Medical Services

UMT provides various benefits to its employees after regularization; one of these benefits is Medical Coverage for employee and his/her dependants.

Medical coverage is of two types:

1. Indoor Health Facility:

Indoor health facility is utilized when confinement in the hospital is necessary for treatment. Currently we have coverage through Pak-Qatar Family Takaful. All regular fulltime employees of less than 65 years of age are provided medical insurance coverage under the Group Health Insurance Scheme. Only the employee, his/her spouse and children are covered under this scheme. Parents are not covered under this scheme. Sons of employees are covered till the age of 25 while daughters are covered till they got married.

How it works:

University bears the expense of premium of the insurance provided by Pak-Qatar Family Takaful. All medical facilities under this scheme have to be pre-approved through a pre-authorization process except in case of emergency. The Pre-authorization Form is available on the OHR website please visit the following link to download the form.

http://umt.edu.pk/hrforms/Pak-Qatar-Takaful/Pre_Authorization_Form.pdf

In case of emergency please contact OHR immediately after hospitalization – and in cases of planned treatment please inform OHR a week before hospitalization to avoid any inconvenience. Medical expenses 30 days prior and 30 days post hospitalization is covered by whether treatment is had from the panel hospital or otherwise.

There are two types of treatment available under this scheme:

(i)  Treatment in Panel Hospital:

In case the employee visits hospitals on the panel of Pak-Qatar Family Takaful he/she will not have to pay any money as long as the cost of treatment remains within the limits of coverage provided by the insurance company – any amount over and above the limit will have to be borne by the employee. For limits of coverage please contact the OHR. List of panel hospitals is available on the UMT website. Please visit the following link for further information:

Pak Qatar Panel Hospital List

(ii)  Treatment in non-panel Hospitals:

Treatment in non-panel hospitals can also be availed however the employee has to first pay the cost of treatment and claim the same from the insurance company. All non-panel expenses have to be claimed on the Claim Form available at the following link:

http://umt.edu.pk/faculty-staff/forms.html

The following documents (in original) are required to claim reimbursement of non-panel hospitalization expense:

1. Claim form - Filled, signed and stamped by the physician
2. Discharge Summary
3. Itemized bill – Details of all hospital fees mentioned separately
4. All medicine receipts
5. Any other bills related to
6. Copy of Birth certificate in case of delivery

Pak-Qatar Family Takaful reserves the right to limit the reimbursement for the medically necessary treatment to only the reasonable and customary charges – reasonable and customary charges mean charges for medical care which shall be considered by Pak-Qatar Takaful to be reasonable and customary to the extent that they do not exceed the general level of charges being made by others of similar standing in the locality where the charges are incurred when giving like or comparable treatment, services or supplies to individual of same sex and of age for a similar disease or injury.

What is not covered:

All cosmetic procedures, all non-medicine items, vaccines (unless there is a medical need).

Specialized Investigations outdoor cover under indoor policy:

The following medically necessary specialized investigations expense ordered by a physician is covered by the insurance company:

1. MRI
2. CT Scan
3. Endoscopy
4. Thallium Scan
5. Angiography

Please note that pre-authorization id mandatory for afore mentioned specialized investigation outpatient expenses.

Summary of covered benefits

1. Daily room and ward charges
2. Physician Visits
3. Specialist consultation charges
4. ICU Charges
5. Drugs, dressing and medicines prescribed by the attending physician
6. Laboratory investigations and other diagnostic procedures
7. Physiotherapy
8. Intravenous injections and solutions;
9. Administration of blood and blood plasma, including the cost of blood and blood plasma and any fluids administered during surgery;
10. General nursing services

Surgical Operation Charges

The Benefits payable if a surgical operation is performed on the individual Covered. These charges can be for:

1. Surgeon Fee
2. Anesthetist Fee
3. Operating theatre charges

Day Care Surgery Charges

The cover provided by the Hospital Treatment & Services benefit extends to include Day Care Surgery. Day Care Surgery means all medically necessary surgical procedures and related treatment provided by or on the order of a Physician to the insured person at a Hospital.

Emergency Services

1. Services provided to the Individual Covered as an out-patient in a Hospital Emergency Ward immediately following an Accident requiring immediate medical attention. This also covered emergency treatment necessary to relieve dental pain only within forty eight (48) hours following the Accident.
2. Emergency room Services due to acute medical condition require and need urgent medical attention of the Physician. But not an overnight Stay.

How to avail this facility

Please fill the “Health Form” to provide your basic information and your dependants for insurance cover purposes. The form is available on the following link:

https://admin.umt.edu.pk/Media/Site/UMT/SubSites/OHR/FileManager/Downloads/HealthForms/Request form for Indoor Medical Coverage.pdf

For the limits of treatment please contact the OHR. Please note that all expenses over and above the prescribed limit will be borne by the employee.

2. Outdoor Health Facility (OPD):

Visits to doctors and diagnostics (ultra-sound, ECG, Lab Tests etc), not requiring hospitalization, are covered under out-door health facility. To avail these facilities please fill in the “Request Form for OPD Cards” available at the following link:

https://admin.umt.edu.pk/Media/Site/UMT/SubSites/OHR/FileManager/Downloads/HealthForms/Request form for Outdoor Medical Coverage.pdf

Please attach 1’x1’ photographs of yourself and your dependants with the form so that OPD cards can be issued to you.  

Who is covered:

All regular fulltime employees, their spouse, children (Sons of employees are covered till the age of 25 while daughters are covered till they got married) and parents are covered under this facility.  

How it works:

UMT has entered into agreements with several renowned hospitals and labs to provide outdoor health facility.  The list of those hospitals and labs is available at

List of UMT Panel Hospitals

List of Doctors @ Fatima Memorial Hospital

List of Doctors @ Iqraa Hospital

List of Doctors @ Rasheed Hospital

List of Doctors @ Niazi Hospital

List of Doctors @ Mansoorah Hospital

List of Doctors @ Masood Hospital

List of Doctors @ Farooq Hospital

The employee just has to show the OPD card issued by OHR in the panel hospitals or labs. Please present copy of the card and prescription to the Chughtais Lahore Labs to avail this facility. Kindly bring copy of the card to the hospital. 15 % of the cost incurred on all diagnostics will be charged to the employees’ salary while the rest is paid by UMT.

Treatment in non-panel hospitals can also be availed however the employee has to first pay the cost of treatment and claim the same from the Office of Human Resources – only the rates of panel hospital are reimbursed. In case of non-panel OPD visits and diagnostics, only the agreed rates with the panel hospital are reimbursed after deduction of 15%.  If the cost of a single diagnostic test is above Rs. 5000 then 50 % of the total cost will be reimbursed.

How to claim:

All non-panel consultation and diagnostics expenses can be claimed on the “Expense Claim Voucher” (available in OHR and OTR) after attaching original receipts of payments made.

What is not covered:

All types of

a.    Medicines and vaccinations are not covered.
b.    Dental treatment is not covered.

Note: Please note that Outdoor and Indoor hospitals are different.