Telefax - MedNet

MedNet Saudi Arabia LLC 

Al Khobar – Al Rakha 

2ed Floor – Office # 1222 

Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

Revised Self Funded (TPA) Policy – AGOC Retirees 

Telefax Ref: - AGOC – Revised 

To: AGOC Providers From: Dr. Tariq Baig 

Fax: Cc: Dr. Afsar Ehtesham 

Phone: Date: March 17, 2012 

Subject: Revised Policy (TPA): AGOC Pages (incl. this): 5 

Dear Provider, 

Please be notified of ARAMCO Gulf Operations 

Company (AGOC) new changes on medical policy 

which has been issued under MedNet as self-funded 

scheme (Third Party Administrator) with effective 

from July 1 st , 2011. Therefore, you are kindly advised 

to apply the new below-mentioned policy changes with 

immediate effect. 

All Members will be holding MedNet Gold cards and 

are entitled for Private room. You are requested to 

note the main differences of AGOC scheme from our 

standard CCHI policy term as; 

• No Deductible or Co-Payment. 

• For all life threatening and Non-life threatening 

congenital illnesses, treatment for functional 

purposes (Like Heart disease,) with medical 

justification will be covered. 

• General Check up is covered once a year 

and need pre approval. 

• New born babies under AGOC policy will not be 

covered after delivery immediately. 

• Psychiatric Diseases are covered as acute 

cases. Maintenance medication is covered (no 

need for pre-approval). 

• Basic Vaccination and Immunization, requested 

by MOH including meningitis for Hajj, anti flue 

Vaccination and Prophylactic Immunizations, 

are covered. Note: vaccination for cases of 

desensitization is not covered. 

• Optical (Prescribed Medical Glasses including 

frame up to SR 500), REFRACTION TEST 

DOES NOT NEED APPROVAL 

• Hearing Aids (Prescribed & up to SR 

11,000)every 2 years. 

Challenge for Better Healthcare 

Please reply Please recycle 

،، ﻦﻳﺪﻤﺘﻌﻤﻟا ﺔﻴﺒﻄﻟا تﺎﻣﺪﺨﻟا يدوﺰﻣ / 

P.O. Box 5537 Jeddah 21432 Kingdom of Saudi Arabia 

Tel.: +966 2 644 4448 Fax: +966 2 644 6464 E-mail: info@mednet.com.sa Web: www.mednetgulf.com 

ةدﺎﺴﻟا 

ﻢﺗ ﻲﺘﻟا ﺞﻴﻠﺨﻟا لﺎﻤﻋﻷ ﻮﻜﻣارأ ﺔآﺮﺷ ﺔﻘﻴﺛﻮﻟ 

ةﺪﻳﺪﺠﻟا تﺎﺜﻳﺪﺤﺘﻟﺎﺑ ﻢﻜﻏﻼﺑإ دﻮﻧ 

ًارﺎﺒﺘﻋإ ﺔﻴﺤﺼﻟا ﺔﻳﺎﻋﺮﻟا ﺞﻣﺎﻧﺮﺑ ةرادإ مﺎﻈﻧ ﺐﺴﺣ ﺖﻧﺪﻣ ﺔآﺮﺷ ﻊﻣ ﺎﻬﻣﺎﻤﻀﻧا 

تاﺮﻴﻐﺘﻟا ﻩﺬه ﺚﻳﺪﺤﺗ ﻰﻠﻋ ﻪﻳﻮﻨﺘﻟا ىﺮﺟ اﺬﻬﻟ . م2011 

ﻮﻴﻟﻮﻳ 1 ﺦﻳرﺎﺗ ﻦﻣ 

. يرﻮﻓ ﻞﻜﺸﺑ ﺎﻬﻘﻴﺒﻄﺗو 

ﻲ��ﻓ ﻢﻳﻮ��ﻨﺘﻟا نﻮﻘﺤﺘﺴ��ﻳ و نﻮ��ﻠﻟا ﺔ��ﻴﺒهذ ﺖﻧﺪ��ﻣ تﺎ��ﻗﺎﻄﺑ نﻮﻠﻤﺤﻴ��ﺳ صﺎﺨ��ﺷﻷا ﻊ��ﻴﻤﺟ 

