Description

Premium per person per annum: 65,429
Premium per family of 6 per annum: 307,516
Annual Limit: 1,500,000
Region of Cover: Nigeria

OUTPATIENT SERVICES: 150,000
General Consultation: Covered
Specialist Consultation: Covered
Lab Investigations: Covered (up to 15,000)
Prescribed Drugs: Covered (up to 15,000)
Management of Chronic Conditions (Consult, Drugs & Tests): Not covered
Nutritionist & Dietician Consultations: Not covered

PHYSIOTHERAPY SERVICES
Physiotherapy Sessions: 5 per annum
Prescribed Appliances- Cervical Collar, Clutches, Prosthesis Devices: Not covered
INPATIENT SERVICES: 400,000
Admissions in Hospital: General ward
Admissions per Annum: 20 days
Accommodation for parents whose infants are on admission: 1 day
Feeding on Admission: Covered
Drugs and Infusions: Covered
Intensive Care, Neonatal ICU, Special Baby Unit Care : 24 hours (200,000 limit)

MATERNITY/GYNAECOLOCICAL SERVICES
MATERNITY BENEFIT (Limits Apply): 150,000
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: 24 hours
Family Planning Services (Counselling, IUCDs, Injectables, Oral Contraception) : IUCDs, Pills & Injectibles (up to 10,000)
IMMUNIZATIONS
Routine (NPI) Immunizations (OPV, BCG, DPT, Measles, HBV, Vitamin A): 0 – 5 years
Additional Immunizations (Heberix, MMR, Menavax, Rotarix, Yellow Fever): Not covered
Travel Immunization : 5,000

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 100,000 from the emergency care limit)

ACCIDENTS AND EMERGENCIES SERVICES
Emergency Care (Accidents & Emergencies, Resuscitative Lifesaving Treatment and Stabilization): 100,000
Ambulance Service: Hospital to Hospital

SURGERIES
Minor Surgeries: Limit N250k per person after 12 months
Intermediate Surgeries: Limit N250k per person after 12 months
Major Surgeries: Limit N250k per person after 12 months
ENT services: As part of surgery limit

OPTICAL SERVICES
Optical Care (Registration, Drugs, Eye tests & Eye Glasses): Limit N10k 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 N10K per annum After 6 months.
Secondary Dental Care and Investigations (Panoramic xray) Composite extraction: Limit N10K per annum After 6 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):Basic: (Physical Exam, BP, Blood Sugar, PCV/HB, Urinalysis)
* Infertility Investigation (Basic Non-Surgical Investigation): Basic Invest. only USS, SFA
Renal Dialysis: 1 emergency session
Tele medicine – chat with a doctor consultation online 24/7: Covered
Network Gym Access : Not covered
Enrollee App : Covered