|
CONSULTATION |
|
| General Outpatient Consultation & Treatment | Covered |
| Specialist Consultation | Covered up to 2 Session per Annum Based on referral from primary provider |
| Hospital Ward care | Covered |
| 24 hours Toll freelines Chat Access to Healthcare professionals | Covered |
| Free Chats with Doctors and Nurses when in need of care during medical emergencies | Covered |
| Accident & Emergency (Local evacuation within scope of benefit and subject to overall Limit | Covered |
| Cumulative Inpatient/Hospitalization for 10 days only/Annum | Covered |
|
LABORATORY |
|
| Routine Hematology | Covered |
| Routine Clinical Chemistry | Covered |
|
DIAGNOSTICS |
|
| Ultrasound scan | Covered |
| X-Rays | Covered |
| Other Routine Radiological Investigations ( Subject to Healthpoint approval) | Covered |
| ECG Life Threatening Emergency | Covered |
| CT-Scan Life Threatening Emergency | Covered |
|
SURGERY (Minor procedures) |
|
| Surgical Incision & Drainage ( I & D ) | Covered |
| Wound Management | Covered |
| Suturing of Wound | Covered |
|
Benefits |
Standard + |
| Out-patient consultation | Covered |
| Specialist Consultation | Not covered |
| Admissions (including feeding) | Covered
(General Ward – 15 days maximum/annum) |
| Hospital Category
|
Providers listed under Standard Plus Plan Only |
| Accommodation for mothers whose dependants are on admission | Not covered |
| Provision of prescribed Drugs | Covered
|
| Accident and Emergency: Resuscitative or lifesaving initial treatment | Covered
|
| Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests | Not Covered
|
| Blood transfusion | 2 Pints |
| X-rays, diagnostic & laboratory tests | Covered |
| Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) | |
| Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) | . |
| Additional immunizations for 6 years and above (Meningitis, Yellow fever and Hepatitis B) | . |
| Surgeries including day case procedure (minor, intermediate and major surgeries) | . |
| Surgeries including day case procedure – minor, intermediate and major surgeries – International Refundable limit | . |
| HIV/AIDS Care & Treatment (management of opportunistic infection only) | Referral to Govt. Facilities/Centres |
| Inter-state Referral Services for services not available in State or Out of station Care | . |
| Medical Enquiries | Covered
|
| Second Opinion Services | . |
| Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care | . |
| Antenatal Care, Normal Delivery, Caesarian Section – Global Refund on Deliveries | . |
| Family Planning Services | Counselling |
| Physiotherapy | . |
| Ophthalmic Care (Treatment of chronic & acute eye diseases) | . |
| Ophthalmic Surgery | . |
| Optical ware – Lense and frame or contact lenses | . |
| Primary Dental Care | Pain relief |
| Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics | . |
| Advanced and complex investigations – CT Scan, MRI & Echocardiogram | . |
| Mortuary Services (Cleaning, Embalment, Storage & Autopsy. | . |
| Benefits | PRO |
| Out-patient consultation | Covered |
| Specialist Consultation | Covered up to 3 visit/annum |
| Admissions (including feeding) | Covered
(Standard Ward of Cumulative of 15 days in a year) |
| Hospital Category | Providers listed under Pro+ Plan |
| Accommodation for mothers whose dependants are on admission | Not covered |
| Provision of prescribed Drugs | Covered |
| Accident and Emergency: Resuscitative or lifesaving initial treatment | Covered |
| Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests | Covered |
| Blood transfusion | Covered (2 Pints maximum/annum) |
| X-rays, diagnostic & laboratory tests | Covered |
| Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) | Covered |
| Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) | Not Covered |
| Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) | Not Covered |
| Additional immunizations for 6 years and above (Meningitis, Yellow fever and Hepatitis B) | Not Covered |
