Emerald

New generation cover for those who need affordable in-hospital and day-to-day benefits. The member makes a basic monthly contribution plus a predetermined optional monthly allocation amount (MAA). The MAA is deposited into the member’s individual savings account, called the Accumulation Fund (AF). All in-hospital and related expenses are paid out of the Fund’s pool, which consists of all the individual members’ basic contributions. All recognised day-to-day expenses are paid from the member’s Accumulation Fund. The principle of the New Generation Option is completely different to that of the Traditional Options. The member takes an active role in the management of a portion of his/her medical expenses. He/she has access to funds in his/her personal medical savings account called the Accumulation Fund (“AF”) for day-to-day expenses. This offers protection against possible abuse of the Fund and of the accumulation funds.

Key Benefits

Hospital: Major Medical Expenses
AHB Cover: GP & Specialist in-hospital services payable to a maximum of 225% of NAMAF Tariff

Benefit Cover
Accommodation – private wards 100%
Accommodation – other than recognised hospital 100% of cost
MRI & CAT Scans 100%
Internal Appliances & Materials 100% of cost
Oncology – Active Therapy (Surgery, Chemotherapy and Radiotherapy) 100%
Organ Transplant 100%
Refractive Surgery 100%
Maternity - Confinement – Full Procedure
  • 12 Ante-natal Consultations
  • 2 Sonars per Beneficiary per pregnancy
100%

Optional Cover: Member Selection
AHB Cover: GP & Specialist in-hospital services payable to a maximum of 225% of NAMAF Tariff

General Practitioners 100% of cost of Accumulation Fund
Dentistry 100% of cost of Accumulation Fund
Medicine & Injections 100% of cost of Accumulation Fund
Optical 100% of cost of Accumulation Fund
Primary Health Care Services 100% of cost of Accumulation Fund
Auxiliary Services 100% of cost of Accumulation Fund
Specified Illness Conditions 100% of cost of Accumulation Fund

Contribution Cover
Emerald Group Contributions Applicable Major Medical Expenses - Hospitalisation
Member determines contribution to the accumulation fund Day-to-Day expenses - Member in control of utilisation of Day-to-Day Expenses payable from Accumulation Fund

Contributions

Individuals
Age Band Main Adult Child
0 25 769 487 192
26 30 856 547 192
31 35 944 610 192
36 40 1067 689 196
41 45 1169 765 196
46 50 1263 833 196
51 55 1380 919 196
56 60 1478 989 196
61 65 1575 1060 196
66+ 1680 1129 196
Individuals
Age Band Main Adult Child
0 25 769 487 180
26 30 856 547 180
31 35 909 560 180
36 40 979 598 183
41 45 1048 658 183
46 50 1138 723 183
51 55 1175 755 183
56 60 1243 809 183
61 65 1348 879 183
66+ 1380 901 183