cooperative Health Insurance):
Regulator for Health Insurance in Saudi Arabia.
Provider:
Physician, hospital, group practice, nursing home,
pharmacy or any facility, individual or group of
individuals that provides a health care service.
Definitions
Reasonable and Customary:
It means that the medical expenses are
comparable with the level of fees charged by the
majority of licensed doctors or hospitals in the
member’s network in Saudi Arabia. It also means
that the medical treatment does not differ
significantly from what the licensed doctors
consider acceptable for being the usual and
customary treatment for any particular service.
Benefits:
The costs of providing health services included in
the insurance cover within the limits shown in the
Table of Applicable
Healthcare Benefits:
The mandatory benefits as specified in the
regulations set forth by CCHI provide
comprehensive coverage. However, depending
on your Saudi Enaya coverage you may receive
higher benefits Please refer to your Table of
Benefits.
Table of Benefits:
The attached table of benefit applicable to your
plan shows the maximum benefits we will pay for
each member.
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 Coverage:
The amount and extent of risk covered by Saudi
Enaya.
Standard Exclusions:
The health benefits and services excluded from
your coverage.
Reimbursement:
A method for compensation of expenses incurred
by the insured member at a provider.
Direct Billing:
The facility of non-payment granted to the
insured at the provider appointed by Saudi Enaya
whereby all such costs are directly billed to Saudi
Enaya by the provider.
Network:
All the primary physicians, specialists, hospitals
and other providers who participate in this plan
to provide your medical care. A list of your
network providers is enclosed with this
membership package.
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Chronic Condition:
A medical condition or episode of ill health which
persists for a long period.
Pre-existing & Chronic Diseases:
All pre-existing and chronic diseases are covered
except those listed in the Standard Exclusions.
Medical Report:
A document filed by the doctor explaining the
symptoms, diagnosis and treatment given.
Emergency:
The medical treatment required for an insured
person as a result of an accident, or an illness
requiring prompt medical attention.
Emergency Treatment:
You are covered up to 100% of your annual limit
for covered emergency services available outside
of your network, subject to the geographical
coverage as per your enclosed Table of Benefits.
Out-patient Treatment:
The Out-patient benefit covers all eligible
treatments, procedures and services other than
those listed in the Standard Exclusions.
Co-Insurance:
Your plan may include a Co-Insurance payment
which is the amount that is required to be paid to
the provider when you are being treated for an
applicable out-patient service. This will be
specified on your membership card as a
percentage % of the treatment cost with a
maximum limit of SAR100.
In-patient Treatment:
The In-patient benefit covers all eligible
treatments, procedures and services other than
those listed in the Standard Exclusions.
Room Type:
Depending on your level of coverage, your
hospital room will be specified on your
membership card as a normal suite, private room,
semi-private room or shared room.
Companion Cover:
If you have a dependent child that is under the
age of 12 or if medically necessary as assessed by
the attending Physician, Saudi Enaya will pay for a
companion to accompany the child during the
hospital stay.
Maternity:
• Maternity benefits are automatically provided for
all eligible females and covers the cost of
pregnancy, normal deliver y, caesarean section
and maternity complications including legal
abortion and miscarriage. (Please refer to the
enclosed Table of Benefits)
• The cost of ear piercing for new born girls and
circumcision for newborn boys is also covered
under this benefit.
• Maternity coverage is specified on your
membership card with a sign indicating your
coverage. “Y” means maternity is covered and “N”
means maternity is not covered.
Dental:
Dental benefits cover the cost of consultation,
x-rays, normal and surgical extractions, root canal
treatment, amalgam/composite filling, gum
treatment and prescribed medicines.
Optical:
The optical benefit includes consultation, vision
tests and prescription glasses, including frames.
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 Programs for every family

Saudi Enaya offers a variety of medical insurance programs that are each compliant with the requirements
mandated by the CCHI.
The programs vary in the levels of access to health care providers locally or internationally, room type and
benefit limits. Saudi Enaya additionally offers special coverage programs such as Lasik Surgery, pediatric or
Congenital Disorder based on the specific needs of each customer.

Diamond Gold Silver Bronze Classic

Member Name Member Name Member Name Member Name Member Name
Company Name Company Name Company Name Company Name Company Name
Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000
ID No.: 1234567891 Class: VIP ID No.: 1234567891 Class: A ID No.: 1234567891 Class: B ID No.: 1234567891 Class: C ID No.: 1234567891 Class: CL
Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000
Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100
100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018
Network: 1 Maternity: N Network: 3 Maternity: N Network: 5 Maternity: N Network: 7 Maternity: N Network: 9 Maternity: N

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The Diamond Program provides exceptional services and
features that meet the requirement of our valued customers.
Different options to consider starting from network of services
providers to adding exceptional coverage to choose from.
Diamond program goes beyond the minimum requirements of
CCHI and includes the following:
The Diamond Program
• Annual aggregate limit up to 1 million SAR
• Members will have access to top hospitals and medical centers of the
service network. Two service networks available for customers to
choose (Network 1 & 2)
• Standard Suite or Royal Suite
• Determining the percentage of copayment according to the
available options or health council
- Deductible / endurance / copayment (outside clinics) of standard
minimum required network is 20% maximum up to 75 riyals
- Deductible / endurance / copayment (outpatient clinics) for
hospitals outside the standard minimum required network is 20%
as a maximum up to 300 SR
- Deductible / endurance / copayment (outpatient clinics) for the
rest of the providers of outside standard minimum required
network is 20% maximum up to 100 SR
• Dental coverage is up to 10,000 SAR with the possibility of adding
braces and fixtures
• Optical coverage is up to 2000 Saudi riyals
• Pregnancy and birth is up to 30,000 SAR
• Global emergency evacuation program through Assist America
• International direct billing
• Home country treatment for foreigner members live in KSA
• 2 international network to choose
- Worldwide 1: international network includes USA & Europe
- Worldwide 2: international network without USA & Europe
• The option to have Medical tourism as part of the international
treatment plan
• Additional coverage can be adding such as Lasik Surgery, pediatric or
Congenital Disorder
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The Gold Program provides high benefits and features to match
customers’ needs. Members will enjoy the benefit of international
network as well as the different amount offered to choose from
based on customers’ demand. Gold program offers more than
CCHI standard and includes the following benefits:
The Gold Program
• Annual aggregate limit up to 750,000 SAR
• Members will have access to top hospitals and medical centers of the
service network. Two service networks available for customers to
choose (Network 3 & 4)
• Private Room
• Determining the percentage of copayment according to the
available options or CCHI
- Deductible / endurance / copayment (outside clinics) of standard minimum
required network is 20% maximum up to 75 riyals
- Deductible / endurance / copayment (outpatient clinics) for hospitals
outside the standard minimum required network is 20% as a maximum up
to 300 SR
- Deductible / endurance / copayment (outpatient clinics) for the rest of the
providers of outside standard minimum required network is 20% maximum
up to 100 SR
• Dental coverage is up to 10,000 SAR with the possibility of adding
braces and fixtures
• Optical coverage is up to 2000 SAR
• Pregnancy and birth is up to 30,000 SAR
• Global emergency evacuation program through Assist America
• International direct billing
• Home country treatment for foreigner members live in KSA
• 2 international network to choose
- Worldwide 1: international network includes USA & Europe
- Worldwide 2: international network without USA & Europe
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 The Silver Program

• Annual aggregate limit up to 600,000 SAR

• Members will have access to top hospitals and medical centers of the
service network. Two service networks available for customers to
choose (Network 5 & 6)
• Semi Private Room
• Determining the percentage of copayment according to the
available options or CCHI
- Deductible / endurance / copayment (outside clinics) of standard minimum
The Silver Program offers services and features to match the required network is 20% maximum up to 75 riyals
requirement of customers. Members will have the option of - Deductible / endurance / copayment (outpatient clinics) for hospitals
choosing the coverage amount they need. This program includes outside the standard minimum required network is 20% as a maximum up
to 300 SR
the following benefits:
- Deductible / endurance / copayment (outpatient clinics) for the rest of the
providers of outside standard minimum required network is 20% maximum
up to 100 SR
• Dental coverage is up to 5,000 SAR
• Optical coverage is up to 700 Saudi SAR
• Maternity coverage up to the max 15,000 SAR (CCHI Standard)
• Home country treatment for foreigner members live in KSA
• Global emergency evacuation program through Assist America

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 The Bronze Program

• Determining the percentage of copayment according to the

available options or CCHI
- Deductible / endurance / copayment (outside clinics) of standard minimum
required network is 20% maximum up to 75 riyals
- Deductible / endurance / copayment (outpatient clinics) for hospitals
outside the standard minimum required network is 20% as a maximum up
to 300 SR
- Deductible / endurance / copayment (outpatient clinics) for the rest of the
providers of outside standard
The Bronze program offers services and features more to the
• Members will have access to top hospitals and medical centers of the
standard of CCHI. Customers can increase the amount of coverage
of medical insurance, if they prefer. This program includes the service network. Two service networks available for customers to
following benefits: choose (Network 7 & 8)
• Shared Room
• Out-patient Co-insurance percentage determined by customers from
Nil up to 20% max & up to 100 SAR
• Dental coverage is up to 3,000 SAR
• Optical coverage is up to 500 Saudi SAR
• Maternity coverage up to the max 15,000 SAR (CCHI Standard)

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 The Classic Program

• Annual aggregate limit up to 500,000 SAR (CCHI Standard)

• Members will have access to top hospitals and medical centers of the
service network. Two service networks available for customers to
choose (Network 9 & 10)
• Shared Room
• Determining the percentage of copayment according to the
The Classic program offer basic features and services that available options or CCHI
matches CCHI limit. Customers can enjoy the benefit of Saudi - Deductible / endurance / copayment (outside clinics) of standard minimum
required network is 20% maximum up to 75 riyals
Enaya services with a lower cost program. It includes the - Deductible / endurance / copayment (outpatient clinics) for hospitals
following: outside the standard minimum required network is 20% as a maximum up
to 300 SR
- Deductible / endurance / copayment (outpatient clinics) for the rest of the
providers of outside standard minimum required network is 20% maximum
up to 100 SR
• Dental limits 2,000 SAR (CCHI Standard)
• Optical limit is 400 SAR (CCHI Standard)
• Maternity coverage up to the max 15,000 SAR (CCHI Standard)

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 Table of Beneftis
Class Diamond Gold Silver Bronze Classic

Network 1 or 2 3 or 4 5 or 6 7 or 8 9 or 10

Standard Suite Private Semi Private

Room Type or Royal Suite Room Room
Shared Room Shared Room

From From
500,000 SAR 500,000 SAR
Maximum Annual Limit up to up to
500,000 SAR 500,000 SAR 500,000 SAR
1,000.000 SAR 1,000.000 SAR

KSA & KSA &

KSA & home
Geographical Coverage worldwide 1 worldwide 1
country
KSA only KSA only
or worldwide 2 or worldwide 2

For hospitals outside the standard minimum required network is zero up to 20% maximum up to 300 SAR

Out-patient coinsurance For clinics outside the standard minimum required network is zero up to 20% maximum up to 100 SAR

Within the standard minimum required network is zero up to 20% maximum up to 75 SAR

Dental Benefit (Annual limit): From 2000 SAR From 2000 SAR
• Consultation • Root canal treatment up to 10,000 SAR up to 10,000 SAR From 2,000 SAR From 2,000 SAR
• X-Ray • Gum treatment possibility to add possibility to add
2,000 SAR
up to 5,000 SAR up to 3,000 SAR
• Extraction of natural tooth • Comprehensive cleaning teeth braces, fixtures, braces, fixtures,
once during the contractual year and bridge and bridge
• Amalgam & composite fillings

Optical limit covers: From 400 SAR From 400 SAR

• Eye test From 400 SAR up to 2,000 SAR From 400 SAR up to 500 SAR From 400 SAR
• Regular lenses up to 2,000 SAR Frame sublimit up to 750 SAR Frame sublimit Frame sublimit
• Frame 400 SAR 400 SAR

Maternity limit covers: Covered from Covered from Covered up to Covered up to Covered up to
• Pregnancy 15,000 SAR 15,000 SAR the maximum the maximum the maximum
• Normal delivery up to 30,000 SAR up to 30,000 SAR limit 15,000 SAR limit 15,000 SAR limit 15,000 SAR

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 Class Diamond Gold Silver Bronze Classic

Network 1 or 2 3 or 4 5 or 6 7 or 8 9 or 10

Maternity Coverage Details (Only if selected)

Newborn baby Covered from day one

Cost of circumcision cases for newborn boys Maximum up to SR 500 and SR 300 sequent during the term of the policy
and ear piercing for newborn girls
pregnancy and childbirth complications Covered up to annual aggregate limit

Premature Babies Covered up to the annual aggregate limit, if maternity benefit is covered

In-Patient Coinsurance/Deductible NIL

In & Out-Patient Limit Covered up to Annual Aggregate Limit

Daily accommodation& supplies limit for Shared room maximum up to SAR 150 / Day.
the companion
Life threatening Congenital cases Covered up to Annual Aggregate Limit

Pre-existing& chronic conditions Covered up to Annual Aggregate Limit

Physiotherapy when medically necessity Covered

Renal dialysis costs Maximum up to SAR 100,000

Acute Psychiatric Cases Costs Maximum up to SAR 15,000 during the term of the policy

Medical hearing Aids Costs Maximum up to SR 6,000 during the term of the policy

Costs in cases of acquired heart valve damage Maximum up to SR 70,000 during the term of the policy

Vaccinations (as per MOH) Covered for children up to 6 years

Costs of organ donation operation (The donor) Maximum up to SR 50,000 during the term of the policy

Alzheimer's patient costs Maximum up to SR 15,000 during the term of the policy

Autism cases costs Maximum up to SR 15,000 during the term of the policy

Costs of national program of early examination Maximum up to SR 100,000 during the term of the policy
for newborn to reduce disability
Disability cases costs Maximum up to SR 100,000 during the term of the policy

Ambulance service for emergency cases Covered

Repatriation of the remains of the deceased Maximum up to SAR 10,000 during the term of the policy

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Class Diamond Gold Silver Bronze Classic

Network 1 or 2 3 or 4 5 or 6 7 or 8 9 or 10

• Emergency Treatments outside KSA will be covered 100% on Reimbursement Basis as per claims incurred for
Diamond and Gold classes, and Emergency Treatments outside KSA will be covered on Reimbursement Bases for Silver
class, subject to reasonable & customary charges of similar medical procedure, treatment and medication at the
appointed network providers in KSA, however Claims incurred outside KSA will not be covered for Bronze and Classic classes
Coverage Outside KSA
• Elective treatment outside KSA will be covered 100% for Diamond and Gold classes, and 80% for Silver class on
Reimbursement Basis subject to reasonable & customary charges of similar medical procedure, treatment and
medication at the appointed network providers in KSA, and subject otherwise to Pre-Authorization from Saudi Enaya.
However, Claims incurred Outside KSA is not covered for Bronze and Classic Classes Product.

Emergency Treatment outside Network will be covered 100% on Reimbursement Basis as per incurred.
Elective treatment outside Network will be covered 80% for Diamond, Gold and Silver classes, subject to reasonable &
Coverage Outside Network (In KSA) customary charges of similar medical procedure, treatment and medication at the appointed network providers in
KSA, and subject otherwise to Pre-Authorization from Saudi Enaya.

Shared Room: 600 SAR / Day

Limit of daily room and board for the patient
which include charges for bed, nursing, medical Semi-Private Room: 600 SAR / Day
visits and supervision, catering services,
excluding cost of drugs and medical supplies Private Room: 600 SAR / Day
prescribed by the physician.
Normal Suite: 750 SAR / Day

General Practitioner SAR 50

First Specialist / 200 S.R.

Maximum Annual Limit Second Specialist /100 S.R.

Consultant SAR 300

Rare specialties such as cardiac, neurology and blood vessel surgeries, and complicated specialties: SAR 500

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 Class Diamond Gold Silver Bronze Classic

Costs of covering obesity surgery by

means of the process of sleeve Is covered by a maximum of SAR 20,000 during the validity of the Policy
quantification (only if BMI exceeds 45 BMI)

Treatment of acute and non-acute SR 15,000 for a maximum of acute psychological cases during the period of the policy and
psychological conditions includes (SR) 5,000 for acute psychological cases of (4) sessions with medicines during the term of
the policy

Coverage of the early hearing screening

program (audiometry test only) and the
program of critical congenital heart Covered
defects (cardiac sound waves) for all
infants

The cost of infant formula for infants in Covered

need of medical care up to the age of 24
months, in accordance with the
regulations governing the benefit of
infant formula
Should be prescribed by the treating physician and that the diagnosis includes one of the
following cases:
Metabolic diseases, milk or sugar allergies, problems with absorption, metabolic diseases,
diseases of the National Early Neonatal Screening Program to reduce disability, preterm and
underweight children or underweight of gestational age

Costs of coverage of the RSV immuniza-
tion program for children according to
the Ministry of Health Supplementary
Respiratory Infections Table (6)
Covered
A. less than one year:
- The child born less than (29) weeks gestation.
- Premature child suffering from chronic lung disease.
- Child suffering from congenital heart disease.
B. Less than 2 years:
- A child who suffers from pneumonia or the nervous
system and can not get rid of phlegm.

Treatment of Psoriasis
(Will not cover any cosmetics (moisturiz- Covered
ing creams)

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 Services

Saudi Enaya customers are an extension of our family. We put their needs at the heart of everything we do and every decision
we make. The priority is to be there for them whenever they require assistance, clarifications or support. At Saudi Enaya we
constantly strive to better understand the specific needs of each of our customers; this knowledge and insight allows us to
better service their requirements and fulfill their aspirations.

NETWORK OF SERVICE PROVIDERS

We give our members the ability to access big range of trusted medical services centers, around the country, that are accredit-
ed and licensed by both CCHI and the Ministry of Health. Our network of service providers includes top, specialized and well
known service providers ready to serve our members and give them the medical solution they need. We are dedicated to offer
medical coverage where ever you go around the kingdom. More than 1,000 specialized hospitals, medical centers, dentist
centers, optical centers and pharmacies are welling to serve our clients.

MEMBER CARE
Caring is part of our name “Enaya”. Our members benefit from the support and services we deliver to them 365 days a year

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 Member assistance around the clock (24/ 7):
Customer Service contact details are easy to locate on membership cards, on our website and on all our collateral. Our
professional and bilingual staff is always available and ready to support with:
• Guidance and assistance with the selection of providers
• Information regarding health care benefits
• Coordination of emergency assistance
• Response to all inquiries

SMS Services:
Our instant messaging service means that our members receive timely texts for topics that include:
• Pre-Authorization requests received by Saudi Enaya
• Saudi Enaya response to the preauthorization request
• Updates the latest information

Direct Billing & Reimbursement:

Saudi Enaya guarantees its members that they can receive treatment on a direct billing basis for all the network service
providers listed for their program level. This means that Saudi Enaya will pay for all services (in accordance to the benefits of
that specific program’s coverage). Members will only be responsible to pay for their out-patient coinsurance (according to
program level) directly to the service provider.
If services are required from any provider outside the network, (as per the table of benefits, members are allowed to
proceed on cash basis and submit invoices for reimbursement, as explained below.

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Members can utilize services outside of their designated Network Provider, by reimbursement. The amount will be reimbursed
in accordance to the member’s program specifications. (Please refer to the enclosed Table of Benefits for more details)paying
cash for these services and forwarding the invoices to Saudi Enaya for more details)

All Reimbursement Claims must be submitted with the following original documentations:
• Saudi Enaya Reimbursement form completed and signed.
• Detailed medical report filled out by your treating doctor along with his signature, date and stamp.
• Itemized invoices.
• Prescriptions, if applicable.
• Investigation results of any laboratory/diagnostic reports, if applicable.

Please note:
• Reimbursement claims must be received no longer than 30 days after the date of treatment for services available within KSA
and 60 days for services available outside KSA.
• Processing and settlement of your reimbursement claim will take 14 working days upon the receipt of the claim along with
required documentation.

Hospital Delegates:
Saudi Enaya hospital delegates are available in selected locations to assist and support our members in:
• Itemized invoices
• Supervising and resolving their issues
• Facilitate member’s appointments
• Guide members on hospital process
• Send pre-authorization requests
• Immediate assistance when required

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 Inpatient Services

All Inpatient Hospitalization

Pre-Authorization required
& Day Cases (Medical & Surgical)
Pre-Authorization:
What is Pre-Authorization? No pre-authorization required, Saudi Enaya should be
Admission for Emergency cases
Saudi Enaya requires your network provider to contact
us to gain medical approval prior providing specific Out Patient Services
service or treatment.
Dental & Optical Services, Circumcision & Ear piercing,

This is done to ensure that: Out Patient Services requiring Approval Chemotherapy & Radiotherapy, Psychiatric Cases, Renal
Dialysis and Hearing Aid

• You are eligible for the treatment or service under

Diamond: Requires pre-authorization if total amount
your policy benefits. exceeds SR 2,000.
Gold: Requires pre-authorization if total amount exceeds SR
• The proposed treatment or service is medically 1,000.
Other Out Patient Services
necessary. Silver: Requires pre-authorization if total amount exceeds SR
(Excluding Consultation & Medication) 1,000.
• The proposed treatment or service is within the Bronze: Requires pre-authorization if total amount exceeds
SR 1,000.
reasonable and customary charges of comparable Classic: Requires pre-authorization if total amount exceeds

network Providers SR 1,000

• There is enough remaining benefit limit on your Acute Cases: Do not require prior pre-authorization.
Medication Chronic Cases: Treatment for more than one month requires
membership to cover the treatment or service cost pre-authorization.

Maternity Requires pre-authorization for RST visit only

First session does not require pre-authorization; subsequent

Physiotherapy sessions require pre-authorization.

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 HEALTH CARE SERVICES
As part of its commitment to the wellbeing of its members, Saudi Enaya provides health tips and advice for different condi-
tions on a regular basis. Saudi Enaya doctors are always available to answer questions and to provide support and guidance.
Maternity Care
Members benefit from the support of our doctors during the pregnancy’s term and the delivery.
Chronic disease care:
Saudi Enaya doctors provide members with information on symptoms and medical tips for chronical disease.
Direct Medication:
In the event of a chronic disease, Saudi Enaya eases the burden by establishing a “Direct Medication” solution that allows its
members to refill their prescriptions directly from (1) Al Nahdi Pharmacies and (2) Al Dawa Pharmacies.

Home Care Services:

Our member’s health and wellbeing are part of our consideration. Saudi Eanay always care about the health condition of
members and provide services to comfort members. Now, our members can have home care service through our trusted
partner Specialized Medical Group for Home Health care. These services, available now in Jeddah, include the following:
• Home E.C.G
• Oxygen Inhalation /Hour
• I.V. Cannulation
• I.V. Cannulation Plus I.V. Therapy
• Small And Medium dressing
• Large dressing
• Home Physiotherapist
• Sampling for Lap Tests
• Ultra Sound

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 INTERNATIONAL SERVICES CARE

No matter where their travels take them, Saudi Enaya is always there with each of its participating members; through the
provision of exceptional international services that make their journeys more comfortable.

Access to a Vast International Network:

Saudi Enaya offers a variety of top international hospitals and health care centers available to service the needs of our
members during their travels. Two international networks to consider, based on your needs of coverage, that include USA,
Europe and the rest of the world

Medical Tourism:
Saudi Enaya offers comprehensive medical service for medical services that will be provided outside the Kingdom. Members
will have the benefits of traveling abroad to get the medical treatment they need, based on the case. The medical tourism
covers the expenses of transportation, accommodation, flights and treatments.

International Direct Billing:

Saudi Enaya provides international direct billing to hospitals and medical centers so members do not have to concern
themselves with payment of claims during their travel.

Home Country Treatment:

Saudi Enaya provides home country treatment services for expatriate members living in KSA.

Global Emergency Evacuation and Repatriation Through Assist America:

Our members benefit from a unique global emergency services program from Assist America. This program immediately
connects members to doctors, hospitals, pharmacies and other service providers in case of a medical emergency while
travelling 150 KILOMETERS or more away from your permanent residence, or in another country. The Assist America
Operations Center is staffed 24 hours

27
a day, 365 days a year by trained multilingual and medical personnel, (including nurses and doctors), to advise and assist in the
event of an emergency.
One simple phone call to the Assist America number listed on the membership card connects our members to:
• A state-of-the-art Operations Center
• Experienced crisis management professionals
• Worldwide response capabilities
• Air and ground ambulance service providers

Assist America completely arranges and pays for the assistance services it provides without limits on the covered cost. This
alleviates many of the obstacles and potential expenses that can be caused by medical emergencies away from home. It is
important that our members keep their membership card with them at all times so that they can call for services whenever
needed. Assist America is not a travel or medical insurance program; rather it is a provider of global emergency services.