| Surgeries including day case procedure (minor, intermediate and major surgeries) | Covered (limit of
N80, 000/annum |
| Intensive Care Services | Not Covered |
| Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit) | Not Covered |
| Kidney Dialysis | Not Covered |
| Health Checks (Principal Only). | Annual Physical Checks only |
| HIV/AIDS Care & Treatment (management of opportunistic infection only) | Referral to Govt. Centres |
| Inter-state Referral Services for services not available in State or Out of station Care | Covered |
| Medical Enquiries | Covered |
| Second Opinion Services | Covered |
| Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care | Covered to a limit of N80, 000 |
| Family Planning Services | IUCDs, Pills & Injectibles |
| Physiotherapy | 3 Sessions |
| Ophthalmic Care (Treatment of chronic & acute eye diseases) | Primary Eye Care |
| Ophthalmic Surgery | Not Covered |
| Optical ware – Lense and frame or contact lenses | Covered (N3, 000 limit/ annum) |
| Primary Dental Care | Covered |
| Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics | Not Covered |
| Mortuary Services (Cleaning, Embalment, Storage & Autopsy | Not Covered |
| Benefits | PRO + | |
| Out-patient consultation | Covered | |
| Specialist Consultation | Covered | |
| Admissions (including feeding) | Covered
(General Ward – 30 days maximum/annum) |
|
| Hospital Category | Providers listed under Pro+ Plan Only | |
| Accommodation for mothers whose dependants are on admission | 48 hours | |
| Provision of prescribed Drugs | Covered | |
| Accident and Emergency: Resuscitative or lifesaving initial treatment | Covered | |
| Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests | Covered | |
| Blood transfusion | Covered (4 pints maximum/annum) | |
| X-rays, diagnostic & laboratory tests | Covered | |
| Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) | Covered | |
| Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) | Hepatitis B, HiB & Yellow fever only | |
| Surgeries including day case procedure (minor, intermediate surgeries) | Covered ( limit of N200,000/annum) | |
| Advanced and complex investigations – CT Scan, MRI & Echocardiogram | Covered (only on emergency/once per annum) | |
| Intensive Care Services | Covered (24 hours) | |
| Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit) | Covered (24 hours) | |
| Kidney Dialysis | Emergency (1session only) | |
| Health Checks (Principal Only). | On-site only – Physical, BP, Blood Sugar, BMI | |
| Ambulance Services | Roadside/Hospital to Hospital | |
| Infertility Treatment | Counselling, Sperm functional Assessment, USS & HSG (N25,000 limit) | |
| Psychiatric Treatment | Outpatient Care Only (3 months) | |
| HIV/AIDS Care & Treatment (management of opportunistic infection only) | Covered | |
| Inter-state Referral Services for services not available in State or Out of station Care | Covered | |
| Medical Enquiries | Covered | |
| Second Opinion Services | Covered | |
| Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care | Covered to a limit of N200, 000 | |
| Family Planning Services | IUCDs, Pills & Injectibles | |
| Physiotherapy | 7 sessions | |
| Ophthalmic Care (Treatment of chronic & acute eye diseases) | Covered (N 50,000 limit per annum) | |
| Optical ware – Lense and frame or contact lenses | Covered (N 6,000 limit per annum) | |
| Primary Dental Care | Covered (non-surgical extraction & filling x 3 teeth maximum/annum, therapeutic scaling & polishing – relating , pain relief) | |
| Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics | Covered (N 10,000 limit per annum) | |
| Mortuary Services (Cleaning, Embalment, Storage & Autopsy | N 50,000 limit | |
| Premium per person/Month | N4,000 .00K | |
| Benefits | Pro Max |
| Region of cover | Local |
| Hospital | Lagoon Hospitals |
| Inpatient Limit (N) | 600,000.00 |