ﻲ��ﺘﻟاو ﺞﻴ��ﻠﺨﻟا لﺎ��ﻤﻋﻷ ﻮ��ﻜﻣارأ ﺔآﺮ��ﺷ ﺔ��ﻘﻴﺛو تﺎﻓﺎ��ﺿإ 

ﺎ��ﻤﻜﻟ 

ﻖ��ﻓﺮﻣو ﺔ��ﺻﺎﺧ ﺔ��ﻓﺮﻏ 

: ﻲﻧوﺎﻌﺘﻟا ﻲﺤﺼﻟا نﺎﻤﻀﻟا ﺲﻠﺠﻣ مﺎﻈﻨﻟ ﺔﻴﺳﺎﺳﻷا ﺔﻴﻄﻐﺘﻟا ﻦﻋ ﺪﻳﺰﺗ 

. ﺔآرﺎﺸﻣ ﻎﻠﺒﻣ وأ ﻞﻤﺤﺗ ﻎﻠﺒﻣ ﺪﺟﻮﻳﻻ 

. ﺔﻴﻘﻠُﺨﻟا بﻮﻴﻌﻟا 

جﻼﻋ ﺔﻴﻄﻐﺗ 

ﻞ�ﻣﺎﺣ ﻞ�ﻜﻟ ﺔﻨﺴ�ﻟا ﻲ�ﻓ ةﺪ�ﺣاو ةﺮﻣ) 

ﻞﻣﺎﺸﻟا ﻲﺒﻄﻟا ﺺﺤﻔﻟا ﺔﻴﻄﻐﺗ 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ جﺎﺘﺤﻳو ( ﺔﻗﺎﻄﺑ 

ﺔ�ﻴﻄﻐﺘﻟا ﺖ�ﺤﺗ ﻦﻳﺬ�ﻠﻟا و ﺖﻧﺪ�ﻣ ﺔ�ﻗﺎﻄﺑ ﻲﻠﻣﺎ�ﺤﻟ ﻦﻳدﻮﻟﻮﻤﻟا لﺎﻔﻃﻷا 

. ةﺮﺷﺎﺒﻣ ﻢﻬﺗدﻻو ﺪﻌﺑ ﻢﻬﺘﻴﻄﻐﺗ ﻒﻗﻮﺘﺗ ﺔﻴﺒﻄﻟا 

ﻲ��ﻠﻘﻌﻟاو ﻲﺴ��ﻔﻨﻟا باﺮﻄ��ﺿﻻ ةدﺎ��ﺤﻟا تﻻﺎ��ﺤﻟا جﻼ��ﻋ ﺔ��ﻴﻄﻐﺗ 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ ﻰﻟا جﺎﺘﺤﻳ ﻻو ﻪﻟ ﺔﻌﺑﺎﺘﻟا ﺔﻴﺋﺎﻗﻮﻟا تﺎﺟﻼﻌﻟاو 

حﺎ��ﻘﻟ وأ / و ﺔﺤﺼ��ﻟا ةرازو ﻦ��ﻣ ﺔ��ﺑﻮﻠﻄﻤﻟا ﺔﻴ��ﺳﺎﺳﻻا تﺎ��ﺣﺎﻘﻠﻟا 

ﺮ��ﻴﻏ ﺔﻴﺳﺎﺴ��ﺤﻟا تﺎ��ﺣﺎﻘﻟ : ﺔ��ﻈﺣﻼﻣ. 

