Individual Health

Individual health insurance refers to coverage that individuals purchase independently, rather than through an employer or government program, providing personalized health benefits tailored to their needs.

It helps cover medical costs like doctor visits, hospital stays, Investigations and medicines, in exchange for a timely payment called a premium.

Takaful Oman offers ethical and Shariah-compliant health solutions with competitive pricing, flexible plans, wide hospital networks, and a seamless digital experience.

·       Adults: 18 to 65 years

·       Dependent children: 3 months to 25 years

The policy is issued on an annual basis (1 year) and is renewable subject to terms and conditions.

Yes. You do need a personal health insurance plan as your employee health insurance covers medical expenses only till the time your employment in valid in the organization the moment you leave the job your policy term ends. Looking at the medical inflation it is important to have a personal health insurance plan, which you choose as per your medical needs unlike a corporate health plan which is commonly designed for all employees.

Health insurance covers wide-ranging medical expenses like the cost of medicines, doctor's consultations, Diagnostic investigations, surgery, room rent, Physiotherapy, ambulance charges and more.

Yes. The policy offers coverage that goes beyond Oman, so protection can travel with you. Coverage includes Sultanate of Oman under Direct Billing and Reimbursement.

Any treatment Outside Oman in Gulf Region, Southeast Asia (SEA) & Thailand, the Indian Sub-Continent, and the Home Country under the reimbursement basis, subject to policy terms and conditions.

Kindly note reasonable and customary charges applicable for any treatment under reimbursement basis within and outside the Oman as per the eligible network and coverage. 

The policy provides access to an extensive hospital network in Oman as per the plan opted:

•        Gold Network: Kindly refer to the Our Provider Network link for the full list of covered hospitals.
•        Silver Premium Network: Kindly refer to the Our Provider Network link for the full list of covered hospitals.

For treatments at non-network providers, expenses must be paid upfront by the member. These costs can then be reimbursed after submitting the required documents, subject to policy limits and eligibility.

Reimbursement claims will be processed subject to reasonable and customary charges applied as per the eligible network.

You can submit the reimbursement claim 100% digitally through Mobile App by our TPA partner ‘HalthPassby MedNet’ and Website ‘www.mednet-global.com’ OR

You can find the reimbursement claim form in the Downloads section of our website. Please click here to get a copy now! 

Yes, emergency ambulance services are covered costs for emergency transportation to the hospital up to OMR 100, subject to policy terms.

·       Initial waiting period: Typically, 30 days-claims for non-accidental illnesses are not covered during this short span.

·       Pre-existing and chronic conditions waiting period: 12 months

·       Specific diseases or procedures waiting period (Ex: Cataract, Hernia, Kidney Stone, Tonsilitis):  12 months

·       Maternity benefits waiting period: 12 months

·       Joint replacement and Vertebral Column Disorder / DNS: 24 months

You can obtain medical insurance online by visiting www.takafuloman.om or by visiting any of our sales outlets.

A pre-existing disease is a condition, ailment or injury that already exists at the time you buy a health insurance policy and these PEDs are generally excluded from the policy coverage for an initial waiting period. It could be diabetes, hypertension, thyroid, asthma etc

Yes, you may have to undergo medical tests before buying a health insurance. Also, some health insurance policies ask for it only if you have a pre-existing illness based on UW discretion or you are above 55 years old.

To put it simply, these are the medical conditions and/or services which are not covered by your healthcare plan. These may vary according to the type of product aligned with UHIP regulations. So, before buying a plan or filing a claim, please refer to your policy’s Table of Benefits and Exclusions.

Please check Takaful Oman Individual Health exclusions list relevant to your plan.

The ‘co-pay’ or ‘Co-Insurance’ refers to the share of a medical bill you’ll cover, with the remaining handled by us. It could be a percentage of the bill or a fixed amount you’re liable to pay for each bill you incur. It’s already part of all the limits prescribed by your policy.

To put it simply, it is the cost of a medical service we have agreed to with our network providers in a particular geographical area. More so, it is the maximum they will charge us for a particular service. This serves as the basis for settlement of your claim.

We understand that non-network prices could be quite high, thereby adversely impacting the policy’s renewal premium. So, when you avail a service from someone outside your plan’s network, we use the Reasonable and Customary charge to process your claims and not the actual out-of-pocket expenses you incur (unless your policy states otherwise).