Description

Premium per person per annum :130,858
Premium per family of 6 per annum: N/A
Annual Limit : 3,000,000
Region of Cover : Nigeria
OUTPATIENT SERVICES : 100,000
General Consultation : covered
Specialist Consultation : covered
Lab Investigations : covered (up to 10,000)
Prescribed Drugs : covered (up to 10,000)
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: 250,000
Admissions in Hospital : General ward
Admissions per Annum: 10 days
Accommodation for parents whose infants are on admission : not covered
Feeding on Admission: covered
Drugs and Infusions: covered
Intensive Care, Neonatal ICU, Special Baby Unit Care: not covered
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: After 12 months
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): covered
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 : Plain X-Ray only (7,000 max)
Ultrasound Scans : Not Covered
*Special Investigations (ECG & EEG, Myelogram, CT scan, ECHO, MRI Scan at designated centers) :emergency only (50,000 max)
ACCIDENTS AND EMERGENCIES SERVICES
Emergency Care (Accidents & Emergencies, Resuscitative Lifesaving Treatment and Stabilization) : 50,000
Ambulance Service : Hospital to Hospital
SURGERIES
Minor Surgeries : Limit N80k per person after 12 months
Intermediate Surgeries:Limit N80k per person after 12 months
Major Surgeries : not covered
ENT services
OPTICAL SERVICES
Optical Care (Registration, Drugs, Eye tests & Eye Glasses) : not covered
Eye Surgeries : not covered
DENTAL SERVICES
Primary Dental Care (Pain Relief, Scaling &Polishing, Simple Fillings, Simple Extractions).Scale & Polishing limited to Once per year : Limit N3K per annum
Secondary Dental Care and Investigations (Panoramic xray) Composite extraction : not covered
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) : not covered
Renal Dialysis : not covered
Tele medicine – chat with a doctor consultation online 24/7 : covered
Network Gym Access : not covered
Enrollee App : covered