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: 150,000
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: 400,000
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: 24 hours(200,000 limit) Excluding NICU & SBCU
MATERNITY/GYNAECOLOCICAL SERVICES
MATERNITY BENEFIT (Limits Apply): –
Antenatal Care & Delivery Post Natal Care – 6 weeks Neonatal Care including Ear piercing, Circumcision : Not covered
Intensive Care, Neonatal ICU, Special Baby Unit Care: Not covered
Family Planning Services (Counselling, IUCDs, Injectables, Oral Contraception): Not covered
IMMUNIZATIONS
Routine (NPI) Immunizations (OPV, BCG, DPT, Measles, HBV, Vitamin A): Not covered
Additional Immunizations (Heberix, MMR, Menavax, Rotarix, Yellow Fever): Not covered
Travel Immunization : Not covered
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 couple (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 9 months.
Secondary Dental Care and Investigations (Panoramic xray) Composite extraction: Limit N10K 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): 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