*Assist America’s services do not replace medical insurance during medical emergencies away from home. All medical costs
incurred should be submitted according to the program a member is enrolled in and are subject to the policy limits of the
coverage.
Key Services:

• Care of Minor Children: Assist America will arrange for the care of children left unattended as the result of a medical
emergency and pay for any transportation costs involved in such arrangements.
• Return of Moral Remains: Assist America will assist with the logistics of returning a member’s remains home in the event of
his or her death. (This service includes arranging the preparation of the remains for transport, procuring required documenta-
tion, providing the necessary shipping container as well as paying for transport).
• Lost Luggage or Document Assistance: Assist America will help members locate lost luggage, documents, or personal
belongings.

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 • Interpreter and Legal Referrals: Assist America will refer members to interpreters and / or legal personnel, as necessary.

• Pre-trip Information: Assist America offers members country profiles that include visa requirements, immunization and
inoculation recommendations, as well as security advisories for any travel destination.

• Medical Consultation, Evaluation & Referral: Calls to Assist America’s Operations Center are evaluated by medical personnel
and referred to qualified doctors and / or hospitals.

• Hospital Admission Assistance: Assist America fosters prompt hospital admission by validating the member’s health
coverage or by advancing funds to the hospitals as needed.

• Emergency Medical Evacuation: If adequate medical facilities are not available locally, Assist America will use whatever
mode of transport, equipment and personnel necessary to evacuate a member to the nearest facility capable of providing a
high standard of care.

• Medical Monitoring: Assist America’s medical personnel will maintain regular communication with the member’s attending
physician and / or hospital and relay information to the family, as appropriate.

• Medical Repatriation: If a member still requires medical assistance upon being discharged from a hospital, Assist America
will repatriate them home or to a rehabilitation facility with a medical or nonmedical escort, as necessary.

• Prescription Assistance: If a member needs a replacement prescription while travelling, Assist America will help in filling that
prescription.

• Emergency Message Transmission: Assist America will receive and transmit authorized emergency messages for members.

• Compassionate Visit: If a member is travelling alone and will be hospitalized for more than five days, Assist America will
provide economy, roundtrip, common carrier transportation to the place of hospitalization for a designated family member
or friend.

29
Conditions and Exclusions:
Conditions
:
Assist America will not provide services in the following instances:
• Travel undertaken specifically for securing medical treatment.
• Injuries resulting from participation in acts of war or insurrection.
• Commission of unlawful act(s)
• Attempt at suicide.
• Incident involving the use of drugs unless prescribed by a physician.
• Transfer of member from one medical facility to another medical facility of similar capabilities and providing a similar level of care.

Assist America will not evacuate or repatriate a member:

• Without medical authorization.
• With mild lesions, simple injuries such as sprains, simple fractures, or mild sickness which can be treated by local doctors and do not
prevent the member from continuing his/her trip or returning home.
• With a pregnancy over six months.
• With mental or nervous disorders unless hospitalized.
Exclusions:

Trips exceeding 90 days from legal residence without prior notification to Assist America (separate purchase of Expatriate coverage is
available).
While assistance services are available worldwide, transportation response time is directly related to the location / jurisdiction where
an event occurs. Assist America is not responsible for failing to provide services or for delays in the delivery of services caused by
strikes or conditions beyond its control, including by way of example and not by limitation, weather conditions, availability of airports,
flight conditions, availability of hyperbaric chambers, communications system, or where rendering of service is limited or prohibited
by local law or edict.
All consulting physicians and attorneys are independent contractors and not under the control of Assist America.
Assist America is not responsible or liable for any malpractice committed by professionals rendering services to a member.
For questions regarding the program, contact:
Saudi Enaya Coporative Insurance, Prince Sultan St. AR Rawdah District, Jeddah, Saudi Arabia 23435, P.O.Box 3528, Jeddah 21481
Kingdom of Saudi Arabia | Telephone: 8003010030

30
 ONLINE CARE

Saudi Enaya provides E-services to enhance communication and transaction for members

Corporate Portal:

As part of our member care, we provide online services for our members to facilitate the working process of requests. Now,
clients don’t need to send emails or make phone calls for different endorsements services; They need to log on to
http://Corporate/saudienayaservices/
To the following benefits:
• Adding members to the policy
• Deleting members from the policy
• Editing information of members
• Upgrading or downgrading class of members
• Tracking claims and preauthorization

Online Support:

We give our members the ability to communicate with us and get online support through our email care@saudienaya.com.
Also, members can get in touch with our support through our social media channels
sa.enaya @saudi_enaya Saudi Enaya

32

01 Intentional self-inflicted injuries.
02 Sickness resulting from abuse of some medicines,
stimulants or tranquilizers, or from use of alcohol,
narcotics and similar substances.
03 Cosmetic treatment or surgery unless
necessitated by a bodily injury not excluded
under these exclusions.
04 General checkups, inoculations, drugs or
preventive measures not required for medical
treatment covered under this policy (excluding
preventive measures determined by the Ministry
of Health, such as vaccination, maternity and child
care).
05 Treatment received by a beneficiary free of charge.
06 Rest cures, general health cures and treatment in
social welfare institutions.
07 Any illness or injury resulting directly from the
beneficiary’s profession.
Exclusion List as per CCHI
08 Medically recognized venereal or sexually
transmitted diseases.
09 Costs of treatment following diagnosis of HIV or
any disease related to HIV, including AIDS and its
derivatives, alternatives, or other forms.
10 All costs related to tooth implants, dentures,
fixed or movable bridges or orthodontic
treatment, unless resulting from violent external
means.
11 Vision or hearing correction tests and visual or
hearing aids, unless requested by a licensed
physician.
12 The beneficiary’s transportation expenses within
and between cities in the Kingdom by means
other than ambulances of the Saudi Red
Crescent or licensed ambulances.
13 Hair loss, baldness or artificial hair.
14 Psychological, mental or nervous disorders.
34
 15 Allergy tests of any nature, unless relating to
medicines, diagnosis or treatment.
16 Equipment, means, drugs and procedures, or
hormone treatment aimed at regulating
reproduction, contraception, fertility, infertility,
impotence, secondary sterility, in-vitro fertilization
or any other method of artificial fertilization.
19 Treatment of acne.
20 Organ or marrow transplant, or implant of
artificial organs to replace any organ of the body.
21 Any activities known to involve high risk of
exposing a person to an illness or an accident, or
expected to aggravate a previous illness or injury.

Any congenital weakness or deformity unless it is 22 Alternative medicine.

life threatening, except for cases requiring
treatment in accordance with a medical report 23 Artificial and ancillary limbs except those
issued by the health facility approved by the required by the beneficiary as per a medical
council. decision issued by the health care facility
approved by the council.
18 Any costs or additional expenses incurred by the
beneficiary’s companion during a hospital stay, 24 Natural changes related to menopause, including
except for the hospital room and board charges menstrual disorders.
for one companion such as a mother
companying her child aged up to twelve years or
whenever medically necessary as assessed by the
attending physician.

35
This policy shall not cover medical benefits or corpse repatriation to home
country in claims resulting directly from:

01 War, invasion, acts of foreign enemy, acts of aggression (whether or not war is declared) or civil war.
02 Ionizing radiations, pollution from radioactive activity of any nuclear fuel or waste resulting from the
combustion of nuclear fuel.
03 Radioactive, toxic, explosive or other hazardous properties of any nuclear plant or any of its nuclear
components.
04 Beneficiary’s service or participation in armed forces or police activities.
05 Riot, disorder, terrorism, and similar actions.
06 Riots, strike or terrorism.

Note: All exclusions listed above are as per CCHI.

36
 ‫ﻟﻦ ﺗﻐﻄﻲ ﻫﺬه اﻟﻮﺛﻴﻘﺔ اﻟﻤﻨﺎﻓﻊ اﻟﻄﺒﻴﺔ أو إﻋﺎدة اﻟﺠﺜﻤﺎن إﻟﻰ اﻟﻤﻮﻃﻦ اﺻﻠﻲ ﻓﻲ اﻟﺤﺎﻻت اﻟﻨﺎﺗﺠﺔ ﻣﺒﺎﺷﺮة ﻋﻦ‪:‬‬
‫‪ ٠١‬اﻟﺤﺮب‪ ،‬اﻟﻐﺰو‪ ،‬أﻋﻤﺎل اﻟﻌﺪو اﺟﻨﺒﻲ‪ ،‬أﻋﻤﺎل اﻟﻌﺪوان )ﺳﻮاء أﻋﻠﻨﺖ اﻟﺤﺮب أم ﻟﻢ ﺗﻌﻠﻦ(‪ ،‬اﻟﺤﺮب اﻫﻠﻴﺔ‪.‬‬
‫‪ ٠٢‬ا‰ﺷﻌﺎﻋﺎت اﻳﻮﻧﻴﺔ أو اﻟﺘﻠﻮث ﺑﺎﻟﻨﺸﺎط ا‰ﺷﻌﺎﻋﻲ ﻣﻦ أي وﻗﻮد ﻧﻮوي أو أﻳﺔ ﻧﻔﺎﻳﺎت ﻧﻮوﻳﺔ ﻧﺎﺗﺠﺔ ﻋﻦ اﺣﺘﺮاق وﻗﻮد ﻧﻮوي‪.‬‬
‫ﻣﺮﻛﺒﺎﺗﻬﺎ اﻟﻨﻮوﻳﺔ‪.‬‬ ‫اﻟﻤ ﱠ‬
‫ﺸﻌﺔ أو اﻟﺴﺎﻣﺔ أو اﻟﻤﺘﻔﺠﺮة أو أي ﺧﺼﺎﺋﺺ ﺧﻄﺮة أﺧﺮى ي ﺗﺠﻤﻌﺎت ﻧﻮوﻳﺔ أو ي ﻣﻦ ﱠ‬ ‫‪ ٠٣‬اﻟﺨﺼﺎﺋﺺ ُ‬
‫‪ ٠٤‬ﻣﺰاوﻟﺔ اﻟﺸﺨﺺ اﻟﻤﺆﻣﻦ ﻟﻪ أو ﻣﺸﺎرﻛﺘﻪ ﻓﻲ ﺧﺪﻣﺔ اﻟﻘﻮات اﻟﻤﺴﻠﺤﺔ أو اﻟﺸﺮﻃﺔ أو ﻋﻤﻠﻴﺎﺗﻬﺎ‪.‬‬
‫‪ ٠٥‬أﻋﻤﺎل َ‬
‫اﻟﺸ َﻐﺐ‪ ،‬ا‰ﺿﺮاب‪ ،‬ا‰رﻫﺎب أو ﻣﺎ ﻳﺸﺎﺑﻬﻬﺎ ﻣﻦ أﻋﻤﺎل‪.‬‬
‫ﻣﻼﺣﻈﺔ‪ :‬ﺟﻤﻴﻊ ﻣﺎ ذﻛﺮ أﻋﻼه‪ ،‬ﻣﻄﺎﺑﻖ ﻟﺸﺮوط وأﺣﻜﺎم ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ ‪CCHI‬‬

‫‪٣٦‬‬
‫‪ ٢٤‬ﺗﺘﻄﻠﺒﻬﺎ ﺣﺎﻟﺔ اﻟﻤﺆﻣﻦ ﻟﻪ ﺑﻤﻮﺟﺐ ﻗﺮار ﻃﺒﻲ ﺑﺎﻟﻤﺮﻓﻖ اﻟﺼﺤﻲ‬ ‫‪ ١٧‬اﺟﻬﺰة واﻟﻮﺳﺎﺋﻞ واﻟﻌﻘﺎﻗﻴﺮ وا‰ﺟﺮاءات أو اﻟﻤﻌﺎﻟﺠﺔ‬
‫اﻟﻤﻌﺘﻤﺪ ﻣﻦ اﻟﻤﺠﻠﺲ‪.‬‬ ‫ﺑﺎﻟﻬﺮﻣﻮﻧﺎت ﺑﻬﺪف ﺗﻨﻈﻴﻢ اﻟﻨﺴﻞ أو ﻣﻨﻊ اﻟﺤﻤﻞ أو ﺣﺼﻮﻟﻪ أو‬
‫اﻟﻌﻘﻢ أو اﻟﻌﺠﺰ اﻟﺠﻨﺴﻲ أو ﻧﻘﺺ اﻟﺨﺼﻮﺑﺔ أو اﻟﺘﺨﺼﻴﺐ‬
‫اﻟﺘﻐﻴﺮات اﻟﻄﺒﻴﻌﻴﺔ ﻟﺴﻦ اﻟﻴﺄس ﻟﻠﻤﺆﻣﻦ ﻋﻠﻴﻬﺎ وﻳﺸﻤﻞ ذﻟﻚ‬ ‫ﺑﻮاﺳﻄﺔ اﻧﺎﺑﻴﺐ أو أﻳﺔ وﺳﺎﺋﻞ أﺧﺮى ﻟﻠﺘﻠﻘﻴﺢ اﻻﺻﻄﻨﺎﻋﻲ‪.‬‬
‫‪ ٢٥‬ﺗﻐﻴﺮات اﻟﻄﻤﺚ‪.‬‬
‫‪ ١٨‬ﺣﺎﻻت اﻟﻀﻌﻒ أو اﻟﺘﺸﻮه اﻟﺨﻠﻘﻲ إﻻ إذا ﻛﺎﻧﺖ ﺗﺸﻜﻞ ﺧﻄﻮرة ﻋﻠﻰ‬
‫ﺣﻴﺎة اﻟﻤﺆﻣﻦ ﻟﻪ‪ ،‬ﻣﺎﻋﺪا اﻟﺤﺎﻻت اﻟﺘﻲ ﻳﺠﺐ ﻋﻼﺟﻬﺎ ﺑﻤﻮﺟﺐ ﻗﺮار‬
‫ﻃﺒﻲ ﺑﺎﻟﻤﺮﻓﻖ اﻟﺼﺤﻲ اﻟﻤﻌﺘﻤﺪ ﻣﻦ اﻟﻤﺠﻠﺲ‪.‬‬
‫‪ ١٩‬أي ﺗﻜﺎﻟﻴﻒ أو ﻣﺼﺎرﻳﻒ إﺿﺎﻓﻴﺔ ﻳﺘﻜﺒﺪﻫﺎ اﻟﻤﺮاﻓﻖ ﻟﻠﻤﺆﻣﻦ ﻟﻪ‬
‫أﺛﻨﺎء ﺗﻨﻮﻳﻤﻪ أو إﻗﺎﻣﺘﻪ ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﻋﺪا ﻧﻔﻘﺔ ا‰ﻗﺎﻣﺔ وا‰ﻋﺎﺷﺔ‬
‫ﻓﻲ اﻟﻤﺴﺘﺸﻔﻰ ﻟﻤﺮاﻓﻖ واﺣﺪ ﻟﻠﻤﺆﻣﻦ ﻟﻪ‪ ،‬ﻛﻤﺮاﻓﻘﺔ ام‬
‫ﻟﻄﻔﻠﻬﺎ ﺣﺘﻰ ﺳﻦ اﻟﺜﺎﻧﻴﺔ ﻋﺸﺮة‪ ،‬أو ﺣﻴﺜﻤﺎ ﺗﻘﺘﻀﻲ اﻟﻀﺮورة‬
‫اﻟﻄﺒﻴﺔ ذﻟﻚ ﺣﺴﺐ ﺗﻘﺪﻳﺮ اﻟﻄﺒﻴﺐ اﻟﻤﻌﺎﻟﺞ‪.‬‬

‫‪ ٢٠‬ﻣﻌﺎﻟﺠﺔ اﻟﺒﺜﻮر )ﺣَ ّ‬

‫ﺐ اﻟﺸﺒﺎب(‬
‫ﺣﺎﻻت زرع اﻋﻀﺎء اﻟﻤﻨﻘﻮﻟﺔ واﻟﻨﺨﺎع اﻟﻌﻈﻤﻲ أو زرع اﻋﻀﺎء‬
‫‪ ٢١‬اﻻﺻﻄﻨﺎﻋﻴﺔ اﻟﺒﺪﻳﻠﺔ اﻟﺘﻲ ﺗﺤﻞ ﻣﺤﻞ أي ﻋﻀﻮ ﺑﺎﻟﺠﺴﻢ‪.‬‬
‫اﺧﻄﺎر اﻟﺸﺨﺼﻴﺔ اﻟﻮاردة ﻓﻲ ﻗﺴﻢ اﻟﺘﻌﺮﻳﻔﺎت ﻣﻦ ﻫﺬه‬
‫‪ ٢٢‬اﻟﻮﺛﻴﻘﺔ‪.‬‬
‫أدوﻳﺔ ووﺳﺎﺋﻞ اﻟﻌﻼج ﺑﺎﻟﻄﺐ اﻟﺒﺪﻳﻞ‪.‬‬
‫‪٢٣‬‬
‫اﻃﺮاف اﻟﺼﻨﺎﻋﻴﺔ واﻃﺮاف اﻟﻤﺴﺎﻋﺪة‪ ،‬ﻣﺎﻋﺪا ﺗﻠﻚ اﻟﺘﻲ‬

‫‪٣٥‬‬
‫ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻟﻦ ﺗﻐﻄﻲ اﻟﻤﻄﺎﻟﺒﺎت اﻟﺘﻲ ﺗﻨﺸﺄ ﻋﻤﺎ ﻳﻠﻲ‪:‬‬

‫‪ ١٠‬ﻣﺼﺎرﻳﻒ ﻋﻼج اﻟﻔﺘﺮة اﻟﻼﺣﻘﺔ ﻟﺘﺸﺨﻴﺺ ﻓﻴﺮوس ﻧﻘﺺ‬
‫اﻟﻤﻨﺎﻋﺔ اﻟﺒﺸﺮﻳﺔ ‪ HIV‬أو اﻟﻌﻠﻞ ذات اﻟﺼﻠﺔ ﺑﻬﺬا اﻟﻤﺮض ﺑﻤﺎ‬
‫اﻟﻤﻜﺘﺴﺒﺔ( أو ﻣﺸﺘﻘﺎﺗﻬﺎ‬
‫ﻓﻴﻬﺎ ﻣﺮض ا‰ﻳﺪز )ﻧﻘﺺ اﻟﻤﻨﺎﻋﺔ ُ‬
‫أو ﻣﺮادﻓﺎﺗﻬﺎ أو أﺷﻜﺎﻟﻬﺎ اﺧﺮى‪.‬‬
‫‪ ١١‬ﺟﻤﻴﻊ اﻟﺘﻜﺎﻟﻴﻒ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺰرع اﺳﻨﺎن أو ﺗﺮﻛﻴﺐ اﺳﻨﺎن‬
‫اﻻﺻﻄﻨﺎﻋﻴﺔ أو اﻟﺠﺴﻮر اﻟﺜﺎﺑﺘﺔ أو اﻟﻤﺘﺤﺮﻛﺔ أو اﻟﺘﻘﻮﻳﻢ‬
‫ﺑﺎﺳﺘﺜﻨﺎء ﺗﻠﻚ اﻟﺘﻲ ﺗﻨﺸﺄ ﻋﻦ وﺳﺎﺋﻂ ﺧﺎرﺟﻴﺔ ﻋﻨﻴﻔﺔ‪.‬‬
‫‪ ١‬ا‰ﺻﺎﺑﺔ اﻟﺘﻲ ﻳﺴﺒﺒﻬﺎ اﻟﺸﺨﺺ ﻟﻨﻔﺴﻪ ﻣﺘﻌﻤﺪا‬
‫‪ ٢‬اﻣﺮاض اﻟﺘﻲ ﺗﻨﺸﺄ ﺑﻔﻌﻞ إﺳﺎءة اﺳﺘﻌﻤﺎل ﺑﻌﺾ ادوﻳﺔ أو‬
‫اﻟﻤﻬﺪﺋﺎت أو ﺑﻔﻌﻞ ﺗﻌﺎﻃﻲ اﻟﻤﻮاد اﻟﻜﺤﻮﻟﻴﺔ أو‬
‫ﱢ‬ ‫اﻟﻤﻨﺸﻄﺎت أو‬
‫اﻟﻤﺨﺪرات أو ﻣﺎ ﺷﺎﺑﻪ ذﻟﻚ‪.‬‬
‫‪ ٣‬اﻟﺠﺮاﺣﺔ أو اﻟﻤﻌﺎﻟﺠﺔ اﻟﺘﺠﻤﻴﻠﻴﺔ إﻻ إذا اﺳﺘﺪﻋﺘﻬﺎ إﺻﺎﺑﺔ‬
‫ﺟﺴﺪﻳﺔ ﻋﺮﺿﻴﺔ ﻏﻴﺮ ﻣﺴﺘﺜﻨﺎة ﻓﻲ ﻫﺬا اﻟﻘﺴﻢ‪.‬‬

‫‪ ١٢‬اﺧﺘﺒﺎرات ﺗﺼﺤﻴﺢ اﻟﻨﻈﺮ أو اﻟﺴﻤﻊ واﻟﻮﺳﺎﺋﻞ اﻟﺒﺼﺮﻳﺔ أو‬ ‫‪ ٤‬اﻟﻔﺤﻮﺻﺎت اﻟﺸﺎﻣﻠﺔ واﻟﻠﻘﺎﺣﺎت أو اﻟﻌﻘﺎﻗﻴﺮ أو اﻟﻮﺳﺎﺋﻞ‬
‫اﻟﺴﻤﻌﻴﺔ اﻟﻤﺴﺎﻋﺪة ﻣﺎ ﻟﻢ ﺗﻜﻦ ﻣﻄﻠﻮﺑﺔ ﺑﺄﻣﺮ اﻟﻄﺒﻴﺐ‬ ‫اﻟﻮﻗﺎﺋﻴﺔ اﻟﺘﻲ ﻻ ﺗﺘﻄﻠﺒﻬﺎ ﻣﻌﺎﻟﺠﺔ ﻃﺒﻴﺔ ﻣﻨﺼﻮص ﻋﻠﻴﻬﺎ ﻓﻲ‬
‫اﻟﻤﺮﺧﺺ‪.‬‬ ‫ﻫﺬه اﻟﻮﺛﻴﻘﺔ )ﺑﺎﺳﺘﺜﻨﺎء ا‰ﺟﺮاءات اﻟﻮﻗﺎﺋﻴﺔ اﻟﺘﻲ ﺗﺤﺪدﻫﺎ وزارة‬
‫اﻟﺼﺤﺔ ﻣﺜﻼ ﻟﺘﻄﻌﻴﻤﺎت ورﻋﺎﻳﺔ اﻣﻮﻣﺔ واﻟﻄﻔﻮﻟﺔ(‪.‬‬
‫‪ ١٣‬ﻣﺼﺎرﻳﻒ اﻧﺘﻘﺎل اﻟﺸﺨﺺ اﻟﻤﺆﻣﻦ ﻟﻪ داﺧﻞ وﺑﻴﻦ ﻣﺪن‬
‫اﻟﻤﻤﻠﻜﺔ ﺑﻮﺳﺎﺋﻞ ﻧﻘﻞ ﻏﻴﺮ ﺳﻴﺎرات ا‰ﺳﻌﺎف اﻟﺘﺎﺑﻌﺔ‬ ‫‪ ٥‬ﻣﻌﺎﻟﺠﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة ﻟﻠﻤﺮأة اﻟﻤﺘﻌﺎﻗﺪ ﻣﻌﻬﺎ ﻋﻠﻰ أﺳﺎس‬
‫ﻟﺠﻤﻌﻴﺔ اﻟﻬﻼل اﺣﻤﺮ اﻟﺴﻌﻮدي وﺳﻴﺎرات ا‰ﺳﻌﺎف‬ ‫أﻧﻬﺎ ﻏﻴﺮ ﻣﺘﺰوﺟﺔ‪.‬‬
‫اﻟﻤﺮﺧﺺ ﻟﻬﺎ‪.‬‬ ‫‪ ٦‬اﻟﻤﻌﺎﻟﺠﺔ اﻟﺘﻲ ﻳﺘﻠﻘﺎﻫﺎ اﻟﺸﺨﺺ اﻟﻤﺆﻣﻦ ﻟﻪ ﺑﺪون ﻣﻘﺎﺑﻞ‪.‬‬
‫‪ ١٤‬ﺗﺴﺎﻗﻂ اﻟﺸﻌﺮ أو اﻟﺼ َﻠﻊ أو اﻟﺸﻌﺮ ُ‬
‫اﻟﻤﺴﺘﻌﺎر‪.‬‬ ‫‪ ٧‬اﻻﺳﺘﺠﻤﺎم وﺑﺮاﻣﺞ اﻟﺼﺤﺔ اﻟﺒﺪﻧﻴﺔ اﻟﻌﺎﻣﺔ واﻟﻌﻼج ﻓﻲ دور‬
‫‪ ١٥‬اﻟﻤﻌﺎﻟﺠﺔ اﻟﻨﻔﺴﻴﺔ أو اﻻﺿﻄﺮاﺑﺎت اﻟﻌﻘﻠﻴﺔ أو اﻟﻌﺼﺒﻴﺔ‪.‬‬ ‫اﻟﺮﻋﺎﻳﺔ اﻻﺟﺘﻤﺎﻋﻴﺔ‪.‬‬

