What is Health Takaful Insurance?

Health takaful insurance is a financial safety net that covers medical expenses arising from illness, injury, or preventive care. By paying a regular premium, individuals or groups gain access to healthcare services without bearing the full cost out of pocket.

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Your Health, We Care

At Takaful Oman, we recognize that every person's health journey is unique. Our Health Takaful Insurance products are designed to provide comprehensive healthcare solutions tailored to your needs, ensuring you have access to quality medical care whenever you need it.

Our medical plans are crafted to provide you and your loved ones with true peace of mind, reliable financial protection, and access to essential care when it matters the most, all while offering the most affordable health insurance in Oman.

Have you heard of Individual Health Insurance?

Individual health insurance provides medical coverage for a single person or a family altogether, ensuring access to quality healthcare without the burden of high medical costs. It is designed to safeguard your health and financial well-being by providing hospitalization, treatments, and preventive care.

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Why Takaful Oman ?

At Takaful Oman, we prioritize your personal wellbeing and choice as needs vary by individual circumstances; we offer two most attractive health plans in Oman (Gold and Silver) each designed to offer the right balance of coverage and affordability.

Also, unlike conventional insurance, our Takaful model operates on Shariah compliant insurance solutions which are built on ethical principles.

Explore our offerings in detail  to discover how we can contribute to your overall well-being and protect what matters most your health.

Invest Today, Safeguard Tomorrow !

Benefits of buying Takaful Individual Health Insurance Policy

  • Geographic flexibility with coverage beyond Oman's borders
  • Financial protection against high medical costs
  • Access to quality healthcare through a wide hospital network

Support during emergencies with cashless hospitalization options

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What to Consider While Buying an Individual Medical Policy

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Assess your personal health needs

Consider your age, lifestyle, and any existing health conditions. Think about potential future needs such as maternity, dental, or optical care. These factors help the insurer customize a plan that suits you best.

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Coverages offered by the insurer

Review the scope and limits of coverage provided. Ensure the plan includes essential services such as hospitalization, outpatient consultations, diagnostic tests, prescribed medicines, and preventive care.

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Network hospital coverage of the insurer

Check the insurer’s hospital and clinic network. A wider network ensures you can access quality healthcare facilities conveniently and benefit from cashless treatment options.

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Affordability and value

Balance the premium cost with the benefits offered. Choose a plan that provides comprehensive coverage without straining your budget, while still protecting you against major medical expenses.

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Optional add-ons

Evaluate whether you need additional benefits such as dental care, maternity coverage, or optical services. These additions can enhance your protection and provide peace of mind.

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Your Benefits and Our Services

IconIn-Patient and Day-Care
IconOut-Patient

Benefits

Hospital Accommodation, Accidents and Emergencies, Intensive Care and Operation Theatre Costs, Surgical Operations and procedures, Surgeons, Anesthetists and Physicians fees, Prescribed Medicine and drugs, Surgical Appliances, (Artificial body parts surgically implanted to form parts of an insured's body), Diagnostic tests, Oncology Treatment, Radiotherapy and Chemotherapy, Ophthalmology, Acute (reversible) kidney failure, Physiotherapy.


Services

  •   In-patient Treatment: Services /treatments rendered by the Medical Practitioner that requires a stay at the hospital for one or more night is termed as In-Patient Service.

  •      Day Care Treatment: Services /treatments rendered by the Medical Practitioner that are eligible under the Policy benefits wherein admission is necessary but does not require an overnight stay in the hospital is termed Daycare Service.

  •      Pre-Approval Process: Prior to availing of any non-urgency or planned in-patient treatments and/or day care treatments the insured should inform the TPA (by email) with a medical report from the attending Medical Practitioner outlining the diagnosis, plan of management and estimated expense and obtain written pre-authorization for your proposed In-patient/Daycare admission or procedure a minimum of 48 hours prior to the planned admission.

  •      We shall validate, in writing to you, with a specified Pre-approval Code, the extent of the respective procedure's coverage and further requirements, if any, subject to your policy terms, conditions and exclusions.

  •       Verbal confirmation does not constitute pre-authorization. If in doubt, please contact the medical helpline, as shown on your membership card. 