اﺰﻧﻮ��ﻠﻔﻧﻹا و ﺞ��ﺤﻠﻟ ﺎﻳﺎﺤﺴ��ﻟا 

. ةﺎﻄﻐﻣ 

ﺞﻟﺎ�ﻌﻤﻟا ﺐ�ﻴﺒﻄﻟا ﺔﻴﺻﻮﺗ ﺐﺴﺣ ( رﺎﻃﻹا ﻞﻤﺸﺗ) 

ﺔﻴﺒﻄﻟا تارﺎﻈﻨﻟا 

ﻞ��ﻜﻟ لﺎ��ﻳر 500 ﻰﺼ��ﻗأ ﺪ��ﺤﺑ ﻲ��ﻄﻐﺗو ﺔﻘﺒﺴ��ﻣ ﺔ��ﻘﻓاﻮﻣ جﺎ��ﺘﺤﺗ ، 

جﺎ�ﺘﺤﻳ ﻻ ﺮ�ﻈﻨﻟا رﺎﺴ�ﻜﻧا رﺎ�ﺒﺘﺧإ ) . ةﺪﺣاﻮﻟا ﺔﻨﺴﻟا ﻲﻓ ﺔﻗﺎﻄﺑ ﻞﻣﺎﺣ 

( ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ 

جﺎ��ﺘﺤﺗ ﺞﻟﺎ��ﻌﻤﻟا ﺐ��ﻴﺒﻄﻟا ﺔﻴ��ﺻﻮﺗ ﺐﺴ��ﺣ نذﻷا تﺎﻋﺎﻤ��ﺳ ﺔ��ﻴﻄﻐﺗ 

ﻞ��ﻣﺎﺣ ﻞ�ﻜﻟ لﺎ��ﻳر 11,000 ﻰﺼ�ﻗأ ﺪ��ﺤﺑ ﻲ�ﻄﻐﺗو ﺔﻘﺒﺴ��ﻣ ﺔ�ﻘﻓاﻮﻣ 

. 

ﻦﻴﺘﻨﺴﻟا ﻲﻓ ﺔﻗﺎﻄﺑ 

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Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

• Medicines for Chronic diseases above 3 

months period need pre-approval from MedNet 

(No need for pre-approval for medicine up to 

3 months) 

• Post-Transplant treatment is covered 

• Medically indicated vitamins are covered. 

• MOH approved medicines including herbal are 

covered. 

• Physiotherapy: The first Physiotherapy session 

does not need pre-approval but subsequent 

sessions (need pre-approval) 

• Ambulance outside city limits is covered and 

needs pre-approval. 

• Dialysis is covered. 

• Glucometer strips covered 

• Medical Aids are covered as per report from the 

treating doctor and as follows :SR 2,250/year 

1. Standard Wheel chair Sr 500 for cases of 

paralysis and fractures. (Need Approval) 

2. Glucometer, nebulizer every 2 yrs upto 500 

each. (Need Approval) 

3. Crutches for cases of paralysis and 

fractures. (No Need of Approval) 

4. Leg varicose socks. (No Need of Approval) 

5. Medical brace for back pain, spinal 

deformities and Disk.(No Need of Approval) 

6. Neck disk collar(No Need of Approval) 

• Pre-Approval is required only for following 

services: 

1. General Check-up ( Inv. list attached) 

Any Extra Inv. Should be justified by 

requesting doctor 

2. In-patient non-emergency cases. 

3. Medicines for Chronic diseases above 3 

months period (No need for approval for 

medicine up to 3 months). 

4. Wheelchairs up to SR 500. 

5. Ambulance outside city limits 

6. Physiotherapy: The first Physiotherapy 

session does not need pre-approval but 

subsequent sessions (need pre-approval) 


3 ﻩﺪ��ﻤﻟ ﻰﺼ��ﻗأ ﺪ��ﺤﻟ ﺔ��ﻨﻣﺰﻤﻟا ضاﺮ��ﻣﻷا 

ﺔ��ﻳودأ فﺮ��ﺻ ﻰ��ﻄﻐﺗ 

يأر ﺐﺴ��ﺣ فﺮﺼ��ﺗ و ( ﺔﻘﺒﺴ��ﻣ ﺔ��ﻘﻓاﻮﻤﻟ 

ﺔ��ﺟﺎﺤﻟا نوﺪ��ﺑ) 

