Description

Premium per person per annum: 103,332
Premium per family of 6 per annum: 485,660
Annual Limit: N2,000,000
Region of Cover: Nigeria
OUTPATIENT SERVICES: 250,000
General Consultation: Covered
Specialist Consultation: Covered
Lab Investigations: Covered (up to 35,000)
Prescribed Drugs: Covered (up to 35,000)
Management of Chronic Conditions (Consult, Drugs & Tests): 481,500
Nutritionist & Dietician Consultations: Quarterly

PHYSIOTHERAPY SERVICES
Physiotherapy Sessions : 10 per annum
Prescribed Appliances- Cervical Collar, Clutches, Prosthesis Devices :not covered
INPATIENT SERVICES : 400,000
Admissions in Hospital: Semi-Private Ward
Admissions per Annum: 30 days
Accommodation for parents whose infants are on admission: 2 days
Feeding on Admission: Covered
Drugs and Infusions: Covered
Intensive Care, Neonatal ICU, Special Baby Unit Care :3 days (400,000 limit)

MATERNITY/GYNAECOLOCICAL SERVICES
MATERNITY BENEFIT (Limits Apply) :250,000
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 :3 days
Family Planning Services (Counselling, IUCDs, Injectables, Oral Contraception) :IUCDs, Pills & Injectibles (up to 15,000)
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 :7,500

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 250,000 from the emergency care limit)

ACCIDENTS AND EMERGENCIES SERVICES
Emergency Care (Accidents & Emergencies, Resuscitative Lifesaving Treatment and Stabilization) :250,000
Ambulance Service :Hospital to Hospital
SURGERIES
Minor Surgeries: Limit N350k per person
Intermediate Surgeries: Limit N350k per person
Major Surgeries: Limit N350k per person
ENT services: As part of surgery limit

OPTICAL SERVICES
Optical Care (Registration, Drugs, Eye tests & Eye Glasses) : Max N12k per person After 6 months
Eye Surgeries: As part of surgery limit
DENTAL SERVICES
Primary Dental Care (Pain Relief, Scaling &Polishing, Simple Fillings, Simple Extractions).Scale & Polishing limited to Once per year :Limit N20K per annum After 9 months
Secondary Dental Care and Investigations (Panoramic xray) Composite extraction :Limit N20K per annum After 9 months

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): Advanced: (Physical Exam, BP, Blood Sugar, PCV/HB, Urinalysis, Stool Microscopy, Cholesterol), Age 40+Males: PSA every 3 years
Age 40+ Females, Mammogram every 3 years
* Infertility Investigation (Basic Non-Surgical Investigation) : Basic Invest. only USS, SFA, Hormone Profile
Renal Dialysis :2 emergency sessions
Tele medicine – chat with a doctor consultation online 24/7: covered
Network Gym Access: not covered
Enrollee App: covered