      Emergency ambulance applicable from the place of casualty to the nearest hospital



The following Elective/Planned services such as but not limited to require pre-authorization:

  •      All In-Patient treatments specified or limited to under the Policy
  • All Daycare admissions

Benefits

Diagnostic tests, Specialists, Consultants, General Medical Practitioner and Family Physician fees, Out-Patient home visits for emergency conditions, Oncology, Prescribed Medicines & Dressings, Outpatient Surgical Procedures, Physiotherapy

Services

Services/treatments rendered by the Medical Practitioner in the Out-Patient clinic or that which do not require a stay in the hospital is termed as Out-Patient Service. You should note that some non-urgent services require pre-authorization, here are a few examples:

  •      MRI, CT, PET Scans
  •       Endoscopic procedures
  •        Physiotherapy
  •        Complimentary therapies such as Chiropractic, Acupuncture, Osteopathy
  •        Dental services
  •       Maternity related investigations or Out-patient procedures
  • Optical related services

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Optional benefits offered by Takaful Oman

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Routine dental care benefits
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Maternity care benefits
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Optical benefits

What is Covered and not Covered ?

Inclusions
Exclusions

      • The Table of Benefits (TOB) details the services, treatments, limits, and benefits that you are entitled for.
      •     Online access is available for each and every member detailing benefits of the Policy/Plan.

      • The Providers give specific details in accordance with your network tier. Network Tier is detailed in your plan as well as in your medical card. The Network Providers include Hospitals, Polyclinics, Private Practitioner Clinics, Laboratory and Diagnostic Centers and Pharmacies that you may choose to avail your service/treatment from both within Oman as well as outside of Oman. Treatment outside Oman is on reimbursement basis subject to usual, reasonable customary costs at Designated Service Providers in Oman.

      •       The Policy Exclusions detail those services that you are not covered for under your Plan/Policy.

        •  The expenses incurred Outside the Network Provider (within and outside Oman) shall be on a Reimbursement basis, the details of which are explained under Reimbursement Claims/Table of Benefits.


      Non-Medical & Preventive Services

      •        General checkups, routine examinations, recreational therapy, and wellness programs
      •        Investigations for employment, travel, licensing, or insurance purposes
      •        Cosmetic or aesthetic procedures (unless due to accident/injury)
      •        Hair loss, baldness, obesity, acne, keloid, or other non-essential skin treatments

      P  Pre-Existing & Chronic Conditions

        •     Outpatient treatment for pre-existing diseases before completion of waiting period
        •     Congenital deformities or hereditary conditions
        •       Menopause-related changes and menstrual disorders
        •       Genetic disorders, stem cell therapy, or experimental treatments

      High-Risk & Hazardous Activities

      •     Injuries from hazardous sports (scuba diving, parachuting, rock climbing, dune bashing, etc.)
      •     Military operations, riots, terrorism, natural calamities, or criminal acts
      •      Exposure to radioactive, toxic, or explosive substances

      Infectious & Epidemic Diseases

      •       Conditions identified by WHO as epidemics
      •       HIV/AIDS and related illnesses
      •     Sexually transmitted diseases and venereal diseases

      Substance Abuse & Psychological Disorders

      •      Illnesses resulting from alcohol, drugs, stimulants, or tranquilizer abuse
      •       Psychological or psychiatric disorders (except emergencies)
      •        Sleep-related disorders and eating disorders

      Alternative & Complementary Treatments

      •      Complementary or alternative medicine not covered under policy
      •        Immunotherapy or immunomodulatory treatments
      •    Allergy tests or desensitization (unless linked to prescribed medication)

      Dental, Vision & Hearing

      •       Tooth implants, dentures, bridges, orthodontics (unless accident-related)
      •       Vision or hearing correction, aids, or tests (unless accident-related)

          Nasal septum or concha corrections (unless accident-related)

      Transplants & Advanced Procedures

      •        Organ or bone marrow transplants
      •    Artificial organ implants or live cell/tissue transplants


      Supplies & Equipment

      •        Non-medical items: soaps, lotions, supplements, baby supplies, shampoos, multivitamins (unless prescribed for deficiency)
      •        External devices: breast pumps, massage machines, thermometers, BP/sugar monitors, glucose strips
      •     Supports: crutches, braces, slings, orthopedic shoes, wheelchairs, collars, corsets (unless covered under rider list)

      Simplifying Your Healthcare Journey

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      Transparent and Straightforward Enrollments :

      •    Online health plans comparator to identify the best option for your need and budget
      •   Complete digital applications with just a few clicks and taps.
      •   Receive instant health insurance quotes and approvals for most standard cases.