رﻮﻬ��ﺷ 

. ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا 

ﺔ��ﺟﺎﺤﻟا نوﺪ��ﺑو ءﺎﻀ��ﻋﻷا ﻞ��ﻘﻧ تﺎ��ﻴﻠﻤﻋ ﺪ��ﻌﺑ ﺎ��ﻣ جﻼ��ﻋ ﻰ��ﻄﻐﻳ 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻤﻟ 

. ةﺎﻄﻐﻣ ﺎﻴﺒﻃ ةرﺮﺒﻤﻟاو ﺔﻳروﺮﻀﻟا تﺎﻨﻴﻣﺎﺘﻴﻔﻟا 

ةرازو ﻞ�ﺒﻗ ﻦ�ﻣ ةﺪﻤﺘﻌﻤﻟا ﺔﻴﺒﻄﻟا بﺎﺸﻋﻷاو ﺔﻳودﻷا ﻊﻴﻤﺟ ﺔﻴﻄﻐﺗ 

. ﺔﺤﺼﻟا 

ﻲ�ﻌﻴﺒﻄﻟا جﻼ�ﻌﻟا ﻦ�ﻣ ﻰﻟوﻷا ﺔﺴﻠﺠﻟا مﺪﻘﺗ 

ﺚﻴﺣ : ﻲﻌﻴﺒﻄﻟا جﻼﻌﻟا 

ﺔ��ﻘﻓاﻮﻤﻟا ﻰ��ﻟإ ﺔ��ﻴﻟﺎﺘﻟا تﺎﺴ��ﻠﺠﻟا جﺎ��ﺘﺤﺗ ﺎ��ﻤﻨﻴﺑ ﺔﻘﺒﺴ��ﻣ ﺔ��ﻘﻓاﻮﻣ نود 

. ﺎﻬﻨﻣ ةدﺎﻔﺘﺳﻹا ﻞﺒﻗ ﺔﻘﺒﺴﻤﻟا 

ﺎ�ﻣأ ﺔ�ﻨﻳﺪﻤﻟا دوﺪﺣ ﻦﻤﺿ ةروﺮﻀﻟا لﺎﺣ ﻲﻓ فﺎﻌﺳإ ةرﺎﻴﺳ ﻦﻴﻣﺄﺗ 

مﺰ��ﻠﻴﻓ ﺔ��ﻴﺒﻄﻟا ةروﺮﻀ��ﻟا ﺪ��ﻨﻋ ﻚ��ﻟذ و ﺔ��ﻨﻳﺪﻤﻟا دوﺪ��ﺣ جرﺎ��ﺧ ﻰ��ﻓ 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ 

ةﺎﻄﻐﻣ 

ﻰﻠﻜﻟا ﻞﻴﺴﻏ 

. ةﺎﻄﻐﻣ Glucometer لأ ﺔﻃﺮﺷأ 

ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا ﻞﺒﻗ ﻦﻣ ﺮﻳﺮﻘﺗ ﻰﻠﻋ ًاءﺎﻨﺑ ةﺎﻄﻐﻤﻟا ﺔﻴﺒﻄﻟا ةﺰﻬﺟﻷا 

: ﻲﺗﻵﺎآ ﻲهو لﺎﻳر 2,250 ﻰﺼﻗأ ﺪﺤﺑ 

ﻞﻠﺸ��ﻟا تﻻﺎ��ﺤﻟ لﺎ��ﻳر 500 ﻰﺼ��ﻗا ﺪ��ﺤﺑ كﺮ��ﺤﺘﻤﻟا ﻲ�ﺳﺮﻜﻟا . 1 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ ﻰﻟإ جﺎﺘﺤﻳو , رﻮﺴﻜﻟاو 

دﻮ��ﻤﻌﻟا تﺎهﻮﺸ��ﺗو ﺮ��ﻬﻈﻟا مﻻﻵ ﻲ��ﺒﻄﻟا ﺪﺸ��ﻤﻟا و ﺔ��ﻄﺑرﻷا . 2 

ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻤﻟ جﺎﺘﺤﻳ ﻻو. 

