This plan caters for the basic healthcare needs of your staff granting them access to standard healthcare services and protecting them against common illnesses.
| BENEFITS | AVAILABILITY | WAITING PERIOD |
|---|---|---|
OUT-PATIENT SERVICES | ||
HOSPITAL CATEGORY AVAILABLE | Category A | Nil |
Outpatient Treatment | ||
General Consultation | ||
Specialist Consultation: Obs & Gynea, Pediatrician, Physician, General Surgeon | (3 visits/year) | |
Subspecialist Consultation: Orthopedics, ENT, Cardiologist, Urologist, Dermatologist. | ||
Rare Specialist Consultation: Neurologist, Peadiatric Surgeon, Cardiothoracic surgeon, Neurosurgeon, Oncologist, Haematologist. | ||
Prescribed Essential Drug | ||
Routine LaboratoryInvestigations Malaria Parasite; Widal; Full Blood Count and Differentials; Urine Microscopy, Culture and Sensitivity; Urinalysis; Stool Microscopy, Culture and Sensitivity; Blood Sugar; Electrolyte and Urea, Creatinine, Uric acid assay, Calcium and Phosphate assay (As requested by the Doctor) | ||
Dressing of simple wounds/ burns | ||
Counselling and seminars on health related issues | ||
EMERGENCY AND IN-PATIENT SERVICES | ||
Emergency Services (subject to limit of) → | N30,000/year | Nil |
Stabilization | ||
Prescribed Essential Drug and investigations | ||
Ambulance Service (from hospital to hospital) | ||
Ambulance service (Evacuation from Site to Hospital) | ||
Intensive care services, Neonatal ICU, SCBU | ||
Inpatient consultation and treatment | ||
General Review | ||
Specialist Review (as part of specialist care /visit limit under Out-patient services) | ||
Admission | General Ward | |
Length of admission | 10 days per year | |
Nursing care | ||
Feeding while on admission | ||
Prescribed Drugs | ||
MEDICAL IMAGING | ||
Plain X-rays | Nil | |
Contrast Studies | ||
Ultrasound Scan | ||
Electrocardiography (ECG) | ||
Echocardiography or Doppler scan | ||
CT Scan (emergency) | ||
MRI (one per year) - emergency | ||
Laboratory investigations: Hematological, Microbiological, serology & Clinical chemistry, investigations | (Routine Investigations) | |
NEONATAL/PEDIATRIC SERVICES | ||
Under 5 Child Immunization (NPI): | Nil | |
Oral Polio Vaccine (OPV) | ||
BCG vaccine | ||
Pentavalent Vaccine | ||
Diphtheria, Pertussis | ||
Tetanus (DPT) | ||
Hepatitis B | ||
Haemophilus Influenza B (Hib) | ||
Measles | ||
Yellow fever | ||
Additional Immunization (Under 5 years):- | ||
MMR, Chicken Pox, Pneumococcal vaccine (PCV) | ||
Dialysis – Emergency only | ||
VALUE ADDED SERVICES | ||
Complementary Gym/Spa services (principal only) | Nil | |
Physiotherapy services | 5 sessions | |
Health Education, wellness forums and lifestyle optimization programme | ||
TELEMEDICINE SERVICES | ||
OPHTHALMOLOGICAL SERVICES | ||
Eye care services including lens /frame (after 6 months on the scheme) | 6 Months | |
Basic eye care | ||
Lens and frame (Per year) | ||
DENTAL SERVICES | ||
Basic Dental Services (after 6 months on the scheme) | 6 Months | |
MENTAL HEALTH SERVICES | ||
Mental health services (after 6 months of being on the scheme) | First two weeks | 6 Months |
ANNUAL MEDICAL EXAMINATION (Principal Beneficiary Only) | ||
Health Screening at designated centres (after 9 months on the scheme) | 9 Months | |
CHRONIC DISEASE MANAGEMENT | ||
Management of chronic illnesses (consultation, tests and drugs), eg: Diabetes Mellitus, Hypertension, Peptic Ulcer Disease, Arthritis, Sickle Cell Anaemia, etc. (after 12 months of being on the scheme) | 12 Months | |
NEONATAL/PEDIATRIC SERVICES | ||
SCBU, Incubator Care, Blood transfusion & Phototherapy - post delivery after 12 months on scheme | 12 Months | |
Neonatal Care (treatment of sepsis, Ear piercing, male Circumcision) - post delivery after 12 months on scheme | ||
