Day-to-Day benefits cover medical expenses incurred outside the hospital and these benefits are included in all the Options except the TRAUMA Option. Day-to-Day expenses are covered at 100% of NAMAF tariff and are limited to the annual Day-to-Day limits as set out in the brochure for each option.
Major Medical Expenses (MME) are most often associated with hospitalization. All the Options, except for the BASIC Option, cover MME at 100% of NAMAF tariff and all surgical procedures performed in hospital are covered at 225% of NAMAF tariff and are subject to the overall annual limit.
Some Members may have do-payments on day-to-day and major medical expenses. This co-payment derives from the service provider fee being above NAMAF tariff