ﻚﺴﻳﺪﻟاو يﺮﻘﻔﻟا 

ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻤﻟ جﺎﺘﺤﻳ ﻻو ﻲﺒﻗﺮﻟا ﻚﺴﻳﺪﻟا ﻰﺿﺮﻤﻟ ﺔﺒﻘﻟا . 3 

جﺎ��ﺘﺤﻳ ﻻو. 

رﻮﺴ��ﻜﻟاو ﻞﻠﺸ��ﻟا تﻻﺎ��ﺤﺑ ﺔ��ﺻﺎﺨﻟا تازﺎ��ﻜﻌﻟا . 4 

ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻤﻟ 

. ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻤﻟ جﺎﺘﺤﻳ ﻻو نﺎﻘﻴﺴﻟﺎﺑ ﻲﻟاوﺪﻟا براﻮﺟ . 5 

ﻰﺼ�ﻗأ ﺪ�ﺤﺑ Glucometer & Nebulizer لا ةﺰﻬﺟأ . 6 

ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ ﻰﻟا جﺎﺘﺤﻳو ﻦﻴﺘﻨﺳ ﻞآ زﺎﻬﺟ 

ﻞﻜﻟ لﺎﻳر 500 

: ﻲﺗﻵﺎآ ﻲهو ﺔﻘﺒﺴﻣ ﺔﻘﻓاﻮﻣ جﺎﺘﺤﺗ 



ﻂﻘﻓ ﺔﻴﻟﺎﺘﻟا تﺎﻣﺪﺨﻟا 

. ( بﺎﻄﺨﻟا ﻊﻣ ﺔﻘﻓﺮﻣ تﺎﺻﻮﺤﻔﻟا ﺔﻤﺋﺎﻗ ) ﻞﻣﺎﺸﻟا ﻲﺒﻄﻟا ﺺﺤﻔﻟا - 

ﻦ�ﻣ ةرﺮ�ﺒﻣ نﻮﻜﺗ نأ ﺐﺠﻳ ﺔﻘﻓﺮﻤﻟا ﺔﻤﺋﺎﻘﻟا ﻰﻠﻋ ﺔﻴﻓﺎﺿﻹا تﺎﺻﻮﺤﻔﻟا - 

. ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا ﻞﺒﻗ 

. ﺔﺋرﺎﻄﻟا 

ﺮﻴﻏ ﻢﻳﻮﻨﺘﻟا تﻻﺎﺣ 

رﻮﻬﺷ 3 ﻦﻣ ﺮﺜآأ ﻩﺪﻤﻟ فﺮﺼﺗ ﻲﺘﻟا و ﺔﻨﻣﺰﻤﻟا ضاﺮﻣﻸﻟ ﺔﻳودﻷا 

يأر ﺐﺴ�ﺣ ﻚ�ﻟذ و ( ﺔﻘﺒﺴ�ﻣ ﺔﻘﻓاﻮﻣ ﻰﻟإ جﺎﺘﺤﻳ ﻻ ﻞﻗأ وأ رﻮﻬﺷ ثﻼﺛ ) 

. ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا 

. لﺎﻳر 500 ﺔﻳﺎﻐﻟ ﺔآﺮﺤﺘﻤﻟا ﻲﺳاﺮﻜﻟا 

. ﺔﻨﻳﺪﻤﻟا دوﺪﺣ جرﺎﺧ فﺎﻌﺳﻹا تارﺎﻴﺳ 

ﻲ�ﻌﻴﺒﻄﻟا 

جﻼ�ﻌﻟا ﻦ�ﻣ ﻰﻟوﻷا ﺔﺴﻠﺠﻟا مﺪﻘﺗ ﺚﻴﺣ : ﻲﻌﻴﺒﻄﻟا جﻼﻌﻟا 

ﺔ��ﻘﻓاﻮﻤﻟا ﻰ��ﻟإ ﺔ��ﻴﻟﺎﺘﻟا تﺎﺴ��ﻠﺠﻟا جﺎ��ﺘﺤﺗ ﺎ��ﻤﻨﻴﺑ ﺔﻘﺒﺴ��ﻣ ﺔ��ﻘﻓاﻮﻣ نود 

. 