‫‪ ١٦‬اﺧﺘﺒﺎرات اﻟﺤﺴﺎﺳﻴﺔ ﻣﻬﻤﺎ ﻛﺎﻧﺖ ﻃﺒﻴﻌﺘﻬﺎ ﺑﺨﻼف ﺗﻠﻚ‬ ‫‪ ٨‬أي ﻋﻠﺔ أو إﺻﺎﺑﺔ ﺗﻨﺸﺄ ﻛﻨﺘﻴﺠﺔ ﻣﺒﺎﺷﺮة ﻟﻤﻬﻨﺔ اﻟﺸﺨﺺ‬
‫اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎدوﻳﺔ أو اﻟﺘﺸﺨﻴﺺ أو اﻟﻌﻼج‪.‬‬ ‫اﻟﻤﺆﻣﻦ ﻟﻪ‪.‬‬
‫‪ ٩‬ﻣﻌﺎﻟﺠﺔ اﻣﺮاض اﻟﺘﻨﺎﺳﻠﻴﺔ أو اﻟﺘﻲ ﺗﻨﺘﻘﻞ ﺑﺎﻻﺗﺼﺎل اﻟﺠﻨﺴﻲ‬
‫اﻟﻤﺘﻌﺎرف ﻋﻠﻴﻬﺎ ﻃﺒﻴ ًﺎ‪.‬‬

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 ‫اﻟﺮﻋﺎﻳﺔ اﻻﻟﻜﺘﺮوﻧﻴﺔ‬

‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺎت إﻟﻜﺘﺮوﻧﻴﺔ ﻟﻠﻌﻤﻼء ﻟﺘﺤﺴﻴﻦ اﻟﺘﻮاﺻﻞ و اﻟﻌﻤﻠﻴﺎت‪:‬‬

‫اﻟﺒﻮاﺑﺔ ا”ﻟﻜﺘﺮوﻧﻴﺔ‬
‫ﺗﺴﻬﻞ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻋﻤﻠﻴﺎت ا‰ﺿﺎﻓﺎت و اﻟﺘﻌﺪﻳﻼت ﻋﻠﻰ اﻋﻀﺎء اﻟﻤﺴﺠﻠﻴﻦ ﻓﻲ وﺛﻴﻘﺔ اﻟﺘﺄﻣﻴﻦ و ذﻟﻚ ﻣﻦ ﺧﻼل اﻟﺒﻮاﺑﺔ‬
‫ا‰ﻟﻜﺘﺮوﻧﻴﺔ‪ .‬ﻻ داﻋﻲ ‰رﺳﺎل ﺑﺮﻳﺪ إﻟﻜﺘﺮوﻧﻲ او اﻻﺗﺼﺎل ﻟﻠﻘﻴﺎم ﺑﻌﻤﻠﻴﺔ ا‰ﺿﺎﻓﺎت‪ .‬ﻛﻞ ﻣﺎﻫﻮ ﻋﻠﻴﻚ اﻟﺪﺧﻮل اﻟﻰ اﻟﺒﻮاﺑﺔ ﻋﻦ ﻃﺮﻳﻖ‬
‫اﻟﺮاﺑﻂ اﻟﺘﺎﻟﻲ‪:‬‬
‫‪http://Corporate/saudienayaservices/‬‬
‫و ﺗﺸﻤﻞ ﻫﺬه اﻟﺒﻮاﺑﺔ اﻟﺨﺪﻣﺎت اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫إﺿﺎﻓﺔ أﻋﻀﺎء اﻟﻰ اﻟﻮﺛﻴﻘﺔ‬
‫ﺣﺬف أﻋﻀﺎء ﻣﻦ اﻟﻮﺛﻴﻘﺔ‬
‫ﺗﻌﺪﻳﻞ ﻣﻌﻠﻮﻣﺎت اﻋﻀﺎء ﻓﻲ اﻟﻮﺛﻴﻘﺔ‬
‫ﺗﻌﺪﻳﻞ ﻓﺌﺔ اﻋﻀﺎء ﻓﻲ اﻟﻮﺛﻴﻘﺔ‬

‫اﻟﺪﻋﻢ ﻋﺒﺮ ا”ﻧﺘﺮﻧﺖ‬

‫ﻧﻘﺪم ﻟﻌﻤﻼﺋﻨﺎ إﻣﻜﺎﻧﻴﺔ اﻟﺘﻮاﺻﻞ ﻣﻌﻨﺎ ﻋﻦ ﻃﺮﻳﻖ اﻟﺒﺮﻳﺪ ا‰ﻟﻜﺘﺮوﻧﻲ ‪ care@saudienaya.com‬ﻛﻤﺎ ﻳﻤﻜﻦ ﻟﻌﻤﻼﺋﻨﺎ‬
‫اﻟﻜﺮام اﻟﺘﻮاﺻﻞ ﻣﻊ رﻋﺎﻳﺔ اﻟﻌﻤﻼء و ارﺳﺎل اﺳﺘﻔﺴﺎراﺗﻬﻢ ﻋﻦ ﻃﺮﻳﻖ ﻗﻨﻮات اﻟﺘﻮاﺻﻞ ا‰ﺟﺘﻤﺎﻋﻲ‬

‫‪sa.enaya‬‬ ‫‪@saudi_enaya‬‬ ‫‪Saudi Enaya‬‬

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 ‫اﻟﺸﺮوط واﻻﺳﺘﺜﻨﺎءات‬
‫اﻟﺸﺮوط‪:‬‬
‫ﻻ ﺗﻘﺪم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺧﺪﻣﺎت ﻓﻲ اﻟﺤﺎﻻت اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• اﻟﺴﻔﺮ اﻟﻤﺆدي ﺧﺼﻴﺼ ًﺎ ﻟﻠﺤﺼﻮل ﻋﻠﻰ اﻟﻌﻼج اﻟﻄﺒﻲ‪.‬‬
‫• ا‰ﺻﺎﺑﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ اﻟﻤﺸﺎرﻛﺔ ﻓﻲ اﻟﺤﺮوب أو اﻟﺘﻤﺮد‪.‬‬
‫• إرﺗﻜﺎب أﻋﻤﺎل ﻏﻴﺮ ﻗﺎﻧﻮﻧﻴﺔ‪.‬‬
‫• ﻣﺤﺎوﻻت إﻧﺘﺤﺎر‪.‬‬
‫• اﻟﺤﻮادث اﻟﺘﻲ ﺗﺸﻤﻞ ﻋﻠﻰ ﺗﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﻣﺎﻟﻢ ﻳﺼﻒ اﻟﻄﺒﻴﺐ ﻫﺬه اﻟﺨﺪﻣﺎت‬
‫• ﺗﺤﻮﻳﻞ اﻟﻌﻀﻮ ﻣﻦ ﻣﻨﺸﺄة ﻃﺒﻴﺔ ﺧﺮى ذات إﻣﻜﺎﻧﺎت ﻣﻤﺎﺛﻠﺔ ﻣﻊ ﺗﻘﺪﻳﻢ ﻣﺴﺘﻮى ﻣﻤﺎﺛﻞ ﻣﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫ﻻ ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﺧﻼء اﻟﻌﻀﻮ وإﻋﺎدﺗﻪ‪:‬‬

‫• ﺑﺪون ﺗﺼﺮﻳﺢ ﻃﺒﻲ‪.‬‬
‫• ﻓﻲ ﺣﺎﻻت اﺿﺮار اﻟﻄﻔﻴﻔﺔ أو ا‰ﺻﺎﺑﺎت اﻟﺒﺴﻴﻄﺔ ﻣﺜﻞ إﻟﺘﻮاء اﻟﻤﻔﺎﺻﻞ أو اﻟﻘﺼﻮر اﻟﺒﺴﻴﻄﺔ أو ا‰ﻋﺘﻼل اﻟﻤﺮﺿﻲ‬
‫اﻟﻄﻔﻴﻒ اﻟﺬي ﻳﻤﻜﻦ ﻋﻼﺟﻪ ﻋﻠﻰ أﻳﺪي أﻃﺒﺎء ﻣﺤﻠﻴﻴﻦ وﻻ ﻳﻤﻨﻊ اﻟﻌﻀﻮ ﻣﻦ ﻣﺘﺎﺑﻌﺔ رﺣﻠﺘﻪ أو اﻟﻌﻮدة إﻟﻰ اﻟﻮﻃﻦ‪.‬‬
‫• اﻟﺤﻤﻞ اﻟﺬي ﺗﺠﺎوز ﺳﺘﺔ أﺷﻬﺮ‪.‬‬
‫• ﻓﻲ ﺣﺎﻻت اﻻﺿﻄﺮاﺑﺎت اﻟﻌﻘﻠﻴﺔ أو اﻟﻌﺼﺒﻴﺔ ﻣﺎﻟﻢ ﻳﺘﻢ ﺗﻠﻘﻲ اﻟﻌﻼج ﻓﻲ اﻟﻤﺴﺘﺸﻔﻰ‪.‬‬

‫اﻻﺳﺘﺜﻨﺎءات‪:‬‬
‫اﻟﺮﺣﻼت اﻟﺘﻲ ﺗﺘﺠﺎوز ﻣﺪﺗﻬﺎ ‪ 90‬ﻳﻮﻣ ًﺎ ﻣﻦ ا‰ﻗﺎﻣﺔ اﻟﻘﺎﻧﻮﻧﻴﺔ دون إرﺳﺎل إﺧﻄﺎر ﻣﺴﺒﻖ إﻟﻰ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( )ﻳﺘﻮﻓﺮ ﺷﺮاء ﻏﻄﺎء ﺗﺄﻣﻴﻨﻲ‬
‫ﻣﻨﻔﺼﻞ ﻟﻠﻤﻐﺘﺮﺑﻴﻦ )ﺗﺘﻮﻓﺮ ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺟﻤﻴﻊ أﻧﺤﺎء اﻟﻌﺎﻟﻢ‪ ،‬إ ّﻟﺎ أن زﻣﻦ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻨﻘﻞ ﻣﺮﺗﺒﻂ ﺑﺸﻜﻞ ﻣﺒﺎﺷﺮ ﺑﻤﻜﺎن‬
‫وﻧﻄﺎق اﻟﺴﻴﻄﺮة ﺣﻴﺚ وﻗﻊ اﻟﺤﺪث‪) .‬أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻟﻴﺴﺖ ﻣﺴﺆوﻟﺔ ﻋﻦ ﻋﺪم ﺗﻤﻜﻨﻬﺎ ﻣﻦ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت أو اﻟﺘﻮاﻧﻲ ﻓﻲ ﺗﻘﺪﻳﻤﻬﺎ‬
‫ﺑﺴﺒﺐ أﻋﻤﺎل ا‰ﺿﺮاب أو اﺣﻮال اﻟﺨﺎرﺟﺔ ﻋﻦ ﺳﻴﻄﺮﺗﻬﺎ‪ .‬ﺑﻤﺎ ﻳﺸﻤﻞ ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ﻻ اﻟﺤﺼﺮ‪ ،‬أﺣﻮال اﻟﻄﻘﺲ وﺻﻼﺣﻴﺔ اﻟﻤﻄﺎرات‬
‫ﻟﻠﺘﺸﻐﻴﻞ وأﺣﻮال اﻟﺮﺣﻼت اﻟﺠﻮﻳﺔ واﻟﺤﺠﺮات ﻣﻔﺮﻃﺔ اﻟﻀﻐﻂ وأﻧﻈﻤﺔ اﻻﺗﺼﺎﻻت أو ﻓﻲ ﺣﺎﻟﺔ ﻗﺼﺮ اﻟﺨﺪﻣﺔ أو ﺣﻈﺮﻫﺎ ﺑﻤﻮﺟﺐ أي ﻗﺎﻧﻮن‬
‫أو ﻣﺮﺳﻮم ﻣﺤﻠﻲ‪.‬‬

‫ﺟﻤﻴﻊ ﻣﻘﺪﻣﻮ اﻟﺨﺪﻣﺔ ﻣﺘﻌﺎﻗﺪون ﻣﺴﺘﻘﻠﻮن وﻟﻴﺴﻮ ﺧﺎﺿﻌﻴﻦ ﻟﺮﻗﺎﺑﺔ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( وﻻ ﺗﻜﻮن )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻣﺴﺆوﻟﺔ أو‬
‫ﺗﺨﻀﻊ ي ﻣﺴﺎﺋﻠﺔ ﻋﻦ أي ﺧﻄﺄ ﻣﻬﻨﻲ ﻳﺮﺗﻜﺒﻪ ﻣﻘﺪﻣﻮ اﻟﺨﺪﻣﺔ ﻟ‪Ï‬ﻋﻀﺎء‪.‬‬

‫ﻟﻤﺰﻳﺪ ﻣﻦ اﺳﺌﻠﺔ ﻋﻦ اﻟﺒﺮﻧﺎﻣﺞ ﻳﺮﺟﻰ اﻻﺗﺼﺎل ﻋﻠﻰ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻟﻠﺘﺄﻣﻴﻦ اﻟﺘﻌﺎوﻧﻲ‬
‫ﺷﺎرع اﻣﻴﺮ ﺳﻠﻄﺎن ﺣﻲ اﻟﺮوﺿﺔ‪ ،‬ﺟﺪة‪ ،‬اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ‪23435‬‬
‫ص‪.‬ب ‪ 3528‬ﺟﺪة ‪ 21481‬اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪ ،‬ﻫﺎﺗﻒ‪800301003 :‬‬

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 ‫• ﺧﺪﻣﺔ اﻟﺘﺮﺟﻤﺔ اﻟﻔﻮرﻳﺔ واﻻﺳﺘﺸﺎرات اﻟﻘﺎﻧﻮﻧﻴﺔ ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﺣﺎﻟﺔ اﻋﻀﺎد إﻟﻰ ﻣﺘﺮﺟﻤﻴﻦ ﻓﻮرﻳﻴﻦ و؟أو ﻣﻮﻇﻔﻴﻴﻦ‬
‫ﻗﺎﻧﻮﻧﻴﻴﻦ ﺣﺴﺒﻤﺎ ﻳﺘﻄﻠﺐ اﻣﺮ‪.‬‬

‫• ﻣﻌﻠﻮﻣﺎت ﻣﺎ ﻗﺒﻞ اﻟﻘﻴﺎم ﺑﺮﺣﻠﺔ‪ :‬ﺗﻮﻓﺮ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ ﻋﻀﺎﺋﻬﺎ ﻣﻌﻠﻮﻣﺎت ﺷﺎﻣﻠﺔ ﻋﻦ أي ﺑﻠﺪ وذﻟﻚ ﻋﻠﻲ اﻟﻤﻮﻗﻊ ا‰ﻟﻜﺘﺮوﻧﻲ‬
‫‪ www.assistamerica.com‬ﺗﺘﻀﻤﻦ ﺷﺮوط اﻟﺘﺄﺷﻴﺮة‪ ،‬وﺗﻮﺻﻴﺎت اﻟﺘﺤﺼﻴﻦ واﻟﺘﻠﻘﻴﺢ إﻟﻰ ﺟﺎﻧﺐ اﻟﻤﺴﺘﺸﺎرﻳﻦ اﻣﻨﻴﻴﻦ ي وﺟﺔ ﺳﻔﺮ‪.‬‬

‫• اﻻﺳﺘﺸﺎرة واﻟﺘﻘﻴﻴﻢ وا‰ﺣﺎﻟﺔ اﻟﻄﺒﻴﺔ‪ :‬ﻣﺮﻛﺰ ﻋﻤﻠﻴﺎت )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻣﺠﻬﺰ ﺑﻬﻴﺌﺔ ﻣﻮﻇﻔﻴﻦ ﻣﺮﺧﺼﻴﻦ ﻃﺒﻴ ًﺎ‪ ،‬ﻳﻌﻠﻤﻮن ﻋﻠﻰ‬
‫اﻟﺘﻘﻴﻴﻢ اﻻﺗﺼﺎﻻت اﻟﻮاردة ﻣﻦ اﻋﻀﺎء وﻳﻘﺪﻣﻮن اﻟﺘﻮﺻﻴﺎت اﻟﻔﻮرﻳﺔ ﺑﺨﺼﻮص أي ﺣﺎﻟﺔ ﻃﺎرﺋﺔ ﺑﻤﺎ ﻓﻴﻪ ا‰ﺣﺎﻟﺔ إﻟﻰ أﻃﺒﺎء و‪/‬أو‬
‫ﻣﺴﺘﺸﻔﻴﺎت ﻣﺆﻫﻠﺔ ﺣﺴﺐ اﻟﺤﺎﺟﺔ‪.‬‬

‫• ﺿﻤﺎن ﺗﻠﻘﻲ اﻟﻌﻼج ﺑﺎﻟﻤﺴﺘﺸﻔﻰ‪ :‬ﺗﻀﻤﻦ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺗﻠﻘﻲ اﻟﻌﻼج اﻟﻔﻮري ﺑﺎﻟﻤﺴﺘﺸﻔﻰ ﻋﻦ ﻃﺮﻳﻖ اﻟﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ ﺗﻐﻄﻴﺔ‬
‫اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ أو ﺑﺘﺴﺪﻳﺪ اﻣﻮال اﻟﻼزﻣﺔ إﻟﻰ اﻟﻤﺴﺘﺸﻔﻰ ﺑﺎﻟﻘﺪر اﻟﻤﻄﻠﻮب‪.‬‬

‫• ا‰ﺧﻼء اﻟﻄﺒﻲ ﻓﻲ ﺣﺎﻟﺔ اﻟﻄﻮارئ‪ :‬ﻓﻲ ﺣﺎﻟﺔ ﻋﺪم ﺗﻮﻓﻴﺮ ﻣﻨﺸﺂت ﻃﺒﻴﺔ ﺗﺘﻮﻓﺮ ﻓﻴﻬﺎ اﻟﺮﻋﺎﻳﺔ اﻟﻤﻨﺎﺳﺒﺔ ﻣﺤﻠﻴ ًﺎ‪ :‬ﺗﺴﺘﻌﻴﻦ )أﺳﻴﺴﺖ‬
‫أﻣﺮﻳﻜﺎ( ﺑﺄي ﻣﻦ وﺳﺎﺋﻞ اﻟﻨﻘﻞ واﻟﻤﻌﺪات وﻃﺎﻗﻢ اﻟﻌﻤﻞ اﻟﻼزم ‰ﺧﻼء اﻟﻌﻀﻮ اﻟﺬي ﻳﻤﺮ ﺑﺤﺎﻟﺔ ﻃﺎرﺋﺔ إﻟﻰ أﻗﺮب ﻣﻨﺸﺄة ﻃﺒﻴﺔ ﻗﺎدرة‬
‫ﻋﻠﻰ ﺗﻮﻓﻴﺮ ﻣﺴﺘﻮى ﻋﺎﻟﻲ ﻣﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬

‫• اﻟﻤﺮاﻗﺒﺔ اﻟﻄﺒﻴﺔ‪ :‬ﻳﻘﻮم اﻟﻤﻮﻇﻔﻮن اﻟﻄﺒﻴﻮن ﻟﺪى )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺎﻻﺗﺼﺎل اﻟﺪوري ﺑﺎﻟﻄﺒﻴﺐ ‪ /‬اﻟﻤﺴﺘﺸﻔﻰ اﻟﺘﻲ ﺗﻘﺪم اﻟﺮﻋﺎﻳﺔ‬
‫اﻟﺼﺤﻴﺔ ﻟﻠﻌﻀﻮ ﻣﻊ إرﺳﺎل اﻟﻤﻌﻠﻮﻣﺎت إﻟﻰ أﺳﺮﺗﻪ‪.‬‬

‫• ا‰ﻋﺎدة اﻟﻄﺒﻴﺔ‪ :‬إذا ﻛﺎن أﺣﺪ ﻣﺎ ﻳﺰال ﺑﺤﺎﺟﺔ إﻟﻰ ﻣﺴﺎﻋﺪة ﻃﺒﻴﺔ ﺑﻌﺪ اﻟﺨﺮوج ﻣﻦ اﻟﻤﺴﺘﺸﻔﻰ ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﻋﺎدة اﻟﻌﻀﻮ إﻟﻰ‬
‫ﻣﻮﻃﻨﻪ أو ﻣﻨﺸﺄة اﻟﺘﺄﻫﻴﻞ ﻣﺴﺤﻮﺑ ًﺎ ﺑﻤﺮاﻓﻖ ﻃﺒﻲ‪/‬ﻏﻴﺮ ﻃﺒﻲ ﺣﺴﺒﻤﺎ ﻳﺘﻄﻠﺐ اﻣﺮ‪.‬‬

‫• اﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺗﺄﻣﻴﻦ ادوﻳﺔ‪ :‬إذا ﻧﺴﻲ أﺣﺪ اﻋﻀﺎء دواﺋﻪ أو ﻓﻘﺪه وﻫﻮ ﺑﺤﺎﺟﺔ إﻟﻰ وﺻﻔﺔ ﻃﺒﻴﺔ ﻟﻠﺤﺼﻮل ﻋﻠﻴﻪ أﺛﻨﺎء اﻟﺴﻔﺮ‪ ،‬ﺗﻘﻮم‬
‫)أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﻤﺴﺎﻋﺪﺗﻪ ﻓﻲ ﺗﺄﻣﻴﻦ اﻟﻮﺻﻔﺔ اﻟﻄﺒﻴﺔ اﻟﻼزﻣﺔ‪.‬‬

‫• ﻧﻘﻞ رﺳﺎﺋﻞ اﻟﻄﻮارئ ‪ :‬ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺘﻠﻘﻲ وإرﺳﺎل رﺳﺎﺋﻞ اﻟﻄﻮارئ اﻟﺨﺎﺻﺔ ﺑﺎﻋﻀﺎء‬

‫• اﻟﺰﻳﺎرة ﺳﺒﺎب إﻧﺴﺎﻧﻴﺔ‪ :‬إذا ﻛﺎن اﻟﻌﻀﻮ ﻣﺴﺎﻓﺮا ً ﺑﻤﻔﺮده وﺳﻴﺘﻠﻘﻰ اﻟﻌﻼج ﻓﻲ ﻣﺴﺘﺸﻔﻰ ﻛﺜﺮ ﻣﻦ ﺧﻤﺴﺔ أﻳﺎم‪ ،‬ﺗﻘﻮم )أﺳﻴﺴﺖ‬
‫أﻣﺮﻳﻜﺎ( ﺑﺘﻮﻓﻴﺮ ﺗﺬﻛﺮه ذﻫﺎب وﻋﻮدة ﻣﻦ اﻟﺪرﺟﺔ اﻟﺴﻴﺎﺣﻴﺔ إﻟﻰ ﻣﻜﺎن‪ .‬اﻟﻤﺴﺘﺸﻔﻰ ﺣﺪ أﻓﺮاد اﺳﺮة أو اﺻﺪﻗﺎء‬

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‫ﻳﻌﻤﻞ ﻣﻮﻇﻔﻮ ﻣﺮاﻛﺰ ﻋﻤﻠﻴﺎت )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻋﻠﻰ ﻣﺪار ‪ 24‬ﺳﺎﻋﺔ ﻳﻮﻣﻴ ًﺎ وﻟﻤﺪة ‪ 365‬ﻳﻮﻣ ًﺎ ﻓﻲ اﻟﺴﻨﺔ‪ ،‬وﻳﻀﻢ ﻓﺮﻳﻖ اﻟﻌﻤﻞ ﻣﻮﻇﻔﻴﻦ‬
‫ﻃﺒﻴﻴﻦ ﻣﺪرﺑﻴﻦ ﻣﺘﻀﻤﻨ ًﺎ اﻟﻤﻤﺮﺿﺎت واﻃﺒﺎء ﻳﺠﻴﺪون اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﻠﻐﺎت ﻟﺘﻘﺪﻳﻢ اﻻﺳﺘﺸﺎرات واﻟﻤﺴﺎﻋﺪة ﺑﺸﻜﻞ ﺳﺮﻳﻊ واﺣﺘﺮاﻓﻲ‬
‫ﻓﻲ ﺣﺎﻟﺔ اﻟﻄﻮارئ‪.‬‬