| Accidents & Emergencies: Resuscitative or lifesaving initial treatment | Up to Inpatient limit |
| Accommodation (including feeding) | Semi Private Ward (20 Days/Annum) |
| Inpatient medication, medical & surgical consumables | Up to Inpatient limit |
| Surgeries including day case procedures, minor, intermediate and major surgeries (including Caesarean Delivery) | N250,000.00 (limit) |
| Consultations | |
| General consultations (Initial and follow up) | Up to Outpatient Limit |
| Specialist Consultations (Initial and follow up) | Once/Month |
| Telemedicine | Unlimited 24/7 |
| Medications | |
| Chronic Disease Medication | N100,000.00 |
| Outpatient Prescription Medicines | N100,000.00 |
| Tests & Investigations | |
| X-Rays and Basic Diagnostic Tests | Up to Outpatient Limit |
| Laboratory tests (WHO list of essential in-vitro diagnostics | Up to Outpatient Limit |
| Advanced & Complex Investigations (limited to CT Scan and MRI Scan | Twice per annum |
| Maternity and Neo-Natal Services | |
| Antenatal Care +Normal Delivery +Postnatal care (6 weeks) | N150,000.00 |
| Neonatal care services (Male circumcision, Ear piercing) | N50,000.00 |
| Immunizations | |
| NPI Immunizations for 0-5years | BCG, Measles, DPT, Oral polio, IPV, Vitamin A, supplementation, Pentavalent vaccine |
| Additional Immunizations for 0-5years | Hepatitis B, Hib, Chicken pox, MMR, Pneumococcal, Rotavirus, Yellow Fever |
| Additional Immunizations for 6 years and above | Hepatitis B, Yellow Fever |
| Ambulance Evacuation services | |
| Home/Road side to Hospital | 4 times per annum |
| Hospital to Hospital | 4 times per annum |
| Other benefits | |
| Critical illness + Death cover | N400,000.00 |
| Dental Care | Relief of pain, fillings, Non-surgical extractions, preventive care, scaling and polishing, Dental surgical Extraction (N40,000.00 per annum) |
| Family Planning services | IUCDs, Pills & |
| Mortuary services (cleaning, Embalmment, storage, Autopsy) | N50,000.00 |
| Optical care: Eye testing, Treatment of acute and chronic eye diseases | N40,000.00 |
| Physiotherapy | N40,000.00 |
| Psychiatric Treatment | Outpatient only (3 Months) |
HEALTH MAINTAINANCE AND PREVENTIVE SERVICES.
- Annual medical checkup
- Vaccines such as BCG,Measles, DPT,Oral Polio, Vitamin A supplementation, HEPATITIS B,HiB, MMR, Pneumococcal vaccine
INPATIENT CARE
- Room and board (General ward)
- Prescribed diets.
- Services of a dietician
- Skilled nursing
- Isolation ward
- A bed in an emergency room and observation room/Area.
- Use of operating, delivery, cast, and treatment rooms and equipment.
- Prescribed drugs administered while on admission
- Medical and surgical dressings,supplies,casts,splints.etc
- Oxygen and administration of oxygen
- Diagnostic laboratory and medical imaging services.
BIRTH CONTROL, FAMILY PLANNING AND STERILIZATION
- Hormonal methods viz.oral and injectable contraceptive, implants.
- Non-hormonal methods viz.barrier methods((condoms,diaphragms,cervical caps), intra-uterine devices(IUDs), spermicides
BEHAVIORAL HEALTH SERVICES (48HRS)
- Outpatient psychiatric care services.
- Inpatient psychiatric care services excluding convulsive therapy treatment.
DENTAL CARE (MAX LIMIT OF N20, 000)
- Basic dentistry viz.extraction of teeth and roots, fillings (amalgam and composite), scaling and polishing (therapeutic and preventive), X-rays.
DIABETIC EQUIPMENT AND SUPPLIES
- Blood glucose monitors.
- Test strips for glucose monitors
- Insulin preparations, insulin pens and insulin cartridges.
RENAL DIALYSIS
- Acute renal disease involving diagnosis up to 3 sessions.
EMERGENCY MEDICAL SERVICES.
- In country emergency medical services
- Roadside to hospitals, hospital to hospital, hospital to home
- Emergency room stabilization
- Intensive care up to 48hrs.
HEALTH MAINTAINANCE AND PREVENTIVE SERVICES.
- Annual medical checkup
- Vaccines such as BCG,Measles, DPT,Oral Polio, Vitamin A supplementation, HEPATITIS B,HiB, MMR, Pneumococcal vaccine
HIV TREATMENT.
