IBA Medical Insurance Scheme for Retired Employees

1. Overview

The Institute of Bankers, Pakistan (IBA) introduced a dedicated Medical Insurance Scheme for its retired employees in order to provide a comprehensive healthcare safety net after the end of service. The scheme is designed to reduce the financial burden of medical expenses, ensure access to a wide network of hospitals and clinics, and promote preventive health measures among retirees.

2. Who Is Eligible?

Eligibility is limited to individuals who meet all of the following conditions:

• Former employee of IBA who has officially retired under the regular retirement age or superannuation rules.
• Completed a minimum of five (5) years of continuous service with IBA.
• Submitted a retirement certificate and the final settlement statement to the IBA Administration.
• Must be a Pakistani citizen with a valid CNIC.

Spouses and dependent children (up to 25 years of age or unmarried) can be added as cobeneficiaries, provided the primary retiree is the policy holder.

3. Key Benefits

The scheme offers a range of benefits that aim to be both affordable and valuable:

• Annual Medical Allowance: A fixed amount per year (currently PKR 120,000) that can be used for inpatient or outpatient treatment.
• Cashless Hospitalisation: Direct settlement with network hospitals no need for upfront payment.
• PreExisting Condition Coverage: After a waiting period of one year, preexisting illnesses are covered.
• Preventive Care: Annual health checkups, vaccinations, and screening tests are reimbursed up to a set limit.
• Pharmacy Benefits: Discounts on prescribed medicines at selected pharmacy chains.
• Dental & Vision: Partial reimbursement for selected dental procedures and eyecare services.

4. What Is Covered?

The following categories are included under the policy:

Note: Certain highcost treatments (e.g., organ transplants, cosmetic surgery, and experimental therapies) are excluded unless specifically approved by the schemes medical board.

5. How to Submit a Claim

Claims can be processed in two ways cashless (preferred) or reimbursement.

Cashless Hospitalisation

1. Present your IBA retiree ID and the insurance card at the network hospitals admissions desk.
2. The hospital will verify eligibility through the insurers portal.
3. All approved expenses are settled directly by the insurer; you receive only the discharge summary.

Reimbursement Claims (OutPatient / NonNetwork)

1. Collect original receipts, prescriptions, and a detailed invoice.
2. Download the claim form from the IBA Insurance portal.
3. Fill the form, attach supporting documents, and submit via email or the online portal.
4. Claims are usually processed within 710 working days. The amount will be transferred to your registered bank account.

It is essential to keep all documents for at least three years, as the insurer may request additional verification.

6. Frequently Asked Questions

Can I add my adult children after retirement?

Yes, dependent children up to the age of 25 (or unmarried) can be added within the first six months of enrolment. A onetime premium adjustment will apply.

What if I change my residence to another province?

The scheme is panPakistan. As long as you use network hospitals in any province, the cashless facility remains available. Outofnetwork reimbursement follows the same rules.

Is there a waiting period for preexisting conditions?

A standard oneyear waiting period applies from the date of enrolment. After this period, preexisting conditions are covered under the same terms as other illnesses.

How often can I renew the policy?

The policy is automatically renewed each year, provided the retirees status remains active and the annual premium (if any) is paid. No action is required from the member.

Who should I contact for assistance?

For any queries, contact the IBA Retiree Services Desk at +9221111555777 or email retiree.insurance@iba.org.pk. A dedicated helpline is also available from 9am to 5pm, Monday to Friday.