‫ﺑﻤﺠﺮد اﺟﺮاء اﺗﺼﺎل واﺣﺪ ﺑﺴﻴﻂ ﺑﺎﻟﺮﻗﻢ اﻟﻤﺪون ﻋﻠﻰ ﺑﻄﺎﻗﺔ اﻟﺘﻌﺮﻳﻒ اﻟﺸﺨﺼﻲ ﻟﺪﻳﻚ ﻣﻦ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻳﺘﻢ ﺗﻮﺻﻴﻠﻚ ﻋﻠﻰ اﻟﻔﻮر‬
‫ﺑﻤﺎ ﻳﻠﻲ‪:‬‬
‫• ﺷﺒﻜﺔ ﻋﺎﻟﻤﻴﺔ ﻣﻦ ﻣﺰودي اﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ اﻟﻤﺆﻫﻠﻴﻦ ﻣﺴﺒﻘ ًﺎ‪.‬‬
‫• ﻣﺘﺨﺼﺼﻮن ﻣﺘﻤﺮﺳﻮن ﻓﻲ إدارة ازﻣﺎت‪.‬‬
‫• ﻣﺮﻛﺰ ﻋﻤﻠﻴﺎت ﺑﺘﺠﻬﻴﺰات ﻣﺘﻘﺪﻣﺔ وإﻣﻜﺎﻧﺎت اﺳﺘﺠﺎﺑﺔ ﻋﺎﻟﻤﻴﺔ‪.‬‬
‫• ﻣﺰودي ﺧﺪﻣﺎت ا‰ﺳﻌﺎف ارﺿﻲ واﻟﺠﻮي ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﺟﺮاء ﺟﻤﻴﻊ اﻟﺘﺮﺗﻴﺒﺎت ﻣﻊ دﻓﻊ ﻗﻴﻤﺔ ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة اﻟﺘﻲ‬
‫ﺗﻘﺪﻣﻬﺎ دون ﺳﻘﻮف ﻋﻠﻰ ﺗﻜﻠﻔﺔ ﺗﻠﻚ اﻟﺨﺪﻣﺎت‪ .‬وﻻ ﺷﻚ أن ذﻟﻚ ﻣﻦ ﺷﺄﻧﻪ أن ﻳﺨﻔﻒ ﻣﻦ اﻟﺼﻌﻮﺑﺎت وﻳﺤﺪد ﻣﻦ اﻟﻨﻔﻘﺎت اﻟﻤﺤﺘﻤﻠﺔ‬
‫اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻄﻮارئ اﻟﻄﺒﻴﺔ ﺧﺎرج اﻟﻮﻃﻦ‪.‬‬

‫ﻣﻦ اﻟﻤﻬﻢ اﻻﺣﺘﻔﺎظ ﺑﺒﻄﺎﻗﺎت اﻟﺘﻌﺮﻳﻒ اﻟﺸﺨﺼﻲ ﻣﻌﻚ ﻃﻮل اﻟﻮﻗﺖ ﺑﺤﻴﺚ ﻳﻤﻜﻦ اﻻﺗﺼﺎل ﺑﻨﺎ ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت )أﺳﻴﺴﺖ‬
‫أﻣﺮﻳﻜﺎ( ﻣﻦ أي ﻣﻜﺎن ﺗﺤﺘﺎج ﻓﻴﻪ إﻟﻴﻬﺎ‪.‬‬

‫إن )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﻟﻴﺴﺖ ﺷﺮﻛﺔ ﺗﺄﻣﻴﻦ ﺳﻔﺮ أو ﻋﻼج‪ ،‬إﻧﻤﺎ ﻫﻲ ﻣﺰود ﺧﺪﻣﺎت ﻃﻮارئ ﻋﺎﻟﻤﻴﺔ‪.‬‬
‫@ وﻻ ﺗﻌﺘﺒﺮ ﺧﺪﻣﺎت )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺪﻳ ً‬
‫ﻼ ﻋﻦ اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ أﺛﻨﺎء ﺣﺎﻻت اﻟﻄﻮارئ اﻟﻄﺒﻴﺔ ﺧﺎرج اﻟﻮﻃﻦ‪ .‬ﺗﻌﻮد ﺟﻤﻴﻊ اﻟﺘﻜﺎﻟﻴﻒ اﻟﻄﺒﻴﺔ‬
‫اﻟﻤﺘﻜﺒﺪة ﻋﻠﻰ وﺛﻴﻘﺔ اﻟﻌﻨﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﺨﺎﺻﺔ ﺑﻚ‪ ،‬ﻛﻤﺎ ﺗﺨﻀﻊ ﻫﺬه اﻟﺘﻜﺎﻟﻴﻒ ﻟﻠﺤﺪود اﻟﻮاردة ﺑﻮﺛﻴﻘﺔ اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ اﻟﺨﺎﺻﺔ ﺑﻚ‪.‬‬
‫@ ﺗﻠﺘﺰم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﺟﺮاء ﺟﻤﻴﻊ اﻟﺨﺪﻣﺎت وﺗﻮﻓﻴﺮﻫﺎ‪ .‬ﻻ ﺗﻘﺒﻞ أي ﻣﻄﺎﻟﺒﺎت ﺑﺎﻟﺘﻌﻮﻳﺾ ﻋﻦ ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة‪.‬‬
‫اﻟﺨﺪﻣﺎت اﻟﺮﺋﻴﺴﻴﺔ‬
‫• رﻋﺎﻳﺔ اﻃﻔﺎل اﻟﻘﺎﺻﺮﻳﻦ‪ :‬ﺗﻘﻮم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( ﺑﺈﺟﺮاء اﻟﺘﺮﺗﻴﺒﺎت اﻟﻼزﻣﺔ ﻟﺘﻘﺪﻳﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻟ‪Ï‬ﻃﻔﺎل ﻏﻴﺮ اﻟﻤﺼﺤﻮﺑﻴﻦ‬
‫ﺑﻤﺮاﻓﻖ ﻧﺘﻴﺠﺔ ﻟﺤﺎﻟﺔ ﻃﻮارئ ﻃﺒﻴﺔ‪ ،‬وﺗﺪﻓﻊ ﻛﺬﻟﻚ ﺗﻜﺎﻟﻴﻒ اﻻﻧﺘﻘﺎل اﻟﻤﺮﺗﺒﻄﺔ ﺑﻬﺬه اﻟﺘﺮﺗﻴﺒﺎت‪.‬‬

‫• إﻋﺎدة رﻓﺎت اﻟﻤﻮﺗﻰ‪ :‬ﺗﻘﺪم )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( اﻟﻤﺴﺎﻋﺪة اﻟﻼزﻣﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺘﺮﺗﻴﺒﺎت إﻋﺎدة ﺟﺜﻤﺎن اﻟﻌﻀﻮ إﻟﻰ وﻃﻨﻪ ﻓﻲ ﺣﺎﻟﺔ‬
‫وﻓﺎﺗﻪ‪ .‬وﻳﺸﻤﻞ ذﻟﻚ ﺗﺮﺗﻴﺐ إﻋﺪاد اﻟﺠﺜﻤﺎن ﻟﻠﻨﻘﻞ وإﺻﺪار اﻟﻤﺴﺘﻨﺪات اﻟﻼزﻣﺔ‪ ،‬وﺗﻮﻓﻴﺮ وﺳﻴﻠﺔ اﻟﻨﻘﻞ اﻟﻼزﻣﺔ‪ ،‬إﺿﺎﻓﺔ إﻟﻲ دﻓﻊ ﻧﻔﻘﺎت‬
‫اﻟﻨﻘﻞ‪.‬‬

‫• اﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺗﺤﺪﻳﺪ ﻣﻮﻗﻊ اﻟﺤﻘﺎﺋﺐ واﻟﻤﺴﺘﻨﺪات اﻟﻤﻔﻘﻮدة‪ :‬ﺗﺴﺎﻋﺪ )أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ( أﻋﻀﺎﺋﻬﺎ ﻓﻲ ﺗﺤﺪﻳﺪ ﻣﻮﻗﻊ اﻟﺤﻘﺎﺋﺐ و‪/‬أو‬
‫اﻟﻤﺴﺘﻨﺪات و‪/‬أو اﻟﻤﺘﻌﻠﻘﺎت واﻏﺮاض اﻟﺸﺨﺼﻴﺔ اﻟﻤﻔﻘﻮدة‪.‬‬

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 ‫ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﺪوﻟﻴﺔ‬
‫ﺗﻮﻓﺮ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺎت ﻋﻀﺎﺋﻬﺎ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ﺑﺘﻘﺪﻳﻢ ﻋﺪة ﺧﺪﻣﺎت ﺗﻼﺋﻢ اﺣﺘﻴﺎﺟﺎت اﻟﻌﻤﻼء‪.‬‬

‫اﻟﻮﺻﻮل إﻟﻰ ﺷﺒﻜﺔ ﻋﺎﻟﻤﻴﺔ واﺳﻌﺔ‪:‬‬

‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ أﻓﻀﻞ اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﻄﺒﻴﺔ اﻟﻤﻼﺋﻤﺔ ﻟﻌﻤﻼﺋﻬﺎ أﺛﻨﺎء‬
‫ﺳﻔﺮﻫﻢ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ‪ .‬ﻳﻤﻜﻦ ﻟﻌﻤﻼﺋﻨﺎ اﺧﺘﻴﺎر إﺣﺪى اﻟﺸﺒﻜﺎت اﻟﺨﺎرﺟﻴﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺘﺎن ﻟﻠﺨﺪﻣﺎت اﻟﺨﺎرﺟﻴﺔ( واﻟﺘﻲ ﺗﺘﻀﻤﻦ‬
‫دول أوروﺑﺎ وأﻣﺮﻳﻜﺎ وﺑﺎﻗﻲ دول اﻟﻌﺎﻟﻢ‪.‬‬

‫اﻟﺴﻴﺎﺣﺔ اﻟﻌﻼﺟﻴﺔ‪:‬‬
‫ﻛﺠﺰء ﻣﻦ اﻟﺨﺪﻣﺎت اﻟﺨﺎرﺟﻴﺔ اﻟﺘﻲ ﺗﻘﺪﻣﻬﺎ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‪ ,‬ﺗﺘﻴﺢ ﻋﻨﺎﻳﺔ ﺧﺪﻣﺔ اﻟﺮﻋﺎﻳﺔ اﻟﻄﺒﻴﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺤﺎﻻت اﻟﻄﺒﻴﺔ اﻟﺘﻲ ﺗﺘﻄﻠﺐ‬
‫اﻟﻌﻼج ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪ .‬ﺑﺤﻴﺚ ﻳﺘﻤﻜﻦ ﻋﻤﻼﺋﻨﺎ ﻣﻦ اﻟﺴﻔﺮ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ ﻟﺘﻠﻘﻲ اﻟﻌﻼج ﻋﻠﻰ ﻧﻔﻘﺔ اﻟﺸﺮﻛﺔ ﻛﻤﺎ‬
‫ﺗﺸﻤﻞ ﺗﻜﺎﻟﻴﻒ اﻟﺘﺬاﻛﺮ وا‰ﻗﺎﻣﺔ واﻟﻤﻮاﺻﻼت أﻳﻀﺎ‪.‬‬

‫اﻟﺴﺪاد اﻟﺪوﻟﻲ اﻟﻤﺒﺎﺷﺮ‪:‬‬

‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺔ اﻟﺴﺪاد اﻟﻤﺒﺎﺷﺮ ﻟﻠﻤﺮاﻛﺰ اﻟﻄﺒﻴﺔ أو اﻟﻤﺴﺘﺸﻔﻴﺎت ﻟﻌﻤﻼﺋﻬﺎ وذﻟﻚ ﻻ ﻳﺘﻄﻠﺐ ﺳﺪاد اﻟﻌﻤﻴﻞ‬
‫ﻟﻠﻤﺒﻠﻎ ﺛﻢ اﻟﻘﻴﺎم ﺑﺎﻟﻤﻄﺎﻟﺒﺔ ﺑﺬﻟﻚ‬

‫اﻟﻌﻼج ﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ‪:‬‬

‫ﺗﻘﻮم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺑﺘﻐﻄﻴﺔ اﻟﻌﻼج ﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ ﻟ‪Ï‬ﻋﻀﺎء اﻟﻤﻘﻴﻤﻴﻦ داﺧﻞ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬

‫ا”ﺧﻼء ﻓﻲ ﺣﺎﻻت اﻟﻄﻮارئ واﻟﻌﻮدة إﻟﻲ اﻟﻮﻃﻦ ﻣﻦ ﺧﻼل ﺑﺮﻧﺎﻣﺞ‬

‫ﻛﺠﺰء ﻣﻦ ﺗﻐﻄﻴﺘﻚ اﻟﺘﺄﻣﻴﻨﻴﺔ ﻣﻊ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ أﺻﺒﺢ ﻟﺪﻳﻚ ا‪Ö‬ن ﺑﺮﻧﺎﻣﺞ ﻓﺮﻳﺪ ﻓﻲ ﺧﺪﻣﺎت اﻟﻄﻮارئ اﻟﻌﺎﻟﻤﻴﺔ ﻣﻦ ﺷﺮﻛﺔ‬
‫)أﺳﻴﺴﺖ أﻣﺮﻳﻜﺎ(‪ .‬ﻳﺘﻢ ﻣﻦ ﺧﻼل ﻫﺬا اﻟﺒﺮﻧﺎﻣﺞ ﺗﻮﺻﻴﻠﻚ ﺑﺎﻃﺒﺎء واﻟﻤﺴﺘﺸﻔﻴﺎت‪ ،‬واﻟﺼﻴﺪﻟﻴﺎت‪ ،‬وﻏﻴﺮﻫﺎ ﻣﻦ اﻟﺨﺪﻣﺎت اﺧﺮى‬
‫ﻋﻨﺪﻣﺎ ﺗﻜﻮن ﻓﻲ ﺣﺎﻟﺔ ﻃﻮارئ ﻃﺒﻴﺔ أﺛﻨﺎء ﺗﻨﻘﻠﻚ داﺧﻞ اﻟﺒﻼد ﻋﻠﻰ ﺑﻌﺪ ‪ ١٥٠‬ﻛﻴﻠﻮﻣﺘﺮ ﻣﻦ ﻣﻜﺎن إﻗﺎﻣﺘﻚ أو ﺳﻔﺮك ﺧﺎرج اﻟﺒﻼد‬

‫‪٢٧‬‬
 ‫ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﻄﺒﻴﺔ‬

‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﻄﺒﻴﺔ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﻋﻤﻼﺋﻬﺎ وذﻟﻚ ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﺮﻳﻖ اﻟﻄﺒﻲ اﻟﻤﺨﺘﺺ ﻓﻲ ﻃﺮح اﻟﻨﺼﺎﺋﺢ اﻟﻄﺒﻴﺔ‪.‬‬

‫ﺗﺸﻤﻞ ﺧﺪﻣﺎﺗﻨﺎ رﻋﺎﻳﺔ اﻣﻮﻣﺔ اﻟﺘﻲ ﻧﻮﻓﺮﻫﺎ ﻟﻠﻌﻀﻮات ﻣﻦ ﺧﻼل ﺷﺒﻜﺔ ﻣﻦ اﻃﺒﺎء اﻟﻤﺤﺘﺮﻓﻴﻦ اﻟﺬﻳﻦ ﺳﻴﻘﺪﻣﻮن اﻟﻨﺼﺢ واﻟﻤﺸﻮرة‬
‫ﺧﻼل ﻓﺘﺮة اﻟﺤﻤﻞ‪.‬‬

‫ﻳﻮﻓﺮ أﻃﺒﺎؤﻧﺎ ﻣﻌﻠﻮﻣﺎت ﺷﺎﻣﻠﺔ ﺣﻮل اﻋﺮاض واﻟﻨﺼﺎﺋﺢ اﻟﻄﺒﻴﺔ ﻟ‪Ï‬ﻣﺮاض اﻟﻤﺰﻣﻨﺔ‪ ،‬ﺑﻤﺎ ﻳﻌﻮد ﺑﺎﻟﻨﻔﻊ ﻋﻠﻰ ﻋﻤﻼﺋﻨﺎ ﺑﺼﻮرة ﻣﺒﺎﺷﺮة‪.‬‬

‫إﻋﺎدة ﺗﻌﺒﺌﺔ أدوﻳﺔ اﻣﺮاض اﻟﻤﺰﻣﻨﺔ ﺑﺼﻮرة ﻣﺒﺎﺷﺮة ﻋﻦ ﻃﺮﻳﻖ اﻟﺼﻴﺪﻟﻴﺎت اﻟﻤﻮﺻﻰ ﺑﻬﺎ‪:‬‬
‫)‪ (1‬ﺻﻴﺪﻟﻴﺔ اﻟﻨﻬﺪي )‪ (2‬ﺻﻴﺪﻟﻴﺔ اﻟﺪواء‬

‫ﺧﺪﻣﺔ اﻟﺮﻋﺎﻳﺔ اﻟﻤﻨﺰﻟﻴﺔ‬

‫ﺣﺮﺻﺎ ﻣﻨﺎ ﻋﻠﻰ ﺻﺤﺔ ﻋﻤﻼﺋﻨﺎ‪ ,‬ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺔ اﻟﺮﻋﺎﻳﺔ اﻟﻤﻨﺰﻟﻴﺔ ﻟﻌﻤﻼﺋﻨﺎ ﻋﻦ ﻃﺮﻳﻖ اﺣﺪ ﺷﺮﻛﺎﺋﻨﺎ اﻟﻤﻌﺘﻤﺪﻳﻦ اﻟﻤﺠﻤﻊ‬
‫اﻟﻄﺒﻲ اﻟﺘﺨﺼﺼﻲ ﻟﻠﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﻨﺰﻟﻴﺔ ﺣﻴﺚ ﻳﺴﺘﻄﻴﻊ اﻋﻀﺎء ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ‪ -‬ﻓﻲ ﻣﺪﻳﻨﺔ ﺟﺪة ‪ -‬ﻣﻦ اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﻃﺒﻴﺔ‬
‫ﻓﻲ ﻣﻨﺰﻟﻬﻢ‪ .‬و ﺗﺸﻤﻞ ﻫﺬه اﻟﺨﺪﻣﺎت اﻟﺘﺎﻟﻲ‪:‬‬
‫• اﻟﺨﺪﻣﺔ اﻟﻤﻨﺰﻟﻴﺔ اﻟﺪورﻳﺔ ﻣﺜﻞ ﻣﺘﺎﺑﻌﺔ ﻣﺮﺿﻰ اﻟﺴﻜﺮ ورﻋﺎﻳﺔ ﻣﺮﺿﻰ اﻟﻘﻠﺐ وﻏﻴﺮﻫﺎ‪.‬‬
‫• اﻟﻤﻌﺎﻟﺠﺎت اﻟﻤﺨﺘﻠﻔﺔ ﻣﺜﻞ اﻟﺤﻘﻦ اﻟﻮرﻳﺪي‪ ،‬اﻟﺘﻐﺬﻳﺔ اﻟﻮرﻳﺪﻳﺔ‪ ،‬اﻟﻌﻼج ﺑﺎﻟﻤﻀﺎدات اﻟﺤﻴﻮﻳﺔ وﻏﻴﺮﻫﺎ‪.‬‬
‫• أﺧﺬ ﻋﻴﻨﺎت دم‪.‬‬
‫• ﻣﻌﺎﻳﻨﺔ اﻟﺤﺎﻻت اﻟﻤﺮﺿﻴﺔ اﻟﻤﺘﻄﻮرة‪.‬‬
‫• رﻋﺎﻳﺔ اﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺤﻮادث‪.‬‬
‫• ﺧﺪﻣﺔ اﻟﺘﻐﺬﻳﺔ‪.‬‬
‫• ﺧﺪﻣﺔ اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ‪.‬‬
‫• ﺗﺄﻣﻴﻦ ﻛﻞ ﻣﺎ ﻳﻠﺰم ﻣﻦ ﻣﻌﺪات وأﺟﻬﺰة ﻃﺒﻴﺔ وﻛﺎﻓﺔ اﻟﻤﺴﺘﻠﺰﻣﺎت اﻟﻄﺒﻴﺔ‪.‬‬

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 ‫ﺧﺪﻣﺎت اﻟﻤﺮﻳﺾ ﺑﺎﻟﻌﻴﺎدات اﻟﺪاﺧﻠﻴﺔ و اﻟﺘﻨﻮﻳﻢ‬

‫ﺟﻤﻴﻊ ﺣﺎﻻت إﻗﺎﻣﺔ اﻟﻤﺮﻳﺾ اﻟﺪاﺧﻠﻲ‬

‫ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ‬
‫أو اﻟﻌﻼج ﻟﻴﻮم واﺣﺪ )ﻃﺒﻲ و ﺟﺮاﺣﻲ(‬

‫ﻻ ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ‬
‫اﻟﺪﺧﻮل ﻟﻴﻮم واﺣﺪ )ﻃﺒﻲ او ﺟﺮاﺣﻲ(‬
‫ﻳﺠﺐ اﺧﻄﺎر ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﻼل ‪ ٢٤‬ﺳﺎﻋﺔ ﻣﻦ اﻟﺪﺧﻮل‬ ‫اﻟﻤﻮاﻓﻘﺔ اﻟﻄﺒﻴﺔ اﻟﻤﺴﺒﻘﺔ وﻣﺘﻄﻠﺒﺎت ا”ﺧﻄﺎر‬
‫ﺧﺪﻣﺎت اﻟﻤﺮﻳﺾ ﺑﺎﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ اﻟﺘﻲ ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ‬ ‫ﻣﺎﻫﻲ اﻟﻤﻮاﻓﻘﺔ اﻟﻄﺒﻴﺔ اﻟﻤﺴﺒﻘﺔ؟‬
‫ﺧﺪﻣﺎت اﺳﻨﺎن واﻟﻨﻈﺎرات اﻟﻄﺒﻴﺔ‪ ،‬اﻟﺨﺘﺎن‪ ،‬وﺗﺨﺮﻳﻢ اذن‪،‬‬
‫ﺧﺪﻣﺎت اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ‬ ‫ﺗﻄﻠﺐ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻣﻦ ﻣﻘﺪم اﻟﺨﺪﻣﺔ اﻟﺬي ﺗﺘﻌﺎﻣﻞ ﻣﻌﻪ اﻻﺗﺼﺎل ﺑﻬﺎ ﻟﻠﺤﺼﻮل‬
‫اﻟﻤﻌﺎﻟﺠﺔ اﻟﻜﻴﻤﻴﺎﺋﻴﺔ وا”ﺷﻌﺎﻋﻴﺔ ﻟﻠﺤﺎﻻت اﻟﻨﻔﺴﻴﺔ اﻟﻐﺴﻴﻞ‬
‫اﻟﻜﻠﻮي وادوات اﻟﺴﻤﻌﻴﺔ‬ ‫اﻟﺘﻲ ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ‬ ‫ﻋﻠﻰ اﻟﻤﻮاﻓﻘﺔ اﻟﻄﺒﻴﺔ ﻗﺒﻞ ﺗﻘﺪﻳﻢ ﺧﺪﻣﺔ ﻣﺤﺪدة أو ﻋﻼج ﻣﻌﻴﻦ‪.‬‬
‫اﻟﻌﻀﻮ اﻟﻤﺎﺳﻲ‪ :‬ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ اذا ﺗﺠﺎوز اﻟﻤﺒﻠﻎ اﻻﺟﻤﺎﻟﻲ ‪٢٠٠٠‬‬ ‫وﻳﺘﻢ اﺗﺨﺎذ ﻫﺬا ا‰ﺟﺮاء ﻟﻀﻤﺎن ا‪Ö‬ﺗﻲ‪:‬‬
‫رﻳﺎل‬
‫اﻟﻌﻀﻮ اﻟﺬﻫﺒﻲ‪ :‬ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ اذا ﺗﺠﺎوز اﻟﻤﺒﻠﻎ اﻻﺟﻤﺎﻟﻲ ‪١٠٠٠‬‬
‫رﻳﺎل‬
‫• أن ﺗﻜﻮن ﻣﺴﺘﺤﻘ ًﺎ ﻟﻠﻌﻼج أو اﻟﺨﺪﻣﺔ وﻓﻘ ًﺎ ﻟﻮﺛﻴﻘﺔ اﻟﺘﺄﻣﻴﻦ واﻟﻤﻨﺎﻓﻊ اﻟﻤﺘﻌﺎﻗﺪ ﻋﻠﻴﻬﺎ‪.‬‬
‫اﻟﻌﻀﻮ اﻟﻔﻀﻲ‪ :‬ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ اذا ﺗﺠﺎوز اﻟﻤﺒﻠﻎ اﻻﺟﻤﺎﻟﻲ ‪١٠٠٠‬‬ ‫ﺧﺪﻣﺎت أﺧﺮى ﺗﻘﺪم ﻟﻠﻤﺮﻳﺾ اﻟﺨﺎرﺟﻲ‬
‫رﻳﺎل‬
‫)ﺑﺎﺳﺘﺜﻨﺎء اﻟﻜﺸﻒ و اﻟﺪواء(‬ ‫• أن ﻳﻜﻮن اﻟﻌﻼج اﻟﻤﻘﺘﺮح أو اﻟﺨﺪﻣﺔ ﺿﺮورﻳﺔ ﻣﻦ اﻟﻨﺎﺣﻴﺔ اﻟﻄﺒﻴﺔ‪.‬‬
‫اﻟﻌﻀﻮ اﻟﺒﺮوﻧﺰي‪ :‬ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ اذا ﺗﺠﺎوز اﻟﻤﺒﻠﻎ اﻻﺟﻤﺎﻟﻲ ‪١٠٠٠‬‬
‫رﻳﺎل‬
‫اﻟﻌﻀﻮ اﻟﻜﻼﺳﻴﻜﻲ‪ :‬ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ اذا ﺗﺠﺎوز اﻟﻤﺒﻠﻎ اﻻﺟﻤﺎﻟﻲ‬ ‫• أن ﺗﻜﻮن ﺗﻜﻠﻔﺔ اﻟﻌﻼج اﻟﻤﻘﺘﺮح أو اﻟﺨﺪﻣﺔ ﻓﻲ ﺣﺪود اﻟﻤﻌﻘﻮل أو اﻟﻤﻌﺘﺎد ﻣﻘﺎرﻧﺔ‬
‫‪ ١٠٠٠‬رﻳﺎل‬ ‫ﺑﻤﻘﺪﻣﻲ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬
‫اﻟﺤﺎﻻت اﻟﺤﺎدة‪ :‬ﻻ ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ ﻣﺴﺒﻘﺔ‬ ‫• أن ﻳﻜﻮن ﻣﺘﺒﻘﻲ ﻟﺪﻳﻚ ﻓﻲ ﺑﻄﺎﻗﺔ اﻟﻌﻀﻮﻳﺔ ﻣﺎ ﻳﻐﻄﻲ ﺗﻜﻠﻔﺔ اﻟﻌﻼج أو اﻟﺨﺪﻣﺔ‪.‬‬
‫اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ‪ :‬اﻟﻌﻼج ﻛﺜﺮ ﻣﻦ ﺷﻬﺮ ﻳﺘﻄﻠﺐ اﻟﻤﻮاﻓﻘﺔ‬ ‫اﻟﺪواء‬
‫اﻟﻤﻮاﻓﻘﺎت اﻟﻤﺴﺒﻘﺔ وﻣﺘﻄﻠﺒﺎت ا‰ﺧﻄﺎر ﺑﺎﻟﻤﻮاﻓﻘﺎت اﻟﻄﺒﻴﺔ‬

