Medical Plan

Medical Coverage Provided by AUC to Staff Members

AUC meets and exceeds the provisions for medical coverage stated in Egyptian law. The University provides a well-equipped clinic with qualified staff members, physicians and nurses, open to support staff, faculty, dependents of custodians, dependents of personnel subscribing to Cigna health insurance and students. The clinic is open 24 hours.

 

Services of the Clinic for Full-Time Staff Members 

For more details about the clinic, click here.
 

Health Care Plans

AUC provides health plans for employees and their dependents. There are two health plans available, which include an international plan catering to the special needs of relocated personnel, administrators and managers, as well as a local plan provided for all support staff members. The local plan remains an option for managers and administrators. 

 

Local Health Plans 

One local health care plan is available for AUC employees, administered by Medicare Middle East which is the first health maintenance organization (HMO) in the Middle East.

There are different coverage levels in the plan depending on the needs of the employee where premiums differ according to the coverage level. Coverage is provided through two systems. The first is the network system, in which prior General Practitioner “GP” referrals are requested by Medicare. The second is the claims system, in which reimbursements by Medicare are granted at 80 percent of the Medicare price list which is based on the prices of network of providers.

Participation is compulsory for all staff members with the exception of support staff members on job levels from 1 to 4 (skilled and semi-skilled staff members only), externally funded project/grant staff members, casual employees and staff members hired on/or before September 1996. In these cases, participation is on a voluntary basis. Participation may be waived if the employee is already subscribing to an alternative external plan providing medical services of a similar nature and quality, provided that documented proof is submitted to the Office of Human Resources. 

Local coverage is optional for administrators and managers as a substitute to the international plan or as an additional health coverage. When the employee opts to enroll in both plans, the international as well as the local one, the University pays the employer’s share of one plan only. In this case, the participant will be responsible for the employer’s share of the additional plan as well as the employee’s share of both plans.

Outpatient medications for main participants are not covered under Medicare but are covered in full by the AUC clinic.

The local health plan consists of four levels of coverage, each with a corresponding ceiling through which premium is paid in Egyptian pounds according to subscription, which include a single rate, spouse rate and child rate. Premiums are performance rated and may increase or decrease accordingly. The University basically pays half the premium for the employee, a spouse and two children only, and the employee pays both employee and University shares for more than one spouse and any additional child(ren).

Coverage is provided up to the age of 70 for employees (main subscribers) and spouses, whereas it is extended for dependents up to the age of 25 (inclusive) if not married, through which coverage shall stop at the end of the contractual year at the age of 26. The employee shall be fully responsible for reporting to the HR Office as soon as his/her covered son / daughter gets married. In case of not reporting and a proof of marriage is distinguished, the employee shall be required to pay the premiums and any medical treatment fees that have been used through the Medicare plan.

Employees whose monthly salary is LE 2,000 or more are placed at level B, unless they choose to enroll in a higher level of coverage.

Upgrading levels is only permitted on the renewal date of the contract, i.e. July 1st provided that he/she and or his/her family member(s) did not exceed the annual ceiling during the contractual year prior such upgrade request. Whereas downgrading the level is only permitted at the renewal date of the contract for retirees, those who are joining the plan on voluntary basis and those who have a portion of their premium contribution paid in full by them.

Upon enrollment in Medicare, the employee must sign a corresponding enrollment form reflecting the important terms and conditions governing Medicare coverage.

Detailed information about medical services covered by both plans and its corresponding network is available online at the Medicare webpage.
 

International Health Plan 

The international health plan for administrators and managers is administered by Cigna. 

The University provides this plan to accommodate the needs of its expatriate employees in particular, in addition to its administrators and managers.

Participation in the plan is compulsory for all mangers and relocated administrators including their accompanying spouses and dependents (coverage is optional for unaccompaying family member). A conditional waiver is permitted in case of coverage in an alternative health plan, provided that a proof is submitted by the employee confirming such coverage. For local administrators and managers, coverage is voluntary as they may join the local Medicare instead. Where participation is voluntary, the employee must make his or her decision to join the Cigna plan within 24 months of being eligible to do so, otherwise eligibility ceases.

Cigna premiums are performance rated and may increase or decrease accordingly. Premiums are paid in dollars and cover the annual rates according to the status of the insured: the single rate, the couple rate/the single parent with children rate and the family with children rate. Coverage for dependents may continue up to the age of 26.

Detailed information about medical services and expenses covered by the plan is available here.

Detailed brochures are available upon request at the Human Resources office

To communicate directly with the Cigna health plan, visit their website.