- Definitive treatment and monitoring.
- Treatment of opportunistic infections,
MARTERNITY CARE (OVERALL LIMIT OF N150, 000)
- Normal pregnancy
- Prenatal care
- Spontaneous vaginal delivery
- Assisted vagina delivery
- Caesarean section delivery
- Postnatal care
- Puerperal infection
- False labor
- Occasional spotting
- Physician prescribed inpatient bed rest during pregnancy
- Morning sickness
- Hyperemesis gravidarum
- Preeclampsia
- Termination of pregnancy for life-endangering conditions
- Room and board, prescribed diets, the services of a dietician and skilled nursing in connection with childbirth for the mother or newborn, child a vaginal delivery or cesarean delivery
NEONATAL SERVICES UP TO 48HRS
- Incubator care for term and preterm delivery
- Phototherapy
- Exchange blood transfusion
OPHTHALMIC SERVICES (MAX LIMIT OF N10, 000)
- Ophthalmology viz. primary care limited to pain relief and treatment of simple eye infection
- Optical supplies viz, unifocal, bifocal, varifocal, optical frames.
PATIENT EDUCATION
- Prenatal classes
- Diabetes classes
- Asthma classes
- Hypertension classes
PHYSICIAN SERVICE
- General outpatient/inpatient consultation
- Specialist outpatient/inpatient consultation
- Electrocardiography
- Diagnostic medical imaging
- Basic X-rays
- Contrast studies
- Diagnostic ultrasound
- CT Scan
- Diagnostic laboratory tests
- Hematology
- Serology
- Blood chemistry
- Urinalysis
- Urea clearance
- Creatinine clearance
- Stool occult blood
- Microbiology
PRESCRIPTION DRUGS
- Generic
- Branded
REHABILITATION SERVICES (OUTPATIENT SHORT TERM THERAPY)
- Physical, neurocognitive and speech therapy, supply of basic physiotherapeutic appliances i.e. cervical collar, lumbar corset, crutches.
SURGICAL SERVICES (MAX LIMIT OF N150, 000)
- Surgical supplies normally required for covered surgical procedures.
- Anesthesia normally required for covered surgical procedures.
- Administration of blood and blood products.
- Second and third surgical opinions.
- Minor surgeries.
- Intermediate surgeries (uncomplicated).
- Major surgeries.
TERMS
- Coverage of treatment and management of all pre-existing conditions (pregnancy also) have a waiting period of 1 year of membership.
- Hospital inpatient services for covered services (prescription limit of N100,000/policy year).
- 30 days on admission max.
- Standard
-
CONSULTATION
General Outpatient Consultation & Treatment Covered Specialist Consultation Covered up to 2 Session per Annum Based on referral from primary provider Hospital Ward care Covered 24 hours Toll freelines Chat Access to Healthcare professionals Covered Free Chats with Doctors and Nurses when in need of care during medical emergencies Covered Accident & Emergency (Local evacuation within scope of benefit and subject to overall Limit Covered Cumulative Inpatient/Hospitalization for 10 days only/Annum Covered LABORATORY
Routine Hematology Covered Routine Clinical Chemistry Covered DIAGNOSTICS
Ultrasound scan Covered X-Rays Covered Other Routine Radiological Investigations ( Subject to Healthpoint approval) Covered ECG Life Threatening Emergency Covered CT-Scan Life Threatening Emergency Covered SURGERY (Minor procedures)
Surgical Incision & Drainage ( I & D ) Covered Wound Management Covered Suturing of Wound Covered - Standard +
-
Benefits
Standard + Out-patient consultation Covered Specialist Consultation Not covered Admissions (including feeding) Covered (General Ward – 15 days maximum/annum)