‫ﺗﺘﻄﻠﺐ ﻣﻮاﻓﻘﺔ ﻟﻠﺰﻳﺎرة اﻻوﻟﻰ ﻓﻘﻂ‬ ‫ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ و اﻟﻮﻻدة‬

‫اﻟﺠﻠﺴﺔ اوﻟﻰ ﻻ ﺗﺤﺘﺎج ﻣﻮاﻓﻘﺔ ﻣﺴﺒﻘﺔ‪ ،‬أﻣﺎ اﻟﺠﻠﺴﺎت‬

‫اﻟﻼﺣﻘﺔ ﺗﺤﺘﺎج إﻟﻰ ﻣﻮاﻓﻘﺔ ﻣﺴﺒﻘﺔ‬ ‫اﻟﻌﻼج اﻟﻄﺒﻴﻌﻲ‬

‫‪٢٥‬‬
 ‫ﺑﻨﺎء ﻋﻠﻰ اﺳﻌﺎر اﻟﻤﺘﻌﺎرف واﻟﻤﺘﻔﻖ ﻋﻠﻴﻬﺎ وﻓﻘ ًﺎ ﻟﻠﻤﻨﺘﺞ اﻟﺨﺎص ﺑﻚ‪) .‬ﻳﺮﺟﻰ ﻣﺮاﺟﻌﺔ ﺟﺪول اﻟﻤﻨﺎﻓﻊ‬
‫ﺳﻴﺘﻢ إﻋﺎدة ﻫﺬه اﻟﻤﺒﺎﻟﻎ ﻟﻚ ً‬
‫اﻟﻤﺮﻓﻖ ﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺘﻔﺎﺻﻴﻞ(‪.‬‬
‫ُ‬
‫ﻻﺑﺪ أن ﺗﺘﻀﻤﻦ ﺟﻤﻴﻊ اﻟﻤﻄﺎﻟﺒﺎت اﻟﻤﻘﺪﻣﺔ ﻋﻠﻲ أﺻﻮل اﻟﻤﺴﺘﻨﺪات اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• ﺗﻌﺒﺌﺔ ﻧﻤﻮذج اﻟﺘﻌﻮﻳﺾ اﻟﻨﻘﺪي اﻟﺨﺎص ﺑـ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺑﺎ‰ﺿﺎﻓﺔ إﻟﻰ اﻟﺘﻮﻗﻴﻊ واﻟﺨﺘﻢ‪.‬‬
‫• ﺗﻘﺮﻳﺮ ﻃﺒﻲ ﻣﻔﺼﻞ )ﻳﻘﻮم ﻃﺒﻴﺒﻚ اﻟﻤﻌﺎﻟﺞ ﺑﺘﻌﺒﺌﺘﻪ ﻣﻊ ﺗﻮﻗﻴﻌﻪ‪ ،‬وﻛﺘﺎﺑﺔ اﻟﺘﺎرﻳﺦ‪ ،‬ووﺿﻊ اﻟﺨﺘﻢ(‪.‬‬
‫• أﺻﻮل اﻟﻔﻮاﺗﻴﺮ واﻟﺴﻨﺪات اﻟﻤﻔﺼﻠﺔ‪.‬‬
‫• اﻟﻮﺻﻔﺔ اﻟﻄﺒﻴﺔ )إن وﺟﺪت(‬
‫• ﻧﺘﺎﺋﺞ اﻟﻔﺤﻮﺻﺎت ﻓﻲ اﻟﻤﻌﺎﻣﻞ‪ /‬اﻟﺘﻘﺎرﻳﺮ اﻟﺘﺸﺨﻴﺼﻴﺔ )إن وﺟﺪت(‪.‬‬

‫ﻣﻼﺣﻈﺔ‬
‫• ﻻﺑﺪ أن ﻳﺘﻢ ﺗﻘﺪﻳﻢ اﻟﻤﻄﺎﻟﺒﺎت ﻓﻲ ﻣﻮﻋﺪ ﻻ ﻳﺘﻌﺪى ‪ 30‬ﻳﻮﻣﺎ ﻣﻦ ﺗﺎرﻳﺦ اﻟﻌﻼج داﺧﻞ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪ ،‬و‪ 60‬ﻳﻮﻣ ًﺎ ﻟﻠﺨﺪﻣﺎت‬
‫اﻟﻤﻘﺪﻣﺔ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪.‬‬
‫• ﺗﺴﺘﻐﺮق إﺟﺮاءات اﻟﻤﻄﺎﻟﺒﺔ واﻟﺘﺴﻮﻳﺔ ‪ 14‬ﻳﻮم ﻋﻤﻞ ﺑﻌﺪ اﺳﺘﻼم اﻟﻤﻄﺎﻟﺒﺔ واﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ‪.‬‬

‫اﻟﻤﻨﺪوﺑﻮن ﻓﻲ اﻟﻤﺴﺘﺸﻔﻴﺎت‪:‬‬
‫ﺗﻌﻴﻴﻦ ﻣﻨﺪوﺑﻲ ﻣﺴﺘﺸﻔﻴﺎت ﻓﻲ ﻣﻮاﻗﻊ ﻣﺤﺪدة ﻟﺘﻘﺪﻳﻢ اﻟﻤﺴﺎﻋﺪة واﻟﺪﻋﻢ ﻟﻌﻤﻼﺋﻨﺎ اﻟﻜﺮام ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻣﻮر اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• ا‰ﺷﺮاف ﻋﻠﻰ ﻗﻀﺎﻳﺎ اﻟﻌﻤﻼء وﺣﻞ اﻟﻤﺸﺎﻛﻞ‪.‬‬
‫• ﺗﻴﺴﻴﺮ إﺟﺮاءات ﻣﻮاﻋﻴﺪ اﻋﻀﺎء‪.‬‬
‫• ﺗﻘﺪﻳﻢ ا‰رﺷﺎدات ﺣﻮل ا‰ﺟﺮاءات ﻓﻲ اﻟﻤﺴﺘﺸﻔﻰ‪.‬‬
‫• إرﺳﺎل ﻃﻠﺒﺎت اﻟﻤﻮاﻓﻘﺎت اﻟﻤﺴﺒﻘﺔ‪.‬‬
‫• ﺗﻘﺪﻳﻢ اﻟﻤﺴﺎﻋﺪة اﻟﻔﻮرﻳﺔ ﻋﻨﺪ اﻟﻄﻠﺐ‪.‬‬

‫‪2٤‬‬
 ‫ﺧﺪﻣﺎت اﻟﻌﻤﻼء ﻋﻠﻰ ﻣﺪار ‪ 24‬ﺳﺎﻋﺔ ﻃﻮال اﻻﺳﺒﻮع‪:‬‬
‫ﻳﻮﺟﺪ ﻋﻠﻰ ﻇﻬﺮ ﺑﻄﺎﻗﺔ اﻟﻌﻀﻮﻳﺔ رﻗﻢ ﺧﺪﻣﺔ اﻟﻌﻤﻼء واﻟﺒﺮﻳﺪ ا‰ﻟﻜﺘﺮوﻧﻲ‪ .‬وﻛﻤﺎ ﻳﻮﺟﺪ ﻟﺪﻳﻨﺎ ﻓﺮﻳﻖ ﻣﺤﺘﺮف ﻳﺘﺤﺪث ﺑﺎﻟﻠﻐﺘﻴﻦ اﻟﻌﺮﺑﻴﺔ‬
‫وا‰ﻧﺠﻠﻴﺰﻳﺔ ﻟﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• ا‰رﺷﺎد واﻟﻤﺴﺎﻋﺪة ﻓﻲ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﻄﺒﻴﺔ‪.‬‬
‫• ﺗﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﻤﻨﺎﻓﻊ اﻟﺘﻲ ﺗﺴﺘﺤﻘﻬﺎ‪.‬‬
‫• اﻟﺘﻮﺟﻴﻪ واﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺣﺎﻟﺔ اﻟﻄﻮارئ‪.‬‬
‫• اﻟﺮد ﻋﻠﻰ ﻛﺎﻓﺔ اﻻﺳﺘﻔﺴﺎرات‪.‬‬
‫• اﻟﻤﻮاﻓﻘﺔ اﻟﻄﺒﻴﺔ ﻋﺒﺮ ا‰ﻧﺘﺮﻧﺖ‪.‬‬

‫ﺧﺪﻣﺔ اﻟﺮﺳﺎﺋﻞ اﻟﻨﺼﻴﺔ اﻟﻘﺼﻴﺮة )‪:(SMS‬‬

‫ﺳﺘﻘﻮم ﻫﺬه اﻟﺨﺪﻣﺔ ﺑﺈرﺳﺎل اﻟﺮﺳﺎﺋﻞ اﻟﻨﺼﻴﺔ ﻟﻬﺎﺗﻔﻚ اﻟﻤﺤﻤﻮل ﻓﻲ اﻟﺤﺎﻻت اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• ﻋﻨﺪ اﺳﺘﻼم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻃﻠﺐ اﻟﻤﻮاﻓﻘﺔ اﻟﺨﺎص ﺑﻚ ﻣﻦ ﻗﺒﻞ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ‪.‬‬
‫• اﻟﺮد ﻋﻠﻰ ﻃﻠﺐ اﻟﻤﻮاﻓﻘﺔ اﻟﻄﺒﻴﺔ‪.‬‬
‫• ﺗﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺤﺪﺛﺔ اﻟﺨﺎﺻﺔ ﺑﻌﻀﻮﻳﺘﻚ‪.‬‬
‫ﻣﻼﺣﻈﺔ‪ :‬ﻓﻲ ﺣﺎل ﻋﺪم اﺳﺘﻘﺒﺎل رﺳﺎﺋﻞ ﻧﺼﻴﺔ ﻣﻦ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‪ ،‬ﻳﺮﺟﻰ اﻻﺗﺼﺎل ﺑﺨﺪﻣﺔ اﻟﻌﻤﻼء ﻋﻠﻰ ‪ 8003010030‬ﻟﺘﺤﺪﻳﺚ رﻗﻢ‬
‫اﻻﺗﺼﺎل اﻟﺨﺎص ﺑﻚ‪.‬‬

‫اﻟﺪﻓﻊ اﻟﻤﺒﺎﺷﺮ واﻟﺘﻌﻮﻳﺾ اﻟﻨﻘﺪي ﻟﻠﻤﺒﺎﻟﻎ اﻟﻤﺴﺪدة‪:‬‬

‫ﻳﻤﻜﻨﻚ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻌﻼج ﻣﻦ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ اﻟﻤﺪرﺟﻴﻦ ﻓﻲ ﻗﺎﺋﻤﺔ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺣﺴﺐ اﻟﺸﺒﻜﺔ اﻟﺨﺎﺻﺔ ﺑﻚ ﻋﻠﻰ أﺳﺎس‬
‫اﻟﺪﻓﻊ اﻟﻤﺒﺎﺷﺮ‪.‬‬
‫وﻳﻌﻨﻲ ذﻟﻚ أن ﺗﻘﻮم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺑﺪﻓﻊ ﻗﻴﻤﺔ ﻛﺎﻓﺔ اﻟﺨﺪﻣﺎت اﻟﻤﻘﺪﻣﺔ ﻟﻚ‪ ،‬ﻓﻴﻤﺎ ﻋﺪا ﻧﺴﺒﺔ اﻟﺘﺤﻤﻞ اﻟﺘﻲ ﻳﻄﻠﺐ ﻣﻨﻚ ﺳﺪادﻫﺎ‬
‫)إن ﻛﺎن ذﻟﻚ ﻳﻨﻄﺒﻖ ﻋﻠﻰ وﺛﻴﻘﺔ اﻟﺘﺄﻣﻴﻦ اﻟﺨﺎص ﺑﻚ(‪.‬‬
‫وإذا أردت اﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻣﻘﺪﻣﻲ ﺧﺪﻣﺔ ﻏﻴﺮ ﻣﺪرﺟﻴﻦ ﻓﻲ اﻟﺸﺒﻜﺔ اﻟﺨﺎﺻﺔ ﺑﻚ ﺣﺴﺐ ﺟﺪول اﻟﻤﻨﺎﻓﻊ اﻟﻤﺘﺎح ﻟﻚ‪ ،‬ﻓﻴﻤﻜﻨﻚ ذﻟﻚ‪ ،‬وﻟﻜﻦ‬
‫ﻋﻠﻰ أﺳﺎس أن ﺗﻘﻮم ﺑﺴﺪاد اﻟﺘﻜﻠﻔﺔ ﻧﻘﺪاً‪ ،‬ﺛﻢ ﺗﻘﺪم اﻟﻔﻮاﺗﻴﺮ اﻟﺨﺎﺻﺔ ﺑﺬﻟﻚ ﻣﻊ اﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ ﻟﺘﺤﺼﻞ ﻋﻠﻰ ﻣﺎ دﻓﻌﺘﻪ ﻛﻤﺎ ﻫﻮ‬
‫ﻣﻮﺿﺢ أدﻧﺎه‪.‬‬

‫‪٢٣‬‬
‫ﺧﺪﻣﺎت أﻋﻀﺎء ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‬

‫ﺷﺒﻜﺔ ﺧﺪﻣﺎت ﻃﺒﻴﺔ ﻛﺒﻴﺮة‬

‫ﻧﻘﺪم ﻟﻌﻤﻼﺋﻨﺎ أﻓﻀﻠﻴﺔ اﻟﻮﺻﻮل إﻟﻰ ﺷﺒﻜﺔ ﺧﺪﻣﺎت ﻛﺒﻴﺮة واﻟﺘﻲ ﺗﺘﻀﻤﻦ ﻣﺮاﻛﺰ ﻃﺒﻴﺔ ﻣﻀﻤﻮﻧﺔ ﺣﻮل اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ‬
‫اﻟﺴﻌﻮدﻳﺔ وﻣﻌﺘﻤﺪة ﻣﻦ ﻗﺒﻞ وزارة اﻟﺼﺤﺔ وﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ‪.‬‬
‫ﺗﺘﻀﻤﻦ ﺷﺒﻜﺔ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ اﻟﻌﺪﻳﺪ ﻣﻦ أﻓﻀﻞ وأﻛﺒﺮ اﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ واﻟﻤﺴﺘﺸﻔﻴﺎت اﻟﻤﺘﺨﺼﺼﺔ واﻟﻤﻌﺮوﻓﺔ ﻟﺘﻘﺪﻳﻢ‬
‫اﻟﺨﺪﻣﺎت واﻟﺤﻠﻮل اﻟﺼﺤﻴﺔ ﻟﻌﻤﻼﺋﻨﺎ ﺣﻮل اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪.‬‬
‫ﻧﺤﻦ ﻧﺴﻌﻰ ﻟﺘﻘﺪﻳﻢ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﻤﻨﺎﺳﺒﺔ ﻟﻌﻤﻼﺋﻨﺎ ﻓﻲ أي ﻣﻜﺎن ﺣﻮل اﻟﻤﻤﻠﻜﺔ‪ .‬أﻛﺜﺮ ﻣﻦ ‪ 1،000‬ﻣﺴﺘﺸﻔﻰ ﻣﺘﺨﺼﺼﺔ‬
‫وﻣﺮﻛﺰ ﺻﺤﻲ وﻋﻴﺎدات أﺳﻨﺎن وﻋﻴﺎدات ﻋﻴﻮن ﻣﺮاﻛﺰ ﺑﺼﺮﻳﺎت وﺻﻴﺪﻟﻴﺎت ﻣﺴﺘﻌﺪون ﻟﺨﺪﻣﺔ ﻋﻤﻼﺋﻨﺎ‪.‬‬

‫اﻟﻌﻨﺎﻳﺔ ﺑﺎﻟﻌﻤﻼء‬
‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺧﺪﻣﺎت ﻋﺪﻳﺪة ﺧﺎﺻﺔ ﺑﺎﻟﻌﻤﻼء وذﻟﻚ ﻣﻦ أﺟﻞ ﺗﺴﻬﻴﻞ اﺣﺘﻴﺎﺟﺎﺗﻬﻢ وﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﻤﻨﺎﺳﺒﺔ ﻟﻬﻢ‪.‬‬

‫‪2٢‬‬
‫اﻟﻜﻼﺳﻴﻜﻲ‬ ‫اﻟﺒﺮوﻧﺰي‬ ‫اﻟﻔﻀﻲ‬ ‫اﻟﺬﻫﺒﻲ‬ ‫اﻟﻤﺎﺳﻲ‬ ‫اﻟﺒﺮﻧﺎﻣﺞ‬

‫ﺗﻜﺎﻟﻴﻒ ﺗﻐﻄﻴﺔ ﻋﻤﻠﻴﺎت ﺟﺮاﺣﺔ ﻣﻌﺎﻟﺠﺔ اﻟﺴﻤﻨﺔ‬

‫اﻟﻤﻔﺮﻃﺔ ﻋﻦ ﻃﺮﻳﻖ ﻋﻤﻠﻴﺔ ﺗﻜﻤﻴﻢ اﻟﻤﻌﺪة‬
‫ﻣﻐﻄﻰ ﺑﺤﺪ أﻗﺼﻰ ‪ ٢٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻓﺘﺮة ﺳﺮﻳﺎن اﻟﻮﺛﻴﻘﺔ‬
‫)‪ (Sleeve‬ﻓﻘﻂ ﻓﻲ ﺣﺎل ﺗﺠﺎوز ﻛﺘﻠﺔ اﻟﺠﺴﻢ‬
‫‪(BMI) ٤٥‬‬

‫‪ ١٥,٠٠٠‬أﻟﻒ رﻳﺎل ﺳﻌﻮدي ﺑﺤﺪ أﻗﺼﻰ ﻟﻠﺤﺎﻻت اﻟﻨﻔﺴﻴﺔ اﻟﺤﺎدة ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ وﺗﺸﺘﻤﻞ ) ‪ (٥,٠٠٠‬رﻳﺎل‬
‫ﻟﻠﺤﺎﻻت اﻟﻨﻔﺴﻴﺔ اﻟﻐﻴﺮ ﺣﺎدة ل )‪ (٤‬ﺟﻠﺴﺎت ﻣﻊ ادوﻳﺔ ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬
‫ﻣﻌﺎﻟﺠﺔ اﻟﺤﺎﻻت اﻟﻨﻔﺴﻴﺔ اﻟﺤﺎدة واﻟﻐﻴﺮ ﺣﺎدة‬

‫ﺗﻐﻄﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻟﻔﺤﺺ اﻟﻤﺒﻜﺮ ﻟﻼﻋﺎﻗﺔ اﻟﺴﻤﻌﻴﺔ‬

‫)اﺧﺘﺒﺎر ﻗﻴﺎس ﺳﻤﻊ ﻓﻘﻂ( وﺑﺮﻧﺎﻣﺞ ﺗﺸﻮﻫﺎت‬
‫ﻣﻐﻄﻰ‬
‫اﻟﻘﻠﺐ اﻟﺨﻠﻘﻴﺔ اﻟﺤﺮﺟﺔ )ﻣﻮﺟﺎت ﺻﻮﺗﻴﺔ ﻟﻠﻘﻠﺐ(‬
‫ﻟﺠﻤﻴﻊ اﻟﻤﻮاﻟﻴﺪ‬

‫ﻣﻐﻄﻰ‬ ‫ﺗﻐﻄﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻟﻔﺤﺺ اﻟﻤﺒﻜﺮ ﻟﻼﻋﺎﻗﺔ اﻟﺴﻤﻌﻴﺔ‬

‫ﻳﺠﺐ أن ﺗﻮﺻﻒ ﻋﻦ ﻃﺮﻳﻖ اﻟﻄﺒﻴﺐ اﻟﻤﻌﺎﻟﺞ و أن ﻳﺸﻤﻞ اﻟﺘﺸﺨﻴﺺ إﺣﺪى اﻟﺤﺎﻻت اﻟﺘﺎﻟﻴﺔ‪:‬‬ ‫)اﺧﺘﺒﺎر ﻗﻴﺎس ﺳﻤﻊ ﻓﻘﻂ( وﺑﺮﻧﺎﻣﺞ ﺗﺸﻮﻫﺎت‬
‫أﻣﺮاض اﻟﺘﻤﺜﻴﻞ اﻟﻐﺬاﺋﻲ ‪ ،‬ﺣﺴﺎﺳﻴﺔ اﻟﺤﻠﻴﺐ أو اﻟﺴﻜﺮ ‪ ،‬وﺟﻮد ﻣﺸﺎﻛﻞ ﻓﻲ ا”ﻣﺘﺼﺎص‪ ،‬اﻣﺮاض ا”ﺳﺘﻘﻼﺑﻴﺔ ‪ ،‬أﻣﺮاض اﻟﺒﺮﻧﺎﻣﺞ‬ ‫اﻟﻘﻠﺐ اﻟﺨﻠﻘﻴﺔ اﻟﺤﺮﺟﺔ )ﻣﻮﺟﺎت ﺻﻮﺗﻴﺔ ﻟﻠﻘﻠﺐ(‬
‫اﻟﻮﻃﻨﻲ ﻟﻠﻔﺤﺺ اﻟﻤﺒﻜﺮ ﻟﺤﺪﻳﺜﻲ اﻟﻮﻻدة ﻟﻠﺤﺪ ﻣﻦ ا”ﻋﺎﻗﺔ ‪ ،‬اﻟﻄﻔﻞ اﻟﺨﺪج وﻧﺎﻗﺺ اﻟﻨﻤﻮ أو ﻧﺎﻗﺺ اﻟﻮزن اﻟﺸﺪﻳﺪ ﻟﻠﻌﻤﺮ اﻟﺤﻤﻠﻲ‬ ‫ﻟﺠﻤﻴﻊ اﻟﻤﻮاﻟﻴﺪ‬

