Group Medical Plans

MetLife is a provider of innovative health solutions and with our diverse product portfolio and decades of experience we can tailor-make group medical packages that will suit your company's needs whether it’s a small business, a medium sized company or a multinational corporation. We aim to provide comprehensive cover and an efficient claims servicing that will be of value when your employees need it the most.

With MetLife, you can create Basic Plan packages that offer the following types of benefits to your employees:

In-Patient Benefits

  1. Hospitalization Benefits: Daily Benefits (Room & Board)
  2. Hospital Special Services
  3. Emergency Accident and Hospital Out-patient Benefits
  4. Intensive Care Benefits
  5. Ambulance Transportation
  6. Surgical Benefits
  7. Doctor’s In-patient Visits
  8. Maternity Benefits (if inclusion of Maternity is market practice)
  9. Diagnostic x-ray and Laboratory Expense Benefits

Out-Patient Benefits

  1. Clinical  Examination
  2. Investigation services
  3. Medicine & Treatment
  4. Follow – Ups
  5. Minor surgeries and day care
  6. Doctor visit for out-patient, (General Practioner, Specialist,Consultant)
  7. Maternity Benefits
  8. Vaccination

Additional Benefits

  1. Routine Dental Benefit and Comprehensive Dental Services
  2. Routine Optical Benefit
  3. In-Patient and  Out–patient Psychiatric Treatment
  4. Medical Evaluation Benefit
  5. Executive Medical check –ups
  6. Maternity / Obstetrical

To MetLife’s basic plan, employers can choose to add the following additional benefits

  1. Major Medical and Comprehensive Plans : Comprehensive or Major Medical Insurance is intended to ease the burden of the large expenses that can arise from serious illnesses (both sickness and injury) of a non-occupational nature that may afflict an employee or his dependants.
  2. Hospital Cash : A simple plan wherein a daily expense reimbursement is made for eligible expenses incurred during valid hospital stay
  3. Dental Product : This plan can be customised to cover a specified list of services that are classified with different plans and coverages                 
  4. Optical 
  5. Psychiatry 
  6. Maternity plan 

MetLife can create wide ranging customised packages with different plans offering access to different types of provider networks, and facilities within these networks. As an employer, you can choose one or more plans for your organisation.

With each of the packages you select, we provide the MetLife Alico service promise which covers:

  • A clear explanation of policy terms and a pledge to adjudicate claims fairly.
  • Employee handbooks, orientation presentations and continuous education programs
  • Access to the widest network of hospitals, clinics and doctors in Jordan
  • Prompt and efficient payment of claims to employees and providers
  • Competitive pricing, to ensure risk and premium are properly co-related
  • Profit-share arrangements on large accounts through multi-national / regional pooling solutions
  • Managed care focused on providing the best available care at the most reasonable prices, using the latest technology
  • Case Management for large cases

 

Product Details

Eligibility
All full-time permanent employees actively at work in the policyholder’s offices in the country of coverage

Participation Requirements
The Group Medical Plan is designed to cover employers with a minimum of 10 employees. Dependants are eligible for coverage under the comprehensive major medical only. All eligible employees must be enrolled.

Payment Modes
Flexible payment modes are available ranging from quarterly to annual..

Claims
Through MetLife Alico Preferred Providers Organization Network (PPO), your employees and their eligible dependents will enjoy high levels of services, together with efficient claims settlement that will minimize cash outlay. All they need to do is to present their medical insurance card at any of our MetLife PPO Network premises, pay the deductible/co-insurance amount and MetLife will take care of the rest.

 

 

MetLife group insurance policies contain certain exclusions, reductions, limitations and terms for keeping them in force. Contact your MetLife representative for more information.

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