Hospital Category Providers listed under Standard Plus Plan Only Accommodation for mothers whose dependants are on admission Not covered Provision of prescribed Drugs Covered Accident and Emergency: Resuscitative or lifesaving initial treatment Covered Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests Not Covered Blood transfusion 2 Pints X-rays, diagnostic & laboratory tests Covered Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) . Additional immunizations for 6 years and above (Meningitis, Yellow fever and Hepatitis B) . Surgeries including day case procedure (minor, intermediate and major surgeries) . Surgeries including day case procedure – minor, intermediate and major surgeries – International Refundable limit . HIV/AIDS Care & Treatment (management of opportunistic infection only) Referral to Govt. Facilities/Centres Inter-state Referral Services for services not available in State or Out of station Care . Medical Enquiries Covered Second Opinion Services . Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care . Antenatal Care, Normal Delivery, Caesarian Section – Global Refund on Deliveries . Family Planning Services Counselling Physiotherapy . Ophthalmic Care (Treatment of chronic & acute eye diseases) . Ophthalmic Surgery . Optical ware – Lense and frame or contact lenses . Primary Dental Care Pain relief Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics . Advanced and complex investigations – CT Scan, MRI & Echocardiogram . Mortuary Services (Cleaning, Embalment, Storage & Autopsy. . - Pro
-
Benefits PRO Out-patient consultation Covered Specialist Consultation Covered up to 3 visit/annum Admissions (including feeding) Covered (Standard Ward of Cumulative of 15 days in a year)
Hospital Category Providers listed under Pro+ Plan Accommodation for mothers whose dependants are on admission Not covered Provision of prescribed Drugs Covered Accident and Emergency: Resuscitative or lifesaving initial treatment Covered Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests Covered Blood transfusion Covered (2 Pints maximum/annum) X-rays, diagnostic & laboratory tests Covered Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) Covered Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) Not Covered Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) Not Covered Additional immunizations for 6 years and above (Meningitis, Yellow fever and Hepatitis B) Not Covered Surgeries including day case procedure (minor, intermediate and major surgeries) Covered (limit of N80, 000/annum
Intensive Care Services Not Covered Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit) Not Covered Kidney Dialysis Not Covered Health Checks (Principal Only). Annual Physical Checks only HIV/AIDS Care & Treatment (management of opportunistic infection only) Referral to Govt. Centres Inter-state Referral Services for services not available in State or Out of station Care Covered Medical Enquiries Covered Second Opinion Services Covered Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care Covered to a limit of N80, 000 Family Planning Services IUCDs, Pills & Injectibles Physiotherapy 3 Sessions Ophthalmic Care (Treatment of chronic & acute eye diseases) Primary Eye Care Ophthalmic Surgery Not Covered Optical ware – Lense and frame or contact lenses Covered (N3, 000 limit/ annum) Primary Dental Care Covered Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics Not Covered Mortuary Services (Cleaning, Embalment, Storage & Autopsy Not Covered - Pro +
-
Benefits PRO + Out-patient consultation Covered Specialist Consultation Covered Admissions (including feeding) Covered (General Ward – 30 days maximum/annum)
Hospital Category Providers listed under Pro+ Plan Only Accommodation for mothers whose dependants are on admission 48 hours Provision of prescribed Drugs Covered Accident and Emergency: Resuscitative or lifesaving initial treatment Covered Management of Chronic Diseases: Consultation, Prescription drugs & Laboratory tests Covered Blood transfusion Covered (4 pints maximum/annum) X-rays, diagnostic & laboratory tests Covered Routine immunizations for 0-5 years (NPI), including pentavalent vaccines (diphtheria, tetanus, whooping cough) Covered Additional immunizations for 0-5 years (Hepatitis B, HiB, Chicken Pox, MMR, Pneumococcal, Rotavirus, Meningitis, Yellow fever) Hepatitis B, HiB & Yellow fever only Surgeries including day case procedure (minor, intermediate surgeries) Covered ( limit of N200,000/annum) Advanced and complex investigations – CT Scan, MRI & Echocardiogram Covered (only on emergency/once per annum) Intensive Care Services Covered (24 