‫ﻣﻐﻄﻰ‬
‫أﻗﻞ ﻣﻦ ﺳﻨﺔ‪:‬‬ ‫ﺗﻜﺎﻟﻴﻒ ﺗﻐﻄﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻟﺘﺤﺼﻴﻨﺎت ﻟﻔﻴﺮوس‬
‫‪ -‬اﻟﻄﻔﻞ اﻟﻤﻮﻟﻮد أﻗﻞ ﻣﻦ ) ‪ ( ٢٩‬أﺳﺒﻮع ﺣﻤﻠﻲ‬ ‫اﻻﻟﺘﻬﺎب اﻟﺘﻨﻔﺴﻲ اﻟﻤﺨﻠﻮي )‪ (RSV‬ﻟ‪Ë‬ﻃﻔﺎل وﻓﻖ‬
‫‪ -‬اﻟﻄﻔﻞ اﻟﺨﺪﻳﺞ اﻟﺬي ﻳﻌﺎﻧﻲ ﻣﻦ ﻣﺮض اﻟﺮﺋﺔ اﻟﻤﺰﻣﻦ‬
‫‪ -‬اﻟﻄﻔﻞ اﻟﺬي ﻳﻌﺎﻧﻲ ﻣﻦ أﻣﺮاض اﻟﻘﻠﺐ اﻟﺨﻠﻘﻴﺔ‬
‫ﺟﺪول ﺗﺤﺼﻴﻨﺎت اﻟﻔﻴﺮوس اﻟﺘﻨﻔﺴﻲ اﻟﻤﺨﻠﻮي‬
‫أﻗﻞ ﻣﻦ ﺳﻨﺘﻴﻦ‪:‬‬ ‫اﻟﻤﻌﺘﻤﺪة اﻟﺼﺎدر ﻋﻦ وزارة اﻟﺼﺤﺔ اﻟﻮارد ﻓﻲ‬
‫‪ -‬اﻟﻄﻔﻞ اﻟﺬي ﻳﻌﺎﻧﻲ ﻣﻦ اﻋﺘﻼل اﻟﺮﺋﺘﻴﻦ أو اﻟﺠﻬﺎز اﻟﻌﺼﺒﻲ‬ ‫اﻟﻤﻠﺤﻖ رﻗﻢ ‪٦‬‬
‫وﻻ ﻳﺴﺘﻄﻴﻊ اﻟﺘﺨﻠﺺ ﻣﻦ اﻟﺒﻠﻐﻢ‬

‫ﻋﻼج اﻟﺼﺪﻓﻴﺔ‬
‫ﻣﻐﻄﻰ‬ ‫‪ -‬ﻟﻦ ﺗﻐﻄﻰ أي ﻣﺴﺘﺤﻀﺮات ﺗﺠﻤﻴﻞ )ﻛﺮﻳﻤﺎت‬
‫ﺗﺮﻃﻴﺐ(‬

‫‪٢١‬‬
 ‫اﻟﻜﻼﺳﻴﻜﻲ‬ ‫اﻟﺒﺮوﻧﺰي‬ ‫اﻟﻔﻀﻲ‬ ‫اﻟﺬﻫﺒﻲ‬ ‫اﻟﻤﺎﺳﻲ‬ ‫اﻟﺒﺮﻧﺎﻣﺞ‬

‫ﺷﺒﻜﺔ ‪ ١‬أو ﺷﺒﻜﺔ ‪ ٢‬ﺷﺒﻜﺔ ‪ ٣‬أو ﺷﺒﻜﺔ ‪ ٤‬ﺷﺒﻜﺔ ‪ ٥‬أو ﺷﺒﻜﺔ ‪ ٦‬ﺷﺒﻜﺔ ‪ ٧‬أو ﺷﺒﻜﺔ ‪ ٨‬ﺷﺒﻜﺔ ‪ ٩‬أو ﺷﺒﻜﺔ ‪١٠‬‬ ‫اﻟﺸﺒﻜﺔ‬

‫ﺗﻜﺎﻟﻴﻒ اﻟﺒﺮﻧﺎﻣﺞ اﻟﻮﻃﻨﻲ ﻟﻠﻔﺤﺺ اﻟﻤﺒﻜﺮ‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪١٠٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬
‫ﻟﺤﺪﻳﺜﻲ اﻟﻮﻻدة ﻟﻠﺤﺪ ﻣﻦ ا”ﻋﺎﻗﺔ‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ١٠٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ ﺣﺎﻻت ا”ﻋﺎﻗﺔ‬

‫ﻣﻐﻄﻰ‬ ‫ﺧﺪﻣﺔ ﺳﻴﺎرة ا”ﺳﻌﺎف ﻟﻠﺤﺎﻻت اﻟﻄﺎرﺋﺔ‬

‫ﻣﻐﻄﻰ ﺑﺤﺪ أﻗﺼﻰ ‪ ١٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫إﻋﺎدة رﻓﺎت اﻟﻤﺘﻮﻓﻰ إﻟﻰ ﻣﻮﻃﻨﻪ اﺻﻠﻲ‬

‫• اﻟﺤﺎﻻت اﻟﻄﺎرﺋﺔ اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ﻣﻐﻄﺎه ‪ ٪١٠٠‬ﻛﻤﺎ ﻫﻲ ﻟﺒﺎﻗﺔ اﻟﻤﺎﺳﻲ و اﻟﺬﻫﺒﻲ ﻋﻠﻰ أﺳﺎس‬
‫اﻟﺘﻌﻮﻳﺾ اﻟﻨﻘﺪي‪ ،‬و‪ ٪١٠٠‬ﻟﺒﺎﻗﺔ اﻟﻔﻀﻴﺔ ﺣﺴﺐ اﺳﻌﺎر اﻟﺴﺎﺋﺪة واﻟﻤﺘﻌﺎرف ﻋﻠﻴﻬﺎ داﺧﻞ ﺷﺒﻜﺔ اﻟﻤﺮاﻛﺰ اﻟﻄﺒﻴﺔ ﺑﺎﻟﻤﻤﻠﻜﺔ‬
‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪ ،‬أﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺒﺎﻗﺔ اﻟﺒﺮوﻧﺰي و اﻟﻜﻼﺳﻴﻚ ﻓﺎﻟﻤﻄﺎﻟﺒﺎت اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ﻏﻴﺮ‬
‫ﻣﻐﻄﺎه‪.‬‬
‫اﻟﺘﻐﻄﻴﺔ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫• اﻟﺤﺎﻻت اﻟﻐﻴﺮ ﻃﺎرﺋﺔ ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ﻣﻐﻄﺎه ‪ ٪١٠٠‬ﻟﺒﺎﻗﺔ اﻻﻟﻤﺎﺳﻲ و اﻟﺬﻫﺒﻲ‪ ،‬و‪ ٪٨٠‬ﻟﺒﺎﻗﺔ اﻟﻔﻀﻲ ﺣﺴﺐ‬
‫اﺳﻌﺎر اﻟﺴﺎﺋﺪة واﻟﻤﺘﻌﺎرف ﻋﻠﻴﻬﺎ ﻓﻲ ﺷﺒﻜﺔ اﻟﻤﺮاﻛﺰ اﻟﻄﺒﻴﺔ اﻟﻤﻌﺘﻤﺪة داﺧﻞ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪ ،‬ﺷﺮﻳﻄﺔ‬
‫اﻟﺤﺼﻮل ﻋﻠﻰ ﻣﻮاﻓﻘﺔ ﻣﺴﺒﻘﺔ ﻣﻦ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‪ .‬أﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺒﺎﻗﺔ اﻟﺒﺮوﻧﺰي و اﻟﻜﻼﺳﻴﻚ ﻓﺎﻟﻤﻄﺎﻟﺒﺎت اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج‬
‫اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ﻏﻴﺮ ﻣﻐﻄﺎه‪.‬‬

‫اﻟﺤﺎﻻت اﻟﻄﺎرﺋﺔ اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج ﻧﻄﺎق ﺷﺒﻜﺔ اﻟﻤﺴﺘﺸﻔﻴﺎت ﻣﻐﻄﺎه ‪ ٪١٠٠‬ﻟﺠﻤﻴﻊ اﻟﻤﻨﺘﺠﺎت ﻋﻠﻰ أﺳﺎس اﻟﺘﻌﻮﻳﺾ اﻟﻨﻘﺪي‬
‫ﻛﻤﺎ ﻫﻲ‪ .‬اﻟﺤﺎﻻت اﻟﻐﻴﺮ ﻃﺎرﺋﺔ اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج ﻧﻄﺎق اﻟﺸﺒﻜﺔ ﻣﻐﻄﺎه ‪ ٪٨٠‬ﻟﺒﺎﻗﺔ اﻻﻟﻤﺎﺳﻲ و اﻟﺬﻫﺒﻲ و اﻟﻔﻀﻲ ﺣﺴﺐ اﺳﻌﺎر‬
‫اﻟﺴﺎﺋﺪة واﻟﻤﺘﻌﺎرف ﻋﻠﻴﻬﺎ ﻓﻲ ﺷﺒﻜﺔ اﻟﻤﺮاﻛﺰ اﻟﻄﺒﻴﺔ اﻟﻤﻌﺘﻤﺪة داﺧﻞ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ ‪ ،‬ﺷﺮﻳﻄﺔ اﻟﺤﺼﻮل‬ ‫اﻟﺘﻐﻄﻴﺔ ﺧﺎرج ﻧﻄﺎق اﻟﺸﺒﻜﺔ )داﺧﻞ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ(‬
‫ﻋﻠﻰ ﻣﻮاﻓﻘﺔ ﻣﺴﺒﻘﺔ ﻣﻦ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‪ .‬أﻣﺎ ﺑﺎﻟﻨﺴﺒﺔ ﻟﺒﺎﻗﺔ اﻟﺒﺮوﻧﺰي و اﻟﻜﻼﺳﻴﻚ اﻟﺤﺎﻻت اﻟﻐﻴﺮ ﻃﺎرﺋﺔ اﻟﺘﻲ ﺗﻨﺸﺄ ﺧﺎرج‬
‫ﻧﻄﺎق اﻟﺸﺒﻜﺔ ﻏﻴﺮ ﻣﻐﻄﺎة‪.‬‬

‫اﻟﻐﺮﻓﺔ اﻟﻤﺸﺘﺮﻛﺔ‪ ٦٠٠ :‬رﻳﺎل ﺳﻌﻮدي ﻳﻮﻣﻴ ًﺎ‬

‫اﻟﻐﺮﻓﺔ ﺷﺒﻪ اﻟﺨﺎﺻﺔ‪ ٦٠٠ :‬رﻳﺎل ﺳﻌﻮدي ﻳﻮﻣﻴﺎ‬ ‫ﺣﺪ ا”ﻗﺎﻣﺔ وا”ﻋﺎﺷﺔ اﻟﻴﻮﻣﻴﺔ ﻟﻠﻤﺮﻳﺾ ﺑﻤﺎ ﻓﻲ ذﻟﻚ‬
‫رﺳﻮم اﻟﺴﺮﻳﺮ واﻟﺘﻤﺮﻳﺾ واﻟﺰﻳﺎرات اﻟﻄﺒﻴﺔ وا”ﺷﺮاف‬
‫اﻟﻐﺮﻓﺔ اﻟﺨﺎﺻﺔ‪ ٦٠٠ :‬رﻳﺎل ﺳﻌﻮدي ﻳﻮﻣﻴﺎ‬ ‫اﻟﻄﺒﻲ وﺧﺪﻣﺎت ﺗﻘﺪﻳﻢ اﻟﻄﻌﺎم واﻟﺸﺮاب ﺑﺎﺳﺘﺜﻨﺎء‬
‫ﺗﻜﻠﻔﺔ ادوﻳﺔ واﻟﻠﻮازم اﻟﻄﺒﻴﺔ اﻟﺘﻲ ﻳﺼﻔﻬﺎ اﻟﻄﺒﻴﺐ‬
‫اﻟﺠﻨﺎح اﻟﻌﺎدي‪ ٧٥٠ :‬رﻳﺎل ﺳﻌﻮدي ﻳﻮﻣﻴﺎ‬

‫اﻟﻄﺒﻴﺐ اﻟﻤﻤﺎرس اﻟﻌﺎم ‪ ٥٠‬رﻳﺎل ﺳﻌﻮدي‬

‫اﻟﻄﺒﻴﺐ اﺧﺼﺎﺋﻲ اول ‪ ٢٠٠‬رﻳﺎل ﺳﻌﻮدي‬

‫اﻟﺤﺪ اﻗﺼﻰ ﺗﻌﺎب اﺳﺘﺸﺎرة اﻟﻄﺒﻴﺐ )ﻳﺘﻢ ﻓﺤﺺ‬
‫اﻟﻄﺒﻴﺐ اﺧﺼﺎﺋﻲ اﻟﺜﺎﻧﻲ ‪ ١٠٠‬رﻳﺎل ﺳﻌﻮدي‬ ‫اﻟﻤﺴﺘﻔﻴﺪ ﺣﺴﺐ ﺗﺴﻠﺴﻞ إﺟﺮاءات ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺔ إﻻ‬
‫ﻋﻨﺪﻣﺎ ﻻ ﺗﻜﻮن اﻟﺨﺪﻣﺔ ﻣﺘﺎﺣﺔ ﻓﻲ ﻣﺮﻛﺰ ﻣﻘﺪم اﻟﺨﺪﻣﺔ‬
‫اﻟﻄﺒﻴﺐ اﻻﺳﺘﺸﺎري ‪ ٣٠٠‬رﻳﺎل ﺳﻌﻮدي‬

‫اﻟﺘﺨﺼﺼﺎت اﻟﻨﺎدرة ﻣﺜﻞ ﺟﺮاﺣﺎت اﻟﻘﻠﺐ واﻋﺼﺎب واوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ واﻟﺘﺨﺼﺼﺎت اﻟﻤﻌﻘﺪة ‪ ٥٠٠‬رﻳﺎل ﺳﻌﻮدي‬

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 ‫اﻟﻜﻼﺳﻴﻜﻲ‬ ‫اﻟﺒﺮوﻧﺰي‬ ‫اﻟﻔﻀﻲ‬ ‫اﻟﺬﻫﺒﻲ‬ ‫اﻟﻤﺎﺳﻲ‬ ‫اﻟﺒﺮﻧﺎﻣﺞ‬

‫ﺷﺒﻜﺔ ‪ ١‬أو ﺷﺒﻜﺔ ‪ ٢‬ﺷﺒﻜﺔ ‪ ٣‬أو ﺷﺒﻜﺔ ‪ ٤‬ﺷﺒﻜﺔ ‪ ٥‬أو ﺷﺒﻜﺔ ‪ ٦‬ﺷﺒﻜﺔ ‪ ٧‬أو ﺷﺒﻜﺔ ‪ ٨‬ﺷﺒﻜﺔ ‪ ٩‬أو ﺷﺒﻜﺔ ‪١٠‬‬ ‫اﻟﺸﺒﻜﺔ‬

‫ﻣﻐﻄﻰ‬ ‫ﺗﻔﺎﺻﻴﻞ ﺗﻐﻄﻴﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة‬

‫ﻣﻐﻄﻰ ﻣﻦ اﻟﻴﻮم اول‬ ‫اﻟﻄﻔﻞ ﺣﺪﻳﺚ اﻟﻮﻻدة‬

‫ﻣﻐﻄﻰ إﻟﻰ اﻟﺤﺪ اﻗﺼﻰ ‪ ٥٠٠‬رﻳﺎل و ‪ ٣٠٠‬رﻳﺎل ﺑﺎﻟﺘﺘﺎﺑﻊ ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ ﺣﺎﻻت اﻟﺨﺘﺎن )ﻟﻠﺬﻛﻮر(وﺗﺨﺮﻳﻢ اذن ﻟ‪Ë‬ﻧﺜﻰ‬

‫ﻣﻐﻄﻰ ﺣﺘﻰ اﻟﺤﺪ ا”ﺟﻤﺎﻟﻲ اﻟﺴﻨﻮي‬ ‫ﻣﻀﺎﻋﻔﺎت اﻟﺤﻤﻞ واﻟﻮﻻدة‬

‫ﻣﻐﻄﻰ ﺣﺘﻰ اﻟﺤﺪ ا”ﺟﻤﺎﻟﻲ اﻟﺴﻨﻮي ﻓﻲ ﺣﺎل ﺗﻐﻄﻴﺔ ﻣﻨﻔﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة‬ ‫اﻃﻔﺎل اﻟﻤﺒﺘﺴﺮﻳﻦ‬

‫ﺑﺪون‬ ‫ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ اﻟﺘﺄﻣﻴﻨﻴﺔ ﻓﻲ اﻟﻌﻴﺎدات اﻟﺪاﺧﻠﻴﺔ ‪ /‬ﻣﺒﻠﻎ اﻻﻗﺘﻄﺎع‬

‫ﻣﻐﻄﻰ ﺣﺘﻰ اﻟﺤﺪ ا”ﺟﻤﺎﻟﻲ اﻟﺴﻨﻮي‬ ‫ﺣﺪ ﻧﻔﻘﺎت اﻟﻌﻴﺎدات اﻟﺪاﺧﻠﻴﺔ واﻟﺨﺎرﺟﻴﺔ‬

‫‪ ١٥٠‬رﻳﺎل ﺳﻌﻮدي ﻛﺤﺪ اﻗﺼﻰ ﻓﻲ اﻟﻴﻮم‬ ‫ﺣﺪ ا”ﻗﺎﻣﺔ وا”ﻋﺎﺷﺔ اﻟﻴﻮﻣﻲ ﻟﻠﻤﺮاﻓﻖ‬

‫ﻣﻐﻄﻰ ﺣﺘﻰ اﻟﺤﺪ ا”ﺟﻤﺎﻟﻲ اﻟﺴﻨﻮي‬ ‫ﻋﻴﻮب ﺧﻠﻘﻴﻪ ﻣﻬﺪدة ﻟﻠﺤﻴﺎة‬

‫ﻣﻐﻄﻰ ﺣﺘﻰ اﻟﺤﺪ ا”ﺟﻤﺎﻟﻲ اﻟﺴﻨﻮي‬ ‫اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ و اﻟﺴﺎﺑﻘﺔ‬

‫ﻣﻐﻄﻰ‬ ‫اﻟﻌﻼج اﻟﻄﺒﻴﻌﻲ إذا ﻛﺎن ﻟﻀﺮورة ﻃﺒﻴﺔ‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ١٠٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ اﻟﻐﺴﻴﻞ اﻟﻜﻠﻮي‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪١٥٠٠٠‬أﻟﻒ رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ اﻟﺤﺎﻻت اﻟﻨﻔﺴﻴﺔ اﻟﺤﺎدة‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ٦,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ اﻟﺴﻤﺎﻋﺎت اﻟﻄﺒﻴﺔ‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ٧٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ ﺣﺎﻻت ﺗﻠﻒ ﺻﻤﺎﻣﺎت اﻟﻘﻠﺐ اﻟﻤﻜﺘﺴﺒﺔ‬

‫ﻣﻐﻄﻰ ﻟ‪Ë‬ﻃﻔﺎل ﺣﺘﻰ ﺳﻦ ‪ ٦‬ﺳﻨﻮات‬ ‫اﻟﺘﻄﻌﻴﻤﺎت واﻟﻠﻘﺎﺣﺎت )ﺣﺴﺐ وزارة اﻟﺼﺤﺔ(‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ٥٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ اﺟﺮاء ﻋﻤﻠﻴﺔ اﻟﺘﺒﺮع ﺑﺎﻋﻀﺎء )ﻟﻠﻤﺘﺒﺮع(‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ١٥,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ ﻣﺮﺿﻰ اﻟﺰﻫﺎﻳﻤﺮ‬

‫ﺑﺤﺪ أﻗﺼﻰ ‪ ١٥,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﺧﻼل ﻣﺪة اﻟﻮﺛﻴﻘﺔ‬ ‫ﺗﻜﺎﻟﻴﻒ ﺣﺎﻻت اﻟﺘﻮﺣﺪ‬

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‫ﺟﺪول اﻟﻤﻨﺎﻓﻊ ﻟﺠﻤﻴﻊ اﻟﺒﺮاﻣﺞ‬
‫اﻟﻜﻼﺳﻴﻜﻲ‬ ‫اﻟﺒﺮوﻧﺰي‬ ‫اﻟﻔﻀﻲ‬ ‫اﻟﺬﻫﺒﻲ‬ ‫اﻟﻤﺎﺳﻲ‬ ‫اﻟﺒﺮﻧﺎﻣﺞ‬

‫ﺷﺒﻜﺔ ‪ ١‬أو ﺷﺒﻜﺔ ‪ ٢‬ﺷﺒﻜﺔ ‪ ٣‬أو ﺷﺒﻜﺔ ‪ ٤‬ﺷﺒﻜﺔ ‪ ٥‬أو ﺷﺒﻜﺔ ‪ ٦‬ﺷﺒﻜﺔ ‪ ٧‬أو ﺷﺒﻜﺔ ‪ ٨‬ﺷﺒﻜﺔ ‪ ٩‬أو ﺷﺒﻜﺔ ‪١٠‬‬ ‫اﻟﺸﺒﻜﺔ‬

‫ﻏﺮﻓﺔ ﻣﺸﺘﺮﻛﺔ‬ ‫ﻏﺮﻓﺔ ﻣﺸﺘﺮﻛﺔ‬ ‫ﺷﺒﻪ ﻏﺮﻓﺔ ﺧﺎﺻﺔ‬ ‫ﻏﺮﻓﺔ ﺧﺎﺻﺔ‬ ‫ﺟﻨﺎح ﻣﻜﻠﻲ‬ ‫ﻧﻮع اﻟﻐﺮﻓﺔ‬

‫‪ ٥٠٠,٠٠٠‬رﻳﺎل‬ ‫‪ ٥٠٠,٠٠٠‬رﻳﺎل‬ ‫‪ ٥٠٠,٠٠٠‬رﻳﺎل‬ ‫ﻣﻦ ‪ ٥٠٠,٠٠٠‬وﺣﺘﻰ‬ ‫ﻣﻦ ‪ ٥٠٠,٠٠٠‬رﻳﺎل‬ ‫اﻟﺤﺪ اﻗﺼﻰ اﻟﺴﻨﻮي‬
‫ﺳﻌﻮدي‬ ‫ﻣﻠﻴﻮن رﻳﺎل‬ ‫وﺣﺘﻰ ﻣﻠﻴﻮن رﻳﺎل‬

‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬ ‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬

‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬ ‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬ ‫داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬ ‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫وﺧﺎرﺟﻬﺎ‬ ‫وﺧﺎرﺟﻬﺎ‬ ‫اﻟﺘﻐﻄﻴﺔ اﻟﺠﻐﺮاﻓﻴﺔ‬
‫ﻓﻘﻂ‬ ‫ﻓﻘﻂ‬ ‫وﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ‬ ‫اﻟﺸﺒﻜﺔ اﻟﻌﺎﻟﻤﻴﺔ ‪(1‬‬ ‫اﻟﺸﺒﻜﺔ اﻟﻌﺎﻟﻤﻴﺔ ‪(1‬‬
‫)أو اﻟﺸﺒﻜﺔ اﻟﻌﺎﻟﻤﻴﺔ ‪2‬‬ ‫)أو اﻟﺸﺒﻜﺔ اﻟﻌﺎﻟﻤﻴﺔ ‪2‬‬

‫ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ﺻﻔﺮ وﺣﺘﻰ ‪ ٪٢٠‬ﻛﺤﺪ أﻗﺼﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬
‫ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ اﻟﺘﺄﻣﻴﻨﻴﺔ‬
‫ﻟﻠﻌﻴﺎدات ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ﺻﻔﺮ وﺣﺘﻰ ‪ ٪٢٠‬ﻛﺤﺪ أﻗﺼﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫ﻓﻲ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ‬
‫داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ﺻﻔﺮ وﺣﺘﻰ ‪ ٪٢٠‬ﻛﺤﺪ أﻗﺼﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬

‫ﻣﻦ ‪ ٢٠٠٠‬رﻳﺎل‬ ‫ﻣﻦ ‪ ٢٠٠٠‬رﻳﺎل‬ ‫ﺣﺪ ﺗﻐﻄﻴﺔ اﺳﻨﺎن ﻓﻲ اﻟﺴﻨﺔ‬

‫ﻣﻦ ‪ ٢٠٠٠‬رﻳﺎل‬ ‫ﻣﻦ ‪ ٢٠٠٠‬رﻳﺎل‬ ‫وﺣﺘﻰ ‪ ١٠,٠٠٠‬رﻳﺎل‬ ‫وﺣﺘﻰ ‪ ١٠,٠٠٠‬رﻳﺎل‬ ‫ﺷﺎﻣﻠﺔ اﺳﺘﺸﺎرة اﻟﻄﺒﻴﺐ واﺷﻌﺔ اﻟﺴﻴﻨﻴﺔ وﺧﻠﻊ اﺳﻨﺎن وﺣﺸﻮﻫﺎ‬
‫‪ ٢,٠٠٠‬رﻳﺎل‬ ‫وﺣﺘﻰ ‪ ٣,٠٠٠‬رﻳﺎل‬ ‫وﺣﺘﻰ ‪ ٥,٠٠٠‬رﻳﺎل‬ ‫اﻣﻜﺎﻧﻴﺔ اﺿﺎﻓﺔ اﻟﺘﻘﻮﻳﻢ‬ ‫اﻣﻜﺎﻧﻴﺔ اﺿﺎﻓﺔ اﻟﺘﻘﻮﻳﻢ‬ ‫ﺑﺎﻣﻠﻐﻢ واﻟﺤﺸﻮ اﻟﻤﺮﻛﺐ وﺳﺤﺐ اﻟﻌﺼﺐ وﻣﻌﺎﻟﺠﺔ أﻣﺮاض اﻟﻠﺜﺔ‪.‬‬
‫واﻟﺠﺴﺮ واﻟﺘﺮﻛﻴﺐ‬ ‫واﻟﺠﺴﺮ واﻟﺘﺮﻛﻴﺐ‬
‫ﺷﺎﻣﻞ ﺗﻨﻈﻴﻒ اﻻﺳﻨﺎن ﻣﺮة واﺣﺪة ﺧﻼل اﻟﺴﻨﺔ اﻟﺘﻌﺎﻗﺪﻳﺔ‬

