Description

Premium per person per annum: 208,142
Premium per family of 6 per annum: 978,267
Annual Limit: 5,000,000
Region of Cover: Nigeria
OUTPATIENT SERVICES: 300,000
General Consultation: Covered
Specialist Consultation: Covered
Lab Investigations: Covered (up to 50,000)
Prescribed Drugs: Covered (up to 50,000)
Management of Chronic Conditions (Consult, Drugs & Tests): 866,700
Nutritionist & Dietician Consultations: Quarterly
PHYSIOTHERAPY SERVICES
Physiotherapy Sessions: 10 per annum
Prescribed Appliances- Cervical Collar, Clutches, Prosthesis Devices :Cervical Collar, Crutches, Knee and Ankle Braces
INPATIENT SERVICES: 450,000
Admissions in Hospital: Private ward
Admissions per Annum: 35 days
Accommodation for parents whose infants are on admission:3 days
Feeding on Admission: Covered
Drugs and Infusions: Covered
Intensive Care, Neonatal ICU, Special Baby Unit Care: 7 Days (600,000 limit)
MATERNITY/GYNAECOLOCICAL SERVICES
MATERNITY BENEFIT (Limits Apply): 400,000
Antenatal Care & Delivery Post Natal Care – 6 weeks Neonatal Care including Ear piercing, Circumcision:After 12 months
Intensive Care, Neonatal ICU, Special Baby Unit Care: 7 days
Family Planning Services (Counselling, IUCDs, Injectables, Oral Contraception):IUCDs, Pills & Injectibles (up to 20,000)
Tubal ligation and Vasectomy: (up to 200,000);
IMMUNIZATIONS
Routine (NPI) Immunizations (OPV, BCG, DPT, Measles, HBV, Vitamin A): 0 – 5 years
Additional Immunizations (Heberix, MMR, Menavax, Rotarix, Yellow Fever): 0 – 17 years
Travel Immunization: 10,000
DIAGNOSTIC SERVICES
Lab Investigations: Covered up to inpatient/ outpatient limit
Plain & Contrast X-Rays: Subject to out-patient/in-patient limit&;
Ultrasound Scans: Covered
*Special Investigations (ECG & EEG, Myelogram, CT scan, ECHO, MRI Scan at designated centers): Emergency only ( up to 350,000 from the emergency care limit)
ACCIDENTS AND EMERGENCIES SERVICES
Emergency Care (Accidents & Emergencies, Resuscitative Lifesaving Treatment and Stabilization):350,000
Ambulance Service: Hospital to Hospital & Roadside to Hospital
SURGERIES
Minor Surgeries: Limit Max N750,000 per person
Intermediate Surgeries: Limit Max N750,000 per person
Major Surgeries: Limit Max N750,000 per person
ENT services: As part of surgery limit
OPTICAL SERVICES
Optical Care (Registration, Drugs, Eye tests & Eye Glasses): Max N25k per person After 6 months
Glasses (once in 2 years)"
Eye Surgeries: Subject to surgery limit
(After 12 months)
DENTAL SERVICES
Primary Dental Care (Pain Relief, Scaling &Polishing, Simple Fillings, Simple Extractions).Scale & Polishing limited to Once per year: Limit N60K per annum After 9 months
Secondary Dental Care and Investigations (Panoramic xray) Composite extraction
OTHER SERVICES
*HIV/Aids Treatment (Tests, Drugs, Treatment): After 12 months
Mental Health Services (Outpatient Only): 30 days Max After 12 months
*Annual Wellness Check (after 9 months): Comprehensive After 6 months: (Physical Exam, BP, Blood Sugar, PCV/HB, Urinalysis, Stool Microscopy, Cholesterol, Chest X- ray, WOMEN: 40+ Cervical Smear, Mammogram (once every 2 years)MEN: 40+ PSA Screening(once every 2 years)
* Infertility Investigation (Basic Non-Surgical Investigation): Basic Invest. only USS, SFA, Hormone Profile, HSG After 12 months
Renal Dialysis: 3 emergency sessions
Tele medicine – chat with a doctor consultation online 24/7: Covered
Network Gym Access: 2/ sessions per month
Enrollee App: Covered