hours) Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit) Covered (24 hours) Kidney Dialysis Emergency (1session only) Health Checks (Principal Only). On-site only – Physical, BP, Blood Sugar, BMI Ambulance Services Roadside/Hospital to Hospital Infertility Treatment Counselling, Sperm functional Assessment, USS & HSG (N25,000 limit) Psychiatric Treatment Outpatient Care Only (3 months) HIV/AIDS Care & Treatment (management of opportunistic infection only) Covered Inter-state Referral Services for services not available in State or Out of station Care Covered Medical Enquiries Covered Second Opinion Services Covered Antenatal Care, Normal Delivery, Caesarian Section & 6 weeks Postnatal care Covered to a limit of N200, 000 Family Planning Services IUCDs, Pills & Injectibles Physiotherapy 7 sessions Ophthalmic Care (Treatment of chronic & acute eye diseases) Covered (N 50,000 limit per annum) Optical ware – Lense and frame or contact lenses Covered (N 6,000 limit per annum) Primary Dental Care Covered (non-surgical extraction & filling x 3 teeth maximum/annum, therapeutic scaling & polishing – relating , pain relief) Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesics Covered (N 10,000 limit per annum) Mortuary Services (Cleaning, Embalment, Storage & Autopsy N 50,000 limit Premium per person/Month N4,000 .00K - Pro Max
-
Benefits Pro Max Region of cover Local Hospital Lagoon Hospitals Inpatient Limit (N) 600,000.00 Accidents & Emergencies: Resuscitative or lifesaving initial treatment Up to Inpatient limit Accommodation (including feeding) Semi Private Ward (20 Days/Annum) Inpatient medication, medical & surgical consumables Up to Inpatient limit Surgeries including day case procedures, minor, intermediate and major surgeries (including Caesarean Delivery) N250,000.00 (limit) Consultations General consultations (Initial and follow up) Up to Outpatient Limit Specialist Consultations (Initial and follow up) Once/Month Telemedicine Unlimited 24/7 Medications Chronic Disease Medication N100,000.00 Outpatient Prescription Medicines N100,000.00 Tests & Investigations X-Rays and Basic Diagnostic Tests Up to Outpatient Limit Laboratory tests (WHO list of essential in-vitro diagnostics Up to Outpatient Limit Advanced & Complex Investigations (limited to CT Scan and MRI Scan Twice per annum Maternity and Neo-Natal Services Antenatal Care +Normal Delivery +Postnatal care (6 weeks) N150,000.00 Neonatal care services (Male circumcision, Ear piercing) N50,000.00 Immunizations NPI Immunizations for 0-5years BCG, Measles, DPT, Oral polio, IPV, Vitamin A, supplementation, Pentavalent vaccine Additional Immunizations for 0-5years Hepatitis B, Hib, Chicken pox, MMR, Pneumococcal, Rotavirus, Yellow Fever Additional Immunizations for 6 years and above Hepatitis B, Yellow Fever Ambulance Evacuation services Home/Road side to Hospital 4 times per annum Hospital to Hospital 4 times per annum Other benefits Critical illness + Death cover N400,000.00 Dental Care Relief of pain, fillings, Non-surgical extractions, preventive care, scaling and polishing, Dental surgical Extraction (N40,000.00 per annum) Family Planning services IUCDs, Pills & Mortuary services (cleaning, Embalmment, storage, Autopsy) N50,000.00 Optical care: Eye testing, Treatment of acute and chronic eye diseases N40,000.00 Physiotherapy N40,000.00 Psychiatric Treatment Outpatient only (3 Months) - Premium*
-
HEALTH MAINTAINANCE AND PREVENTIVE SERVICES.
- Annual medical checkup
- Vaccines such as BCG,Measles, DPT,Oral Polio, Vitamin A supplementation, HEPATITIS B,HiB, MMR, Pneumococcal vaccine
INPATIENT CARE
- Room and board (General ward)
- Prescribed diets.
- Services of a dietician
- Skilled nursing
- Isolation ward
- A bed in an emergency room and observation room/Area.
- Use of operating, delivery, cast, and treatment rooms and equipment.
- Prescribed drugs administered while on admission
- Medical and surgical dressings,supplies,casts,splints.etc
- Oxygen and administration of oxygen
- Diagnostic laboratory and medical imaging services.
