Frequently Asked Questions (FAQ's)

Q1-Who can apply?
Q2-Can I cover my family members?
Q3-What are the advantages of going to LNH? Can I go to a hospital other than LNH?
Q4-What is the Treatment Guarantee (Pre-authorization)? How do I obtain it?
Q5-What more do I need to know about my membership benefits?
Q6-What is Co-Insurance?
Q7-What are some of the expenses which are not covered?
Q8-When will my coverage start?
Q9-If I or any of my family member is suffering from any disease/illness, will that family member be covered?

Q.1) Who can apply?
If you are over 21 years of age and below 59 years and residing in Karachi, you can apply for the insurance cover.

Q.2) Can I cover my family members?
Yes! Your spouse, and all dependent unmarried children up to 25 years of age can be covered under the scheme.

Q.3) What are the advantages of going to LNH? Can I go to a hospital other than LNH?
Advantages of going to LNH as a HealthPlus insured member are many. First, you will have the convenience of ‘advance scheduling’ your appointment with LNH doctor. A dedicated telephone number at LNH has been arranged to take your appointment requests. Second, you will not be required to wait for more than 30-minutes for your scheduled OPD appointments. Third, you will enjoy courteous and friendly attitude of LNH staff. Fourth, LNH doctors with Allianz EFU doctors will visit you during hospitalization for your well-being and welfare. Fifth, for your convenience and comfort, a help desk at LNH will also be available. Last but not the least, LNH is one of the most well-reputed hospitals of the country, famous for its high quality of healthcare at affordable cost, technical excellence and the human element of care! Please note that several of the above benefits are benefits are only available to HealthPlus members.

You can only go to a hospital other than LNH in case of medical emergencies. However, you need to inform us within 24 hours of all such hospitalizations. Your claim will be reimbursed according to our agreed rates with LNH. Outpatient expenses incurred outside LNH will not be reimbursed.

Q.4) What is the Treatment Guarantee (Pre-authorization)? How do I obtain it?
If you would like to pay directly to LNH and not get yourself involved in the claims reimbursement procedure, you need to have Treatment Guarantee (Pre-authorization). You should either contact our medical department or LNH at least three days in advance from the hospitalization date. The Medical Hotline Number in mentioned on your health card.

Q.5) What more do I need to know about my membership benefits?
As a HealthPlus insured member, ‘peace of mind’ comes in many forms. You will have access to a customer services hotline for queries about your policy, claims and coverage; a 24 hours medical hotline for treatment guarantee (pre-authorization), queries about the treatment, medical counseling and advice, etc. In addition ‘Guide to your Rules’ booklet will help you to maximize your scheme benefits. Last but not the least, in case of Treatment Guarantee, you don’t need to pay to LNH and then get involved in claims reimbursement process.

Q.6) What is Co-Insurance?
In order to keep your outpatient premium at affordable level’s your outpatient benefit is subject to 20% co-insurance. Co-insurance is the fixed percentage of the total medical bill/claim that you will pay. For instance if your outpatient bill comes to Rs.1000, then @ 20%Rs.200 will be paid by you, while the rest 80% i.e, Rs.800 will be paid by the Insurance Company.

Q.7) What are some of the expenses which are not covered?
Expense arising from or related to pregnancy and childbirth (except in Diamond plan), congenital birth defects, war, invasion, civil unrest, pre-existing illnesses, infertility and cosmetic treatment, medical checkup and medical appliances.

Q.8) When will my coverage start?
Your insurance cover will START seven days after we receive the premium payment and completed application form. Policy start date will be mentioned in your policy document and health card.

Q.9) If I or any of my family member is suffering from any disease/illness, will that family member be covered?
Existing diseases, illnesses, injuries and chronic illnesses such as diabetes, arthritis, will not be covered. We reserve the right of not paying the claim directly or indirectly related to any existing illness/ injury. But for your benefit, OPD consultations relating to pre-existing conditions are covered.