SURGICAL OPERATIONS | ||
Surgical Operations (after 12 months on the scheme) | Up to a limit of N50,000 | 12 Months |
Minor (e.g. lump removal) | ||
Intermediate(e.g. appendix operation) | ||
Major (e.g. fibroid operation) | ||
HIV/AIDS & Anti-Viral therapy (after 12 months on the scheme) | ||
Voluntary counselling and testing | 12 Months | |
Diagnosis and treatment of HIV/AIDS at designated centres | Covered at designated centers in Nigeria | |
Antiviral therapy | ||
OBSTETRICS AND GYNECOLOGICAL SERVICES (for family plan only) | ||
MATERNITY SERVICES (after 12 months on the policy) | 12 Months | |
Antenatal, Perinatal care /Normal Delivery and Post natal care | ||
Caesarean section | ||
Family Planning services (oral contraceptives, injectables, IUCD, Implants) | ||
Management of Infertility - Consultation with specialist, SFA, USS, Hormones, Drugs (after 12 months of being on the scheme) | ||
Pre-term admission (after 12 months on scheme) | ||
RETAIL PLAN PREMIUM (PER ANNUM) | ||
PRINCIPAL/INDIVIDUAL | 19,750.00 | |
PRINCIPAL + SPOUSE | 42,640.00 | |
PRINCIPAL + SPOUSE + 1 CHILD | 61,225.00 | |
PRINCIPAL + SPOUSE + 2 CHILDREN | 79,990.00 | |
PRINCIPAL + SPOUSE + 3 CHILDREN | 97,760.00 | |
PRINCIPAL + SPOUSE + 4 CHILDREN | 107,640.00 | |
Overall Insured Naira Limits (Per annum) | ||
PRINCIPAL/INDIVIDUAL | 201,450.00 | |
PRINCIPAL + SPOUSE | 322,320.00 | |
PRINCIPAL + SPOUSE + 1 CHILD | 427,000.00 | |
PRINCIPAL + SPOUSE + 2 CHILDREN | 529,570.00 | |
PRINCIPAL + SPOUSE + 3 CHILDREN | 635,480.00 | |
PRINCIPAL + SPOUSE + 4 CHILDREN | 686,320.00 | |
OVERSEAS EVACUATION PLAN | ||
Emergency Overseas evacuation, treatment & Repartration including USA (as contained under product details). | Please request for a quote | |
DETAILS OF ANNUAL MEDICAL EXAM | ||
Health Screening at designated centres (after 9 months on the scheme) | 9 Months | |
CONDITIONS FOR THE QUOTE:
- The premiums quoted are valid for a period of 90 days from the date of submission.
- Age limit on all the plans is 60 years (principal or spouse).
- Age limit for child dependant is 21 years old.
GENERAL EXCLUSIONS:
The following services are not covered on any of our plans.
- Services not listed as covered in the schedule of benefits by plan types.
- Services rendered by persons who are not certified and registered healthcare practitioners
- Complex Surgeries (e.g. brain, spinal cord, heart, organ transplants) and Congenital malformations/anomalies, speech disorders, etc.
- Artificial limbs and dental prostheses.
- Cytotoxic (anti- cancer) drugs and radiotherapy – for some plans and after the limits.
- Plastic (Cosmetic) surgery
- Joint Replacement and Prosthetic limbs
- Treatment of gross obesity
- Home care and Domiciliary care.
- Orthodontics and Extensive Dental Surgeries including maxillofacial surgeries
- Treatment resulting from attempted suicide.
- Treatment resulting from engaging in physical combat (e.g. street fighting, domestic fighting)
- Treatment resulting from participation in conflicts, social unrest, riots, wars, strike, or other illegal acts etc.
- Treatment from participation in extreme/high risk sports (e.g. car racing, motorcycle racing, polo, boxing, wrestling, horse racing, mountaineering etc.)
- Occupational/Industrial injuries already covered by workman compensation act.
- Drugs that enhance sexual performance.
- Supplements and Herbal drugs
- Weight loss programs.
- Treatment for conditions that occurred as a result of alcohol abuse, drug abuse and other unlawful conduct.
- Definitive anti-viral therapy.
- Voluntary termination of pregnancy, alternative treatments (acupuncture, acupressure, scarification).