BIRTH CONTROL, FAMILY PLANNING AND STERILIZATION
- Hormonal methods viz.oral and injectable contraceptive, implants.
- Non-hormonal methods viz.barrier methods((condoms,diaphragms,cervical caps), intra-uterine devices(IUDs), spermicides
BEHAVIORAL HEALTH SERVICES (48HRS)
- Outpatient psychiatric care services.
- Inpatient psychiatric care services excluding convulsive therapy treatment.
DENTAL CARE (MAX LIMIT OF N20, 000)
- Basic dentistry viz.extraction of teeth and roots, fillings (amalgam and composite), scaling and polishing (therapeutic and preventive), X-rays.
DIABETIC EQUIPMENT AND SUPPLIES
- Blood glucose monitors.
- Test strips for glucose monitors
- Insulin preparations, insulin pens and insulin cartridges.
RENAL DIALYSIS
- Acute renal disease involving diagnosis up to 3 sessions.
EMERGENCY MEDICAL SERVICES.
- In country emergency medical services
- Roadside to hospitals, hospital to hospital, hospital to home
- Emergency room stabilization
- Intensive care up to 48hrs.
HEALTH MAINTAINANCE AND PREVENTIVE SERVICES.
- Annual medical checkup
- Vaccines such as BCG,Measles, DPT,Oral Polio, Vitamin A supplementation, HEPATITIS B,HiB, MMR, Pneumococcal vaccine
HIV TREATMENT.
- Definitive treatment and monitoring.
- Treatment of opportunistic infections,
MARTERNITY CARE (OVERALL LIMIT OF N150, 000)
- Normal pregnancy
- Prenatal care
- Spontaneous vaginal delivery
- Assisted vagina delivery
- Caesarean section delivery
- Postnatal care
- Puerperal infection
- False labor
- Occasional spotting
- Physician prescribed inpatient bed rest during pregnancy
- Morning sickness
- Hyperemesis gravidarum
- Preeclampsia
- Termination of pregnancy for life-endangering conditions
- Room and board, prescribed diets, the services of a dietician and skilled nursing in connection with childbirth for the mother or newborn, child a vaginal delivery or cesarean delivery
NEONATAL SERVICES UP TO 48HRS
- Incubator care for term and preterm delivery
- Phototherapy
- Exchange blood transfusion
OPHTHALMIC SERVICES (MAX LIMIT OF N10, 000)
- Ophthalmology viz. primary care limited to pain relief and treatment of simple eye infection
- Optical supplies viz, unifocal, bifocal, varifocal, optical frames.
PATIENT EDUCATION
- Prenatal classes
- Diabetes classes
- Asthma classes
- Hypertension classes
PHYSICIAN SERVICE
- General outpatient/inpatient consultation
- Specialist outpatient/inpatient consultation
- Electrocardiography
- Diagnostic medical imaging
- Basic X-rays
- Contrast studies
- Diagnostic ultrasound
- CT Scan
- Diagnostic laboratory tests
- Hematology
- Serology
- Blood chemistry
- Urinalysis
- Urea clearance
- Creatinine clearance
- Stool occult blood
- Microbiology
PRESCRIPTION DRUGS
- Generic
- Branded
REHABILITATION SERVICES (OUTPATIENT SHORT TERM THERAPY)
- Physical, neurocognitive and speech therapy, supply of basic physiotherapeutic appliances i.e. cervical collar, lumbar corset, crutches.
SURGICAL SERVICES (MAX LIMIT OF N150, 000)
- Surgical supplies normally required for covered surgical procedures.
- Anesthesia normally required for covered surgical procedures.
- Administration of blood and blood products.
- Second and third surgical opinions.
- Minor surgeries.
- Intermediate surgeries (uncomplicated).
- Major surgeries.
TERMS
- Coverage of treatment and management of all pre-existing conditions (pregnancy also) have a waiting period of 1 year of membership.
- Hospital inpatient services for covered services (prescription limit of N100,000/policy year).
- 30 days on admission max.