      How to raise a claim ?

      We’ve made claim services simple and transparent by dividing them into two easy options.


      Direct Billing

      o   Available at Network Providers.

      o   Bills are settled directly between the provider and TAOI/Respective TPA.

      o   You only pay for charges not covered under your plan.

      ·       Reimbursement

      o   For treatments at Non-Network Provides.

      o   You pay upfront, then submit your claim for reimbursement.

      o   Processing is subject to:

      §  Policy coverage & eligibility

      §  Submission of required documents within timelines

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      Key points to remember

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      Pre-Authorizations

      Prior approval may be necessary for certain services/treatments for which your Provider shall contact TAOI/Respective TPA either in writing or over the phone.

      With this, both you and your provider can be rest assured of:

            

      1.          The eligibility of the stated service under your Policy/Plan.
      2.      The extent/limit of cover of the specific service as per the limits specified in your policy.
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      Emergency Services

      In the event of Emergency treatment pre-approval is not required but it is the liability of the Network Provider to inform TAOI of the case within 24 hours of admission to the hospital.

      What to Keep in Mind ?

      Several elements play a role both in selecting a plan and in determining the premium you’ll pay:

      ·       Age and current health condition – Your stage of life and medical history affect both coverage needs and premium costs.

      • Medical history and pre-existing conditions – Chronic illnesses or past medical issues can influence eligibility and pricing.
      • Coverage limits and scope of benefits – Look closely at what’s included, from routine care to emergencies and specialized treatments.
      • Premium affordability vs. coverage value – Balance cost with the benefits provided to avoid being underinsured or overpaying.
      • Network hospitals available under your plan – Ensure your preferred hospitals and clinics are included for convenient access.
      • Coverage amount and optional add-ons – Maternity, dental, vision, or international coverage can enhance protection but raise costs.
      • Lifestyle factors – Habits such as working in high-risk occupations etc. can significantly impact premiums
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      “Your health is your most valuable asset. Partner with Takaful Oman to protect it.”

      Takaful Oman's individual health insurance represents a new paradigm in healthcare with tiered plans offer solutions for every life stage and budget, while our digital tools and wellness programs extend value far beyond traditional insurance.

      We invite you to explore how our health protection can provide not just financial security but genuine peace of mind for you and your loved ones.

      Article 1.1 - New Health Need for Oman ?

      Oman’s population is made up of distinct groups, each with unique healthcare needs. At the heart of our mission is the commitment to provide comprehensive, accessible, and flexible healthcare solutions that reflect this diversity. Our plans are designed to ensure that every individual, whether a citizen, expatriate, or specialized worker can find coverage that truly fits their lifestyle and circumstances.

      01

      Omani Nationals Seeking Private Enhancement:

      While Omani citizens benefit from government-provided healthcare, many desire additional private options for greater convenience, faster access, and specialized services. Our plans supplement existing coverage, offering enhanced private healthcare access that empowers citizens to take control of their health with confidence and peace of mind.

      02

      Expatriate Professionals and Families:

      Oman’s growing expatriate community brings with it unique healthcare requirements. Foreign professionals and their families often need coverage that extends beyond Oman’s borders, especially for those who travel frequently or have loved ones abroad. Our plans provide geographic flexibility, ensuring that expatriates enjoy seamless healthcare access both locally and internationally.

      03

      Specialized Occupational Groups:

      Certain professions such as construction workers, domestic staff, and industrial employees face higher risks and require dependable healthcare protection. Our plans are designed to safeguard these groups against unexpected medical expenses, offering affordable and reliable coverage that supports their well-being and financial security.

      04

      How Takaful Oman helps?:

      •       Comprehensive coverage tailored to different population segments
      •       Flexible options for both local and international needs
      •        Affordable solutions that protect against unexpected costs
      •        Commitment to inclusivity by addressing the needs of citizens, expatriates, and specialized workers

      By recognizing the diverse healthcare needs across Oman, we ensure that everyone from professionals to laborers has access to quality medical care. Our plans are more than just insurance; they are a promise of security, health, and peace of mind.