ﺔﻘﺒﺴﻤﻟا 

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Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

7. Hearing Aids (Prescribed & up to SR 11,000) 

every 2 yrs 

8. Optical (Prescribed Medical Glasses including 

frame up to SR 500 

9. Glucometer & Nebulizer every 2 yrs up to Sr 

500 each 


ﻩرﺪ�ﻗ ﻰﺼ�ﻗأ ﺪﺤﺑ ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا ﺔﻴﺻﻮﺗ ﺐﺴﺣ نذﻷا تﺎﻋﺎﻤﺳ 

. ﻦﻴﺘﻨﺳ ﻞﻜﻟ يدﻮﻌﺳ لﺎﻳر ( 11,000) 

ﻩرﺪﻗ ﻰﺼﻗأ ﺪﺤﺑ ﺞﻟﺎﻌﻤﻟا ﺐﻴﺒﻄﻟا ﺔﻴﺻﻮﺗ ﺐﺴﺣ ﺔﻴﺒﻄﻟا تارﺎﻈﻨﻟا 

. ةﺪﺣاﻮﻟا ﺔﻨﺴﻠﻟ يدﻮﻌﺳ لﺎﻳر ( 500) 

ﻰﺼ��ﻗأ ﺪ��ﺤﺑ Glucometer & Nebulizer لا ةﺰ��ﻬﺟأ 

. ﻦﻴﺘﻨﺳ ﻞآ زﺎﻬﺟ ﻞﻜﻟ لﺎﻳر 500 

Policy Holder Name AGOC Retirees 

Insurance Co. Self funded Policy 

Policy Limit NO LIMIT 

Policy Type New Policy Policy Status Group 

Effective Date 01 st July 2011 Expiry Date Up To: 30 th June 2012 

Policy Coverage As per AGOC Special policy. 

Card Color Gold 

Deductible (Consultation) 

/ Co-Payment for OPD 

Room Type Private Room 

Dental Unlimited Covered ( Panoramic X ray mandatory) 

NO NEED OF APPROVAL 

Optical Sr 500 Covered and Need for MCC prior Approval 

REFRACTION TEST DOES NOT NEED APPROVAL 

Maternity Covered 

Network AGOC NW 

Note: Dental Claims should be submitted with supporting Panoramic X ray. 

Exclusions of AGOC Policy. 

The company shall not bear the expenses arising from the hereunder enumerated medical services ( 

unless they are work injuries): 

1. DENTAL: Dental Bridges, Crowns, Temporary or Permanent Partial/Complete Dentures, Dental 

Bleaching, Dental Fluoride and Fissure Sealants, Dental Implantation, Orthodontics, Toothpaste and 

Dental Floss or Brushes. 



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Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

2. OPHTHALMOLOGY: Correction of refraction errors by Laser or Lasik, Keratotomy, Esotropia, 

Exotropia, Hyper & Hypotropia. 

3. AUDIOLOGIC: All Auditory Accessories (Except prescribed hearing aids). 

4. GYNAECO-OBSTETRICS: Investigations and Treatment for Infertility (Except due to Hormones 

Disturbance & any infertility caused by accepted organic diseases) all methods of Birth Control 

including its complications (e.g. IUCD complications), Artificial Insemination and In Vitro Fertilization 

(I.V.F) and all other methods of assisting conception. 

5. ANDROLOGICAL: Investigations and treatment for impotence and sexual dysfunction (For 

Hereditary cases) and sexually transmitted diseases in both sexes. 

6. DERMATOLOGICAL: Treatment of Baldness and Hair loss due to Hormonal cause, Skin and Hair 

Care, Wigs and/or Toupee, Hair implantation, Hirsutism, Soaps & Shampoos even if they are 

medically justified, Sunscreens, Moisturizers and Soothing preparations. All cosmetic preparations, 

Treatment of Acne (Except Consultation and Antibiotics either oral or topical), Treatment of Skin 

Pigmentation (Vitiligo treatment is covered) and skin preparations that make skin fairer, smoother or 

lighter. 