‫ﻣﻦ ‪ ٤٠٠‬رﻳﺎل‬ ‫ﻣﻦ ‪ ٤٠٠‬رﻳﺎل‬

‫ﺣﺪ ا”ﻃﺎر ‪ ٤٠٠‬رﻳﺎل‬ ‫وﺣﺘﻰ ‪ ٥,٠٠٠‬رﻳﺎل‬
‫ﻣﻦ ‪ ٤٠٠‬رﻳﺎل‬
‫وﺣﺘﻰ ‪ ٢,٠٠٠‬رﻳﺎل‬
‫ﻣﻦ ‪ ٤٠٠‬رﻳﺎل‬ ‫ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ‬
‫ﺣﺘﻰ ‪ ٧٥٠‬رﻳﺎل‬ ‫ﺣﺘﻰ ‪ ٢٠٠٠‬رﻳﺎل‬ ‫ﺷﺎﻣﻞ اﻟﻔﺤﺺ واﻟﻌﺪﺳﺎت اﻟﻄﺒﻴﺔ اﺳﺎﺳﻴﺔ وا”ﻃﺎر‬
‫ﺣﺪ ا”ﻃﺎر ‪ ٤٠٠‬رﻳﺎل‬ ‫ﺣﺪ ا”ﻃﺎر ‪ ٤٠٠‬رﻳﺎل‬

‫ﻳﺘﻢ اﻟﺘﻐﻄﻴﺔ‬ ‫ﻳﺘﻢ اﻟﺘﻐﻄﻴﺔ‬

‫ﻳﺘﻢ اﻟﺘﻐﻄﻴﺔ ﻛﺤﺪ‬ ‫ﻳﺘﻢ اﻟﺘﻐﻄﻴﺔ ﻛﺤﺪ‬ ‫ﻳﺘﻢ اﻟﺘﻐﻄﻴﺔ ﻛﺤﺪ‬ ‫ﻣﻦ ‪ ١٥,٠٠٠‬رﻳﺎل‬ ‫ﻣﻦ ‪ ١٥,٠٠٠‬رﻳﺎل‬
‫أﻗﺼﻰ ‪ ١٥,٠٠٠‬رﻳﺎل‬ ‫أﻗﺼﻰ ‪ ١٥,٠٠٠‬رﻳﺎل‬ ‫أﻗﺼﻰ ‪ ١٥,٠٠٠‬رﻳﺎل‬
‫ﺣﺪ ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ‬
‫ﺣﺘﻰ ‪ ٣٠,٠٠٠‬رﻳﺎل‬ ‫ﺣﺘﻰ ‪ ٣٠,٠٠٠‬رﻳﺎل‬

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‫اﻟﻜﻼﺳﻴﻜﻲ‬

‫• اﻟﺤﺪ اﻗﺼﻰ اﻟﺴﻨﻮي ﺣﺘﻰ ‪ ٥٠٠٠٠٠‬رﻳﺎل ﺳﻌﻮدي )ﻣﻘﻴﺎس ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ(‬
‫• إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ‰ﺣﺪى ﺷﺒﻜﺎت اﻟﺨﺪﻣﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺔ‬
‫‪ ٩‬أو ﺷﺒﻜﺔ ‪(١٠‬‬
‫• ﻏﺮﻓﺔ ﻣﺸﺘﺮﻛﺔ‬
‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ ﻋﻠﻰ ﺣﺴﺐ اﻻﺧﺘﻴﺎرات اﻟﻤﺘﺎﺣﺔ أو ﻋﻠﻰ ﺣﺴﺐ ﻣﺎ ﻳﻨﺼﻪ ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة‬
‫‪ ٪٢٠‬ﻛﺤﺪ اﻋﻠﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬ ‫ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ اﻟﻜﻼﺳﻴﻜﻲ اﻟﺨﺪﻣﺎت واﻟﻤﻤﻴﺰات ﺣﺴﺐ اﻟﺤﺪ اﻋﻠﻰ‬
‫اﻟﻤﻄﻠﻮب ﻣﻦ ﻣﻘﻴﺎس اﻟﻀﻤﺎن اﻟﺼﺤﻲ وﻳﺸﻤﻞ اﻟﻤﺰاﻳﺎ اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ‬
‫ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﺒﺎﻗﻲ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺧﺎرج‬
‫ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﺳﻨﺎن ﺣﺘﻰ ‪ ٢٠٠٠‬رﻳﺎل ﺳﻌﻮدي )ﻣﻘﻴﺎس ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ(‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ ﺣﺘﻰ ‪ ٤٠٠‬رﻳﺎل ﺳﻌﻮدي )ﻣﻘﻴﺎس ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ(‬
‫• ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ و اﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ ‪ ١٥٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﻛﺤﺪ أﻗﺼﻰ )ﻣﻘﻴﺎس ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ(‬

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‫اﻟﺒﺮوﻧﺰي‬

‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ ﻋﻠﻰ ﺣﺴﺐ اﻻﺧﺘﻴﺎرات اﻟﻤﺘﺎﺣﺔ أو ﻋﻠﻰ ﺣﺴﺐ ﻣﺎ ﻳﻨﺼﻪ ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة‬
‫ﻛﺤﺪ اﻋﻠﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ‬
‫ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﺒﺎﻗﻲ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺧﺎرج‬
‫ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ اﻟﺒﺮوﻧﺰي اﻟﺨﺪﻣﺎت واﻟﻤﻤﻴﺰات أﻋﻠﻰ ﻣﻦ اﻟﺤﺪ اﻋﻠﻰ‬
‫• إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ‰ﺣﺪى ﺷﺒﻜﺎت اﻟﺨﺪﻣﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺔ‬
‫اﻟﻤﻄﻠﻮب ﻣﻦ ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ وﻳﺸﻤﻞ اﻟﻤﺰاﻳﺎ اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ ٧‬أو ﺷﺒﻜﺔ ‪(٨‬‬
‫• ﻏﺮﻓﺔ ﻣﺸﺘﺮﻛﺔ‬
‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ اﻟﺘﺄﻣﻴﻨﻴﺔ ﻓﻲ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ ﻣﻦ ﺻﻔﺮ و ﺣﺘﻰ ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ‬
‫ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻻﺳﻨﺎن ﺣﺘﻰ ‪ ٣,٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ ﺣﺘﻰ ‪ ٥٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ و اﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ ‪ ١٥٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﻛﺤﺪ أﻗﺼﻰ )ﻣﻘﻴﺎس ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ(‬

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‫اﻟﻔﻀﻲ‬

‫• اﻟﺤﺪ اﻗﺼﻰ اﻟﺴﻨﻮي ﺣﺘﻰ ‪ ٦٠٠٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬

‫• إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت و اﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ‰ﺣﺪى ﺷﺒﻜﺎت اﻟﺨﺪﻣﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺔ‬
‫‪ ٥‬أو ﺷﺒﻜﺔ ‪(٦‬‬
‫• ﻏﺮﻓﺔ ﺷﺒﻪ ﺧﺎﺻﺔ‬
‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ ﻋﻠﻰ ﺣﺴﺐ اﻻﺧﺘﻴﺎرات اﻟﻤﺘﺎﺣﺔ أو ﻋﻠﻰ ﺣﺴﺐ ﻣﺎ ﻳﻨﺼﻪ ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة‬
‫ﻛﺤﺪ اﻋﻠﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬ ‫ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ اﻟﻔﻀﻲ اﻟﺨﺪﻣﺎت واﻟﻤﻤﻴﺰات اﻟﺘﻲ ﺗﻼﺋﻢ اﺣﺘﻴﺎﺟﺎت‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ‬ ‫اﻟﻌﻤﻼء ﻣﻊ إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﺤﺪ اﻟﻤﻄﻠﻮب ﻟﻠﺘﻐﻄﻴﺔ‪ .‬ﻫﺬا اﻟﺒﺮﻧﺎﻣﺞ‬
‫ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬ ‫ﻳﺸﻤﻞ اﻟﻤﻤﻴﺰات اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﺒﺎﻗﻲ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺧﺎرج ﺷﺒﻜﺔ‬
‫اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﺳﻨﺎن ﺣﺘﻰ ‪ ٥٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ ﺣﺘﻰ ‪ ٧٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ و اﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ ‪ ١٥٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﻛﺤﺪ أﻗﺼﻰ‬
‫• ا‰ﺧﻼء ﻓﻲ ﺣﺎﻻت اﻟﻄﻮارئ واﻟﻌﻮدة إﻟﻰ اﻟﻮﻃﻦ ﻣﻦ ﺧﻼل ﺑﺮﻧﺎﻣﺞ ‪Assist America‬‬
‫• اﻟﻌﻼج ﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ‬

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‫اﻟﺬﻫﺒﻲ‬
‫• اﻟﺤﺪ اﻗﺼﻰ اﻟﺴﻨﻮي ﺣﺘﻰ ‪ ٧٥٠٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ‰ﺣﺪى ﺷﺒﻜﺎت اﻟﺨﺪﻣﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺔ‬
‫‪ ٣‬أو ﺷﺒﻜﺔ ‪(٤‬‬
‫• ﻏﺮﻓﺔ ﺧﺎﺻﺔ‬
‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ ﻋﻠﻰ ﺣﺴﺐ اﻻﺧﺘﻴﺎرات اﻟﻤﺘﺎﺣﺔ أو ﻋﻠﻰ ﺣﺴﺐ ﻣﺎ ﻳﻨﺼﻪ ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪٪٢٠‬‬
‫ﻛﺤﺪ اﻋﻠﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ‬
‫ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﺒﺎﻗﻲ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺧﺎرج ﺷﺒﻜﺔ‬ ‫ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ اﻟﺬﻫﺒﻲ ﺧﺪﻣﺎت ﻋﺎﻟﻴﺔ اﻟﺠﻮدة وﻣﻤﻴﺰات ﺗﺘﻤﺎﺷﻰ ﻣﻊ‬
‫اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬ ‫ﻣﺘﻄﻠﺒﺎت اﻟﻌﻤﻼء‪ .‬ﻳﺴﺘﻄﻴﻊ ﻋﻤﻼﺋﻨﺎ اﻟﻜﺮام اﻻﺳﺘﻔﺎدة ﻣﻦ ﺧﺪﻣﺎت‬
‫اﻟﻌﻼج ﺧﺎرج اﻟﻤﻤﻠﻜﺔ وزﻳﺎدة ﺣﺪ اﻟﺘﻐﻄﻴﺔ‪ .‬ﻳﻘﺪم ﻫﺬا اﻟﺒﺮﻧﺎﻣﺞ ﺣﺪود‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻻﺳﻨﺎن ﺣﺘﻰ ‪ ١٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﻣﻊ اﻣﻜﺎﻧﻴﺔ اﺿﺎﻓﺔ ﺗﻘﻮﻳﻢ اﺳﻨﺎن واﻟﺘﺮﻛﻴﺒﺎت‬ ‫ﺗﻐﻄﻴﺔ أﻛﺜﺮ ﻣﻦ اﻟﺤﺪ اﻋﻠﻰ اﻟﻤﻄﻠﻮب ﻣﻦ ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ ﺣﺘﻰ ‪ ٢٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬ ‫وﻳﺸﻤﻞ اﻟﻤﺰاﻳﺎ اﻟﺘﺎﻟﻴﺔ‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ ﺣﺘﻰ ‪ ٣٠٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬
‫• ا‰ﺧﻼء ﻓﻲ ﺣﺎﻻت اﻟﻄﻮارئ واﻟﻌﻮدة إﻟﻰ اﻟﻮﻃﻦ ﻣﻦ ﺧﻼل ﺑﺮﻧﺎﻣﺞ ‪Assist America‬‬
‫• اﻟﺪﻓﻊ اﻟﻤﺒﺎﺷﺮ ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫• اﻟﻌﻼج ﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ‬
‫• اﺧﺘﻴﺎر إﺣﺪى اﻟﺸﺒﻜﺎت اﻟﺨﺎرﺟﻴﺔ‪:‬‬
‫‪ -‬دول اﻟﻌﺎﻟﻢ ‪ :١‬ﺷﺒﻜﺔ اﻟﺨﺪﻣﺔ اﻟﺨﺎرﺟﻴﺔ ﺗﺘﻀﻤﻦ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻣﺮﻳﻜﻴﺔ وأوروﺑﺎ وﺑﺎﻗﻲ‬
‫دول اﻟﻌﺎﻟﻢ‬
‫‪ -‬دول اﻟﻌﺎﻟﻢ‪ :٢‬ﺷﺒﻜﺔ اﻟﺨﺪﻣﺔ اﻟﺨﺎرﺟﻴﺔ ﻻ ﺗﺘﻀﻤﻦ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻣﺮﻳﻜﻴﺔ وأوروﺑﺎ‬

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‫اﻟﻤـﺎﺳﻲ‬
‫• اﻟﺤﺪ اﻗﺼﻰ اﻟﺴﻨﻮي ﺣﺘﻰ ﻣﻠﻴﻮن رﻳﺎل ﺳﻌﻮدي‬
‫• إﻣﻜﺎﻧﻴﺔ اﺧﺘﻴﺎر اﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ‰ﺣﺪى ﺷﺒﻜﺎت اﻟﺨﺪﻣﺔ اﻟﻤﺘﻮﻓﺮة )ﺷﺒﻜﺔ‬
‫‪ ١‬أو ﺷﺒﻜﺔ ‪(٢‬‬
‫• ﺟﻨﺎح ﻣﻠﻜﻲ أو ﺟﻨﺎح ﻋﺎدي‬
‫• ﺗﺤﺪﻳﺪ ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ ﻋﻠﻰ ﺣﺴﺐ اﻻﺧﺘﻴﺎرات اﻟﻤﺘﺎﺣﺔ أو ﻋﻠﻰ ﺣﺴﺐ ﻣﺎ ﻳﻨﺼﻪ ﻣﺠﻠﺲ‬
‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( داﺧﻞ ﺷﺒﻜﺔ اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪٪٢٠‬‬
‫ﻛﺤﺪ اﻋﻠﻰ ﺣﺘﻰ ‪ ٧٥‬رﻳﺎل‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج ﺷﺒﻜﺔ اﻟﺤﺪ‬
‫ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ٣٠٠‬رﻳﺎل‬
‫ﻳﻘﺪم اﻟﺒﺮﻧﺎﻣﺞ اﻟﻤﺎﺳﻲ أﻓﻀﻞ اﻟﺨﺪﻣﺎت واﻟﺨﻴﺎرات واﻟﻤﻤﻴﺰات‬
‫‪ -‬ﻣﺒﻠﻎ ا‰ﻗﺘﻄﺎع ‪/‬اﻟﺘﺤﻤﻞ ‪ /‬اﻟﻤﺸﺎرﻛﺔ )ﻋﻴﺎدات ﺧﺎرﺟﻴﺔ( ﻟﺒﺎﻗﻲ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﺧﺎرج ﺷﺒﻜﺔ‬
‫ﻟﺘﺘﻤﺎﺷﻰ ﻣﻊ ﻣﺘﻄﻠﺒﺎت ﻋﻤﻼﺋﻨﺎ اﻟﻜﺮام‪.‬‬
‫اﻟﺤﺪ ادﻧﻰ اﻟﻤﻮﺣﺪة ‪ ٪٢٠‬ﻛﺤﺪ أﻋﻠﻰ ﺣﺘﻰ ‪ ١٠٠‬رﻳﺎل‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻻﺳﻨﺎن ﺣﺘﻰ ‪ ١٠,٠٠٠‬رﻳﺎل ﺳﻌﻮدي ﻣﻊ اﻣﻜﺎﻧﻴﺔ اﺿﺎﻓﺔ ﺗﻘﻮﻳﻢ اﺳﻨﺎن واﻟﺘﺮﻛﻴﺒﺎت‬ ‫ﻋﺪة اﺧﺘﻴﺎرات ﻣﺘﺎﺣﺔ ﻟﻌﻤﻼﺋﻨﺎ ﺑﺪأ ﻣﻦ ﻗﺎﺋﻤﺔ اﻟﻤﺴﺘﺸﻔﻴﺎت وﻣﺮورا ً‬
‫ﺑﺈﺿﺎﻓﺔ ﺧﺪﻣﺎت ﺗﻐﻄﻴﺔ إﺿﺎﻓﻴﺔ ﻣﺜﻞ ﺟﺮاﺣﺔ اﻟﻠﻴﺰك‪ .‬اﻟﺒﺮﻧﺎﻣﺞ اﻟﻤﺎﺳﻲ‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ اﻟﻨﻈﺮ ﺣﺘﻰ ‪ ٢٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬ ‫ﻳﻘﺪم ﺣﺪود ﺗﻐﻄﻴﺔ أﻛﺜﺮ ﻣﻦ اﻟﺤﺪ اﻋﻠﻰ اﻟﻤﻄﻠﻮب ﻣﻦ ﻣﺠﻠﺲ‬
‫• ﺣﺪ ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ ﺣﺘﻰ ‪ ٣٠٠٠٠‬رﻳﺎل ﺳﻌﻮدي‬ ‫اﻟﻀﻤﺎن اﻟﺼﺤﻲ وﻳﺸﻤﻞ اﻟﻤﺰاﻳﺎ اﻟﺘﺎﻟﻴﺔ‪:‬‬
‫• ا‰ﺧﻼء ﻓﻲ ﺣﺎﻻت اﻟﻄﻮارئ واﻟﻌﻮدة إﻟﻰ اﻟﻮﻃﻦ ﻣﻦ ﺧﻼل ﺑﺮﻧﺎﻣﺞ ‪Assist America‬‬
‫• اﻟﺪﻓﻊ اﻟﻤﺒﺎﺷﺮ ﻟﻠﻤﺴﺘﺸﻔﻴﺎت ﺧﺎرج اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫• اﻟﻌﻼج ﻓﻲ ﺑﻠﺪ اﻟﻤﻨﺸﺄ‬
‫• اﺧﺘﻴﺎر إﺣﺪى اﻟﺸﺒﻜﺎت اﻟﺨﺎرﺟﻴﺔ‪:‬‬
‫‪ -‬دول اﻟﻌﺎﻟﻢ ‪ :١‬ﺷﺒﻜﺔ اﻟﺨﺪﻣﺔ اﻟﺨﺎرﺟﻴﺔ ﺗﺘﻀﻤﻦ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻣﺮﻳﻜﻴﺔ وأوروﺑﺎ وﺑﺎﻗﻲ‬
‫دول اﻟﻌﺎﻟﻢ‬
‫‪ -‬دول اﻟﻌﺎﻟﻢ‪ :٢‬ﺷﺒﻜﺔ اﻟﺨﺪﻣﺔ اﻟﺨﺎرﺟﻴﺔ ﻻ ﺗﺘﻀﻤﻦ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻣﺮﻳﻜﻴﺔ وأوروﺑﺎ‬
‫• إﻣﻜﺎﻧﻴﺔ إﺿﺎﻓﺔ ﺧﺪﻣﺔ اﻟﻌﻼج اﻟﺨﺎرﺟﻲ اﻟﺴﻴﺎﺣﻲ ﻛﺠﺰء ﻣﻦ اﻟﺘﻐﻄﻴﺔ اﻟﺨﺎرﺟﻴﺔ‬
‫• إﻣﻜﺎﻧﻴﺔ إﺿﺎﻓﺔ ﺗﻐﻄﻴﺔ ﻋﻼﺟﻴﺔ إﺿﺎﻓﻴﺔ ﻣﺜﻞ ﺟﺮاﺣﺔ اﻟﻠﻴﺰك واﻻﺿﻄﺮاب اﻟﺨﻠﻘﻲ‬

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‫ﺑﺮاﻣﺞ ﻋﻨﺎﻳﺔ‬

‫ﺗﻘﺪم ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﺑﺮاﻣﺞ ﻟﻠﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ واﻟﺘﻲ ﺗﺘﻤﺎﺷﻰ ﻣﻊ ﻣﺘﻄﻠﺒﺎت ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ وﺗﻠﺒﻲ ﺟﻤﻴﻊ اﺣﺘﻴﺎﺟﺎت‬
.‫اﻟﺴﻮق اﻟﺴﻌﻮدي‬
‫ﺗﺨﺘﻠﻒ ﺑﺮاﻣﺠﻨﺎ ﻣﻦ ﻧﺎﺣﻴﺔ ﺗﻐﻄﻴﺔ اﻟﺸﺒﻜﺎت داﺧﻠﻴﺎ و ﺧﺎرﺟﻴﺎ و ﻧﻮع اﻟﻐﺮف و ﻣﻤﻴﺰات اﻟﺘﻐﻄﻴﺔ ﻋﻦ ﻃﺮﻳﻖ اﻻﺧﺘﻴﺎرات اﻟﻤﻘﺪﻣﺔ ﻣﻦ‬
.‫ﻋﻤﻼﺋﻨﺎ ﻣﻊ اﻣﻜﺎﻧﻴﺔ ﺗﻘﺪﻳﻢ ﺗﻐﻄﻴﺔ اﺿﺎﻓﻴﺔ ﻣﺜﻞ ﺟﺮاﺣﺔ اﻟﻠﻴﺰك و اﻻﺿﻄﺮاب اﻟﺨﻠﻘﻲ‬
‫ﻧﻘﺪم ﻟﻠﺸﺮﻛﺎت اﻟﺘﻲ ﺗﻔﻀﻞ اﻟﺤﺼﻮل ﻋﻠﻰ وﺛﻴﻘﺔ ﺗﺄﻣﻴﻦ ﺻﺤﻲ ﺧﻴﺎرات ﻣﺮﻧﺔ ﻣﻊ ﺗﻘﺪﻳﻢ ﺗﻐﻄﻴﺔ ﻣﺨﺘﻠﻔﺔ ﻟﺠﻤﻴﻊ اﻟﻔﺌﺎت‬
.‫اﻟﻤﻄﻠﻮﺑﺔ ﺣﺴﺐ رﻏﺒﺔ اﻟﻌﻤﻴﻞ‬

Diamond Gold Silver Bronze Classic

Member Name Member Name Member Name Member Name Member Name
Company Name Company Name Company Name Company Name Company Name
Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000 Membership No.: 500000 Policy No.: 1000
ID No.: 1234567891 Class: VIP ID No.: 1234567891 Class: A ID No.: 1234567891 Class: B ID No.: 1234567891 Class: C ID No.: 1234567891 Class: CL
Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000 Age: 30 Pre-Approval Above: SR 1000
Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100 Gender: M Co-Pay OPD: 20% max up to SR 100
100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018 100 Expiry Date: 01/01/2018
Network: 1 Maternity: N Network: 3 Maternity: N Network: 5 Maternity: N Network: 7 Maternity: N Network: 9 Maternity: N

6
 ‫ﺗﻐﻄﻴﺔ اﻟﻨﻈﺎرات اﻟﻄﺒﻴﺔ‪:‬‬ ‫ﺗﻐﻄﻴﺔ اﻟﻤﺮاﻓﻖ‪:‬‬
‫وﺗﺸﻤﻞ اﻟﺘﻐﻄﻴﺔ‪ ،‬اﻟﻜﺸﻒ‪ ،‬واﺧﺘﺒﺎر اﻟﻨﻈﺮ‪ ،‬وﻋﻤﻞ اﻟﻨﻈﺎرة‬ ‫إذا ﻛﺎن ﻟﺪﻳﻚ ﻃﻔﻞ ﺗﺤﺖ ‪ ١٢‬ﺳﻨﺔ‪ ،‬ﻓﺴﺘﺘﺤﻤﻞ ﻋﻨﺎﻳﺔ‬
‫اﻟﻄﺒﻴﺔ ﺑﻤﺎ ﻓﻴﻬﺎ ا‰ﻃﺎر واﻟﻌﺪﺳﺎت اﻟﻄﺒﻴﺔ اﻟﻌﺎدﻳﺔ‪.‬‬ ‫اﻟﺴﻌﻮدﻳﺔ ﺗﻜﺎﻟﻴﻒ إﻗﺎﻣﺔ ﻣﺮاﻓﻖ ﻣﻊ اﻟﻄﻔﻞ أﺛﻨﺎء ﻓﺘﺮة‬
‫إﻗﺎﻣﺘﻪ ﻓﻲ اﻟﻤﺴﺘﺸﻔﻰ‪.‬‬

‫ﺗﻐﻄﻴﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة‪:‬‬

‫• ﺟﻤﻴﻊ اﻟﺨﺪﻣﺎت اﻟﺨﺎﺻﺔ ﺑﻤﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة‬
‫ﻟﻠﺴﻴﺪات اﻟﻤﺴﺘﺤﻘﺎت ﻟﻬﺬه اﻟﻤﻨﻔﻌﺔ‪ ،‬وﻳﺘﻀﻤﻦ ذﻟﻚ‬
‫ﺗﻜﺎﻟﻴﻒ اﻟﺤﻤﻞ‪ ،‬واﻟﻮﻻدة اﻟﻄﺒﻴﻌﻴﺔ‪ ،‬واﻟﻘﻴﺼﺮﻳﺔ‪،‬‬
‫واﻟﻤﻀﺎﻋﻔﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺤﻤﻞ واﻟﻮﻻدة ﺑﻤﺎ ﻓﻴﻬﺎ‬
‫ا‰ﺟﻬﺎض اﻟﻘﺎﻧﻮﻧﻲ )ﻳﺮﺟﻰ ﻣﺮاﺟﻌﺔ ﺟﺪول اﻟﻤﻨﺎﻓﻊ اﻟﻤﺮﻓﻖ(‪.‬‬

‫• ﻛﻤﺎ ﻳﺘﻢ ﺗﻐﻄﻴﺔ ﺗﻜﺎﻟﻴﻒ ﺛﻘﺐ اذن ﻟﺤﺪﻳﺜﻲ اﻟﻮﻻدة ﻣﻦ‬

‫اﻟﺒﻨﺎت وﻋﻤﻠﻴﺔ اﻟﺨﺘﺎن ﻟ‪Ï‬وﻻد‪.‬‬

‫• وﺗﻈﻬﺮ ﺗﻐﻄﻴﺔ ﻣﺘﺎﺑﻌﺔ اﻟﺤﻤﻞ واﻟﻮﻻدة ﻋﻠﻰ ﺑﻄﺎﻗﺔ‬

‫اﻟﻌﻀﻮﻳﺔ ﻣﻊ ﻋﻼﻣﺔ ﺗﺸﻴﺮ إﻟﻰ ﺗﻐﻄﻴﺘﻬﺎ )‪ (Y‬ﺗﻌﻨﻲ أن ﻣﺘﺎﺑﻌﺔ‬
‫اﻟﺤﻤﻞ واﻟﻮﻻدة ﻣﻐﻄﺎة‪ ،‬و)‪ (N‬ﺗﻌﻨﻲ أﻧﻬﺎ ﻏﻴﺮ ﻣﻐﻄﺎة‪.‬‬

‫ﺗﻐﻄﻴﺔ اﺳﻨﺎن‪:‬‬
‫وﺗﺸﻤﻞ اﻟﻜﺸﻒ‪ ،‬واﺷﻌﺔ اﻟﺴﻴﻨﻴﺔ‪ ،‬واﻟﺨﻠﻊ اﻟﻌﺎدي‬
‫واﻟﺠﺮاﺣﻲ‪ ،‬وﻋﻼج اﻟﺠﺬور‪ ،‬واﻟﺤﺸﻮ اﻟﻤﻌﺪﻧﻲ اﻟﺒﺴﻴﻂ‬
‫واﻟﻤﺮﻛﺐ‪ ،‬وﻋﻼج اﻟﻠﺜﺔ اﻟﺒﺴﻴﻂ‪ ،‬وادوﻳﺔ اﻟﻤﻮﺻﻮﻓﺔ و‬
‫ﺗﻨﻈﻴﻒ اﺳﻨﺎن ﻣﺮة واﺣﺪة ﺧﻼل اﻟﺴﻨﺔ اﻟﺘﻌﺎﻗﺪﻳﺔ‪.‬‬
 ‫ﻋﻼج اﻟﺤﺎﻻت اﻟﻄﺎرﺋﺔ‪:‬‬
‫اﻟﺘﻤﺘﻊ ﺑﺘﻐﻄﻴﺔ ﺗﺼﻞ إﻟﻰ ‪ ٪ ١٠٠‬ﻣﻦ اﻟﺤﺪ اﻟﺴﻨﻮي اﻟﻤﺨﺼﺺ‬
‫ﻟﻚ ﻟﺨﺪﻣﺎت ﺗﻐﻄﻴﺔ اﻟﻄﻮارئ اﻟﻤﺘﺎﺣﺔ ﺧﺎرج اﻟﺸﺒﻜﺔ‪ ،‬ﻣﻊ‬
‫ﻣﺮاﻋﺎة اﻟﺘﻐﻄﻴﺔ ا‰ﻗﻠﻴﻤﻴﺔ ﺑﺤﺴﺐ ﻣﺎ ﻫﻮ ﻣﻮﺿﺢ ﻓﻲ‬
‫اﻟﺠﺪول اﻟﻤﺮﻓﻖ اﻟﺨﺎص ﺑﺎﻟﻤﻨﺎﻓﻊ‪.‬‬
‫اﻟﺪﻓﻊ اﻟﻤﺒﺎﺷﺮ‪:‬‬
‫ﻣﻴﺰة ﻋﺪم اﻟﺴﺪاد اﻟﻤﻤﻨﻮﺣﺔ ﻟﻠﺸﺨﺺ اﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ ﻓﻲ‬
‫ﻣﻜﺎن ﻣﻘﺪم اﻟﺨﺪﻣﺔ اﻟﻤﺤﺪد ﻣﻦ ﻗﺒﻞ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫ﺣﻴﺚ ﻳﺘﻢ ﺗﺤﻤﻴﻞ اﻟﻨﻔﻘﺎت ﻛﻠﻬﺎ ﻋﻠﻰ ﻓﺎﺗﻮرة ﻋﻨﺎﻳﺔ‬
‫اﻟﺴﻌﻮدﻳﺔ‪.‬‬

‫اﻟﻌﻼج ﻓﻲ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ‪:‬‬ ‫اﻟﺸﺒﻜﺔ‪:‬‬

‫ﺗﻐﻄﻲ ﺟﻤﻴﻊ إﺟﺮاءات اﻟﻌﻼج اﻟﻤﺴﺘﺤﻘﺔ ﻓﻲ اﻟﻌﻴﺎدات‬
‫اﻟﺨﺎرﺟﻴﺔ ﻣﺎﻋﺪا ﺗﻠﻚ اﻟﻤﺬﻛﻮرة ﻓﻲ ﻗﺎﺋﻤﺔ اﻻﺳﺘﺜﻨﺎءات‪.‬‬
‫ﻧﺴﺒﺔ اﻟﻤﺸﺎرﻛﺔ اﻟﺘﺄﻣﻴﻨﻴﺔ‪:‬‬
‫ﺗﺤﺪﻳﺪ اﻟﻘﻴﻤﺔ اﻟﻤﻄﻠﻮب ﺳﺪادﻫﺎ ﻟﻤﻘﺪم اﻟﺨﺪﻣﺔ ﻋﻨﺪ ﺗﻠﻘﻲ‬
‫اﻟﻌﻼج ﻓﻲ اﻟﻌﻴﺎدات اﻟﺨﺎرﺟﻴﺔ أو ﻳﺘﻢ ﺗﻮﺿﻴﺢ ﻫﺬه اﻟﻘﻴﻤﺔ‬
‫ﻋﻠﻰ ﺑﻄﺎﻗﺔ اﻟﻌﻀﻮﻳﺔ ﺑﻨﺴﺒﺔ ﻣﺌﻮﻳﺔ ﻣﻦ ﺗﻜﻠﻔﺔ اﻟﻌﻼج‪،‬‬
‫وﻟﻜﻨﻬﺎ ﻣﻘﻴﺪة ﺑﺄﻻ ﺗﺰﻳﺪ اﻟﻘﻴﻤﺔ ﻋﻦ ‪ ١٠٠‬رﻳﺎل ﺳﻌﻮدي‪.‬‬
‫ﻛﻞ اﻃﺒﺎء اوﻟﻴﻴﻦ واﺧﺼﺎﺋﻴﻴﻦ أو اﻟﻤﺴﺘﺸﻔﻴﺎت أو‬
‫ﻣﻘﺪﻣﻲ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﺬﻳﻦ ﻳﺸﺎرﻛﻮن ﻓﻲ ﺧﻄﺔ‬
‫اﻟﺘﺄﻣﻴﻦ ﻟﺘﻘﺪﻳﻢ اﻟﺮﻋﺎﻳﺔ اﻟﻄﺒﻴﺔ‪ .‬وﺗﻮﺟﺪ ﻗﺎﺋﻤﺔ‬
‫ﺑﺎﻟﻤﺴﺘﺸﻔﻴﺎت واﻟﻌﻴﺎدات ﻣﺮﻓﻘﺔ ﺑﻬﺬا اﻟﺪﻟﻴﻞ وﻫﻲ ﻋﺒﺎرة‬
‫ﻋﻦ ﺷﺒﻜﺔ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ‪.‬‬
‫اﻟﺤﺎﻟﺔ اﻟﻤﺰﻣﻨﺔ‪:‬‬
‫ﺣﺎﻟﺔ ﻃﺒﻴﺔ أو وﺿﻊ ﻣﺮﺿﻲ ﻳﺪوم ﻟﻔﺘﺮة ﻃﻮﻳﻠﺔ‪.‬‬

‫اﻟﻌﻼج ﻓﻲ اﻟﻌﻴﺎدات اﻟﺪاﺧﻠﻴﺔ‪:‬‬ ‫اﻣﺮاض اﻟﺴﺎﺑﻘﺔ واﻣﺮاض اﻟﻤﺰﻣﻨﺔ‪:‬‬

‫ﺗﻐﻄﻲ ﺟﻤﻴﻊ إﺟﺮاءات اﻟﻌﻼج اﻟﻤﺴﺘﺤﻘﺔ ﻓﻲ اﻟﻌﻴﺎدات‬ ‫ﻳﺘﻢ ﺗﻐﻄﻴﺔ ﺟﻤﻴﻊ ﻫﺬه اﻣﺮاض‪ ،‬ﻓﻴﻤﺎ ﻋﺪا ﺗﻠﻚ اﻟﻤﺪرﺟﺔ‬
‫اﻟﺪاﺧﻠﻴﺔ ﻏﻴﺮ ﺗﻠﻚ اﻟﻤﺬﻛﻮرة ﻓﻲ ﻗﺎﺋﻤﺔ اﻻﺳﺘﺜﻨﺎءات‪.‬‬ ‫ﻓﻲ ﻗﺎﺋﻤﺔ اﻻﺳﺘﺜﻨﺎءات‪.‬‬

‫ﻧﻮع اﻟﻐﺮﻓﺔ‪:‬‬ ‫اﻟﺘﻘﺮﻳﺮ اﻟﻄﺒﻲ‪:‬‬

‫ﻳﺘﻢ ﺗﺤﺪﻳﺪ اﻟﻐﺮﻓﺔ ﻋﻠﻰ ﺑﻄﺎﻗﺔ اﻟﻌﻀﻮﻳﺔ‪ :‬إﻣﺎ ﺟﻨﺎح ﻋﺎدي‪ ،‬أو‬ ‫ﻫﻮ ﻋﺒﺎرة ﻋﻦ ﻣﺴﺘﻨﺪ ﻳﻘﻮم ﺑﺘﻌﺒﺌﺘﻪ اﻟﻄﺒﻴﺐ‪ ،‬ﻳﺸﺮح ﻓﻴﻪ‬
‫ﻏﺮﻓﺔ ﺧﺎﺻﺔ‪ ،‬أو ﻏﺮﻓﺔ ﺷﺒﻪ ﺧﺎﺻﺔ‪ ،‬أو ﻏﺮﻓﺔ ﻣﺸﺘﺮﻛﺔ‬ ‫اﻋﺮاض واﻟﺘﺸﺨﻴﺺ واﻟﻌﻼج اﻟﻤﻮﺻﻮف‪.‬‬
‫ﺑﺤﺴﺐ ﻣﺴﺘﻮى اﻟﺘﻐﻄﻴﺔ اﻟﺬي ﻳﻨﻄﺒﻖ ﻋﻠﻴﻚ‪.‬‬
‫اﻟﻄﻮارئ‪:‬‬
‫اﻟﻌﻼج اﻟﻄﺒﻲ اﻟﻤﻄﻠﻮب ﺣﺪ اﺷﺨﺎص اﻟﻤﺆﻣﻦ ﻋﻠﻴﻬﻢ‬
‫ﻧﺘﻴﺠﺔ ﻟﺤﺎدﺛﺔ أو ﺣﺎﻟﺔ ﺗﺴﺘﻠﺰم اﻟﺮﻋﺎﻳﺔ اﻟﻄﺒﻴﺔ اﻟﻔﻮرﻳﺔ‪.‬‬
‫ﻗﺎﺋﻤﺔ اﻟﻤﺼﻄﻠﺤﺎت‬
‫وﻋﻼوة ﻋﻠﻰ ذﻟﻚ‪ ،‬ﻳﻌﻨﻲ أﻻ ﻳﺨﺘﻠﻒ اﻟﻌﻼج اﻟﻄﺒﻲ ﺑﺸﻜﻞ ﻛﺒﻴﺮ‬ ‫اﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‪ /‬اﻟﻌﻀﻮ‪:‬‬
‫ﻣﻤﺎ ﻳﻌﺘﺒﺮه اﻃﺒﺎء اﻟﻤﺮﺧﺼﻮن ﻣﻌﻘﻮ ًﻻ ﻟﻴﻜﻮن اﻟﻤﻌﺘﺎد‬
‫اﻟﺸﺨﺺ )اﻟﻤﻮﻇﻒ أو ﻣﻦ ﻳﻌﻮل( اﻟﺬي ﺗﺸﻤﻠﻪ ﺧﻄﺔ‬
‫واﻟﻤﻘﺒﻮل ي ﺧﺪﻣﺔ ﺑﻌﻴﻨﻬﺎ‪.‬‬
‫اﻟﺘﺄﻣﻴﻦ‪.‬‬
‫اﻟﻤﻨﺎﻓﻊ‪:‬‬
‫رﻗﻢ اﻟﻌﻀﻮﻳﺔ‪:‬‬
‫ﺗﻌﻨﻲ ﻧﻔﻘﺎت ﺗﻮﻓﻴﺮ اﻟﺨﺪﻣﺔ اﻟﺼﺤﻴﺔ اﻟﺘﻲ ﺗﺸﻤﻠﻬﺎ اﻟﺘﻐﻄﻴﺔ‬
‫ﻫﻮ ﻋﺒﺎرة ﻋﻦ رﻗﻢ ﺧﺎص ﻳﺘﻢ ﻣﻨﺤﻪ ﻟﻜﻞ ﻋﻀﻮ ﻣﺆﻣﻦ‬
‫اﻟﺘﺄﻣﻴﻨﻴﺔ ﺿﻤﻦ اﻟﺤﺪود اﻟﻤﺒﻴﻨﺔ ﻓﻲ ﺟﺪول اﻟﻮﺛﻴﻘﺔ‪.‬‬
‫ﻋﻠﻴﻪ ﻓﻲ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻟﻠﺘﻌﺮﻳﻒ‪.‬‬
‫ﻣﻨﺎﻓﻊ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﻘﺪﻣﺔ‪:‬‬
‫اﻟﻤﺆﻣﻦ ﻟﻪ‪:‬‬
‫ﱢ‬
‫ﺗﻮﻓﺮ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ اﻟﻤﻨﺎﻓﻊ ا‰ﻟﺰاﻣﻴﺔ اﻟﺘﻲ ﺣﺪدﺗﻬﺎ اﻟﻘﻮاﻋﺪ‬
‫ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻟﻠﺘﺄﻣﻴﻦ اﻟﺘﻌﺎوﻧﻲ‪.‬‬
‫اﻟﺘﻨﻈﻴﻤﻴﺔ ﻟﻤﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ ﺑﺎ‰ﺿﺎﻓﺔ إﻟﻰ ﻣﺰاﻳﺎ‬
‫إﺿﺎﻓﻴﺔ ﺣﺴﺐ ﺟﺪول اﻟﻤﻨﺎﻓﻊ اﻟﺨﺎص ﺑﻌﻀﻮﻳﺘﻚ‪.‬‬ ‫ﺻﺎﺣﺐ اﻟﻮﺛﻴﻘﺔ اﻟﺘﺄﻣﻴﻨﻴﺔ‪:‬‬
‫ﺟﻬﺔ اﻟﺘﻮﻇﻴﻒ أو اﻟﺸﺨﺺ اﻟﺬي ﺗﺼﺪر ﺑﺎﺳﻤﻪ اﻟﻮﺛﻴﻘﺔ‪.‬‬
‫ﺟﺪول اﻟﻤﻨﺎﻓﻊ‪:‬‬
‫)ﻣﺜﻞ اﻟﺸﺮﻛﺔ اﻟﻤﻨﺘﻤﻲ إﻟﻴﻬﺎ)‪.‬‬
‫اﻟﺠﺪول اﻟﻤﺮﻓﻖ اﻟﺬي ﻳﺤﺘﻮي ﻋﻠﻰ ﻛﻞ اﻟﻤﻨﺎﻓﻊ اﻟﻤﻨﻄﺒﻘﺔ‬
‫ﻋﻠﻰ ﺧﻄﺘﻚ واﻟﺬي ﻳﻌﺮض اﻟﺤﺪ اﻗﺼﻰ ﻟﻠﻤﺰاﻳﺎ اﻟﺘﻲ ﻧﺘﺤﻤﻞ‬ ‫ﻣﺠﻠﺲ اﻟﻀﻤﺎن اﻟﺼﺤﻲ اﻟﺘﻌﺎوﻧﻲ‪:‬‬
‫ﻧﻔﻘﺎﺗﻬﺎ ﻟﻜﻞ ﻋﻀﻮ‪.‬‬ ‫ﻣﻨﻈﻢ اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‪.‬‬
‫اﻟﺘﻐﻄﻴﺔ‪:‬‬ ‫ﻣﻘﺪم اﻟﺨﺪﻣﺔ‪:‬‬
‫اﻟﻘﻴﻤﺔ وﻣﺪى اﻟﻤﺨﺎﻃﺮة اﻟﺘﻲ ﺗﺘﺤﻤﻠﻬﺎ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‪.‬‬ ‫ﻳﻌﻨﻲ اﻟﻄﺒﻴﺐ‪ ،‬أو اﻟﻤﺴﺘﺸﻔﻰ أو اﻟﻤﺠﻤﻮﻋﺔ اﻟﻤﻤﺎرﺳﺔ أو‬
‫اﻟﺘﻤﺮﻳﺾ اﻟﻤﻨﺰﻟﻲ أو اﻟﺼﻴﺪﻟﻴﺔ أو أﻳﺔ ﻣﻨﺸﺄة أو ﻓﺮد أو‬
‫اﻻﺳﺘﺜﻨﺎءات اﻟﻘﻴﺎﺳﻴﺔ‪:‬‬
‫ﻣﺠﻤﻮﻋﺔ أﻓﺮاد ﺗﻘﺪم ﺧﺪﻣﺔ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪.‬‬
‫اﻟﻤﻨﺎﻓﻊ اﻟﺼﺤﻴﺔ واﻟﺨﺪﻣﺎت اﻟﻤﺴﺘﺒﻌﺪة ﻣﻦ اﻟﺘﻐﻄﻴﺔ‪.‬‬
‫اﺳﻌﺎر اﻟﺴﺎﺋﺪة واﻟﻤﺘﻌﺎرف ﻋﻠﻴﻬﺎ‪:‬‬
‫اﻟﻤﻄﺎﻟﺒﺔ‪:‬‬
‫ﻳﻌﻨﻲ اﻟﻨﻔﻘﺎت اﻟﻄﺒﻴﺔ اﻟﺘﻲ ﺗﺘﻔﻖ ﻣﻊ ﻣﺴﺘﻮى اﻟﺮﺳﻮم‬
‫ﻫﻲ ﻃﺮﻳﻘﺔ ﻟﺘﻌﻮﻳﺾ اﻟﻨﻔﻘﺎت اﻟﺘﻲ ﻳﻘﻮم اﻟﻤﺆﻣﻦ ﻋﻠﻴﻪ‬
‫اﻟﻤﺤﺪدة ﻣﻦ ﻗﺒﻞ ﻏﺎﻟﺒﻴﺔ اﻃﺒﺎء اﻟﻤﺮﺧﺼﻴﻦ أو‬
‫ﺑﺴﺪادﻫﺎ ﻟﻤﻘﺪم اﻟﺨﺪﻣﺔ‪.‬‬
‫اﻟﻤﺴﺘﺸﻔﻴﺎت ﻓﻲ ﺷﺒﻜﺔ اﻟﻌﻀﻮ ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ‬
‫اﻟﺴﻌﻮدﻳﺔ‪.‬‬

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 ‫وﻟﻤﺰﻳﺪ ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت ﻳُﺮﺟﻰ اﻻﺗﺼﺎل ﺑﻨﺎ ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ أدﻧﺎه‪:‬‬
‫ﻫﺎﺗﻒ ﻣﻦ داﺧﻞ اﻟﺴﻌﻮدﻳﺔ ‪ - ٨٠٠ ٣٠ ١٠٠ ٣٠‬ﻣﻦ ﺧﺎرج اﻟﺴﻌﻮدﻳﺔ ‪+ ٩٦٦ ٩٢ ٠٠٠ ٤١ ٢٢‬‬
‫‪@saudi_enaya‬‬ ‫‪sa.enaya‬‬ ‫‪saudi.enaya‬‬ ‫‪www.saudienaya.com‬‬
‫اﻟﻌﻨﻮان ﺣﻲ اﻟﺮوﺿﺔ – ﺷﺎرع اﻣﻴﺮ ﺳﻠﻄﺎن – ﻣﺒﻨﻰ ﺷﺮﻛﺔ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫اﻟﻌﻨﻮان اﻟﻮﻃﻨﻲ‪ ٣٥٢٨٨٤٣٣ :‬وﺣﺪة ‪ – ١‬ﺟﺪه – اﻟﺮﻣﺰ اﻟﺒﺮﻳﺪي ‪ ٢٣٤٣٥‬اﻟﺮﻣﺰ ا‰ﺿﺎﻓﻲ ‪٢٠٨٣‬‬
‫ﻣﻼﺣﻈﺔ‪ :‬اﻟﺮﺟﺎء اﻻﺣﺘﻔﺎظ ﺑﻤﻌﻠﻮﻣﺎت اﺗﺼﺎل ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻋﻠﻰ ﻫﺎﺗﻔﻚ اﻟﻤﺤﻤﻮل‪ ،‬ﻟﻠﺤﺼﻮل ﻋﻠﻰ اﻟﻤﺴﺎﻋﺪة اﻟﻔﻮرﻳﺔ‪.‬‬
 ‫أﻫ ً‬
‫ﻼ ﺑﻜﻢ أﻋﻀﺎء ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ‬
‫إﻧﻪ ﻟﻤﻦ دواﻋﻲ ﺳﺮورﻧﺎ أن ﺗﻨﻀﻢ إﻟﻰ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ وﻧﺘﺸﺮف ﺑﺎﺧﺘﻴﺎرك ﻟﻌﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ ﻛﺸﺮﻳﻚ ﻟﻚ ﻓﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ‪،‬‬
‫ﻫﺪﻓﻨﺎ ﻫﻮ أن ﻧﻘﺪم ﻟﻚ أﻓﻀﻞ اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﺗﻠﺒﻲ اﺣﺘﻴﺎﺟﺎﺗﻚ‪.‬‬
‫وﻧﺪﻋﻮك ﻟﻘﺮاءة دﻟﻴﻞ اﻟﻌﻀﻮﻳﺔ ﺑﻌﻨﺎﻳﺔ واﻟﺬي ﻳﺤﺘﻮي ﻋﻠﻰ ﻛﺎﻓﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﻣﻦ ﺷﺄﻧﻬﺎ أن ﺗﺴﺎﻋﺪك ﻟﻤﻌﺮﻓﻪ أﻓﻀﻞ ﻣﻤﻴﺰات‬
‫ﻋﻀﻮﻳﺘﻚ‪ ،‬ﺣﻴﺚ ﻳﻮﻓﺮ اﻟﻤﻌﻠﻮﻣﺎت اﺳﺎﺳﻴﺔ وﻓﻮاﺋﺪ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﺨﺎﺻﺔ ﺑﻚ‪.‬‬
‫وﻫﺬا اﻟﺪﻟﻴﻞ ﻳﺴﺎﻋﺪك ﻋﻠﻰ اﻻﺳﺘﻔﺎدة ﻣﻦ ﺟﻤﻴﻊ اﻟﺨﺪﻣﺎت اﻟﻤﻘﺪﻣﺔ ﻣﻦ ﻋﻨﺎﻳﺔ اﻟﺴﻌﻮدﻳﺔ وﻣﻌﺮﻓﺔ ﺟﻤﻴﻊ ﻣﻤﻴﺰات اﻟﺘﻐﻄﻴﺔ‬
‫اﻟﺨﺎﺻﺔ ﺑﻚ‪.‬‬
 ‫دﻟﻴـﻞ اﻋـﻀـﺎء‬

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