7. SURGICAL: All kinds of Prosthesis, devices and appliances, which are not, required Intraoperatively, 

all kinds of assisting devices and supplementary aids, (Crutches are covered), Plastic 

and Cosmetic Surgeries, Medical Shoes, Beds, hearing aids and artificial limbs. (IOL, Pace maker 

and Artificial joints as Hip or Knee etc. are covered since it is a part of surgery). 

8. All kinds of Dietetic Consultation & treatment & weight loss & treatment programs. 

9. Acupuncture, Hypnotism and Trial treatment. 

10. Any test and/or treatment not required by a medical physician or not medically necessary. 

11. Any test and/or treatment, which is not related to a specific symptom and/or disease. 

12. Any Pharmaceutical Products, which are not considered as specific treatment for a particular 

disease or medicines, which are not licensed by Ministry of Health. 

13. Suicide attempts, voluntary self-injury unless it is due to psychological diseases. 

14. All cases related to Professional Hazardous activities such as, but not restricted to Piloting, 

Diving, Motor Cycling, Parachuting, Hang-Gliding and Professional Sports. 

15. Vaccines related to Desensitization treatment of allergy cases are not covered. 

16. All cases resulting from alcoholism and/or use of drugs or hallucinatory substances. 

17. Smoking Cessation Programs. 

18. Custodial, Hospice and Home Health care. 

19. Physiotherapy for wife after delivery, Milk Products, Food Supplements, Diapers & Napkins, 

Baby Creams & Lotions. 



Tel.: +966 2 644 4448 Fax: +966 2 644 6464 E-mail: info@mednet.com.sa Web: www.mednetgulf.com




Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

20. Any additional benefits or services such as cafeteria services for guests selected by the 

Patient, Tel/Fax services, Internet & e.mails. 

• Kindly find here sample of the MedNet / AGOC Gold cards: 

You are kindly requested to open a separate account for AGOC members under MedNet & accept them 

on free access basis & to provide them with all the medical services covered under the policy. 

Please be informed that all claims have to be submitted strictly within 30 days to MedNet for evaluation as 

usual separately under the Name of AGOC. 

If you have any query regarding medical coverage or before rejecting any medical service please 

contact MCC or Customer Service 24 X 7on Mobile No. 0560500860 or on Phone 920009229 / 

8002445511 or Fax: 02-644-6999. 

Please give special support for all Card holders from above group and confirm receive by return 

Fax to No. 02 / 644 6464 ext. 455 

Please Confirm Receive by Return Fax to No. 02 / 644 6464 ext. 455 

For more details please visit our web site: http://www.mednet.com.sa 

Thank you and best regards, 

Dr. Tariq Mirza Baig 

Network Manager 







Tel. : + 966 3 8584401/02 

Fax. : + 966 3 8584403 

Annual Medical check up For AGOC Retirees includes ( Needs Approval) 

1. Haemogram : Haemoglobin, Packed cell volume, R.B.C. count, MCHC/MCV/MCH, 

Total W.B.C./Differential Count, E.S.R., Peripheral Smear, Platelet Count 

2. Sugar Profile :Fasting Blood Sugar & Prandial blood sugar; with corresponding Urine 

a. (for Diabetics HbA1C) 

3. Renal Profile :Blood Urea Nitrogen , Serum Creatinine , Uric Acid 

4. Liver Profile : Total Protein/Albumin/Globulin, SGPT/SGOT, Alkaline Phosphatase, 

GGTP, S. Bilirubin 

5. PSA for men 

6. Lipid Profile: Total Cholestrol, Triglycerides, HDL, VLDL and LDL 

7. Urine routine examination: Microscopy, Sugar and Albumin 

8. Stool routine examination 

9. Mammography & Pap Smear (for women) 

10.Chest X-ray 

11.Electrocardiogram (ECG) 

12.Consultation with Physician with all reports 

13.Consultation with Ophthalmologist 

� Any extra Investigations need justification from requesting doctor

Telefax - MedNet

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