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PLANS → BUDGET BUDGET-PLUS STANDARD EXECUTIVE

SERVICES ↓

EMERGENCY SERVICES

Local evacuation to Hospital

Covered
Covered
Covered
Covered

Emergency Drug and Investigations (Restricted to Resuscitative Drugs & Routine Investigations)

Covered
Covered
Covered
Covered

OUTPATIENT SERVICES

General Consultation
Covered
Covered
Covered
Covered
Specialist Consultation (After Due Referral)
Covered
Covered
Covered
Covered
Routine Laboratory tests (Baseline Investigations: FBC, MP, Urinalysis & Widal, M/C/S,)
Covered
Covered
Covered
Covered
Provision of Prescribed Drugs as per coverage (Total Exclusion of, Cancer Drugs.)
Covered
Covered
Covered
Covered
Physiotherapy (subject to coverage)

Covered. Maximum of 5 Sessions Per Annum at selected Hospitals

Covered. Maximum of 10 Sessions Per Annum at selected Hospitals

Covered. Maximum of 20 Sessions Per Annum.

Covered. Maximum of 30 Sessions Per Annum.

Supportive Orthotics (Corset Neck Collar)
Not Covered
Covered
Covered
Covered

Gymnasium Services-at Selected Fitness Centres (For Principals only)

Covered
Covered
Covered
Covered

INPATIENT SERVICES

Admission

Covered for open ward. Maximum of cumulative 20 days/annum.

Covered for open ward. Maximum of cumulative 25 days/annum.

Covered for Open and Semi-Private Wards. Maximum of cumulative 30 days/annum.

Covered for Open, Semi-Private, and Private Wards. Maximum of cumulative 40 days/annum.

General Doctor Review
Covered
Covered
Covered
Covered
Specialist Doctor Review (After Due Referral)
Covered
Covered
Covered
Covered
Medical and Nursing Care
Covered
Covered
Covered
Covered
Drugs and Infusions as Prescribed
Covered
Covered
Covered
Covered
Laboratory investigations as Prescribed (Routine)
Covered
Covered
Covered
Covered
Blood Transfusion
Covered
Covered
Covered
Covered

COVERAGE FOR MANAGEMENT OF LONG STANDING/ CHRONIC MEDICAL CONDITIONS:

Hypertension, Diabetes, Asthma, Spondylosis, Sickle Cell Anaemia, Seizure Disorders, Stroke, CVA, Allergies, Glaucoma Medical Treatment, Autoimmune Disorders, ETC.

Not Covered
Not Covered
Covered
Covered
Glaucoma Surgical Treatment
Not Covered
Not Covered
Not Covered
Covered

MATERNITY SERVICES (For Principal and Spouse Under Family Plan Only)

Antenatal Care (From 12 weeks Gestational Age)
Covered
Covered
Covered
Covered
Cervical Cerclage
Not Covered
Not Covered
Covered
Covered
Pregnancy Induced Hypertension Up to 1 Month After Delivery(Pre- Eclampsia/Eclampsia)
Covered
Covered
Covered
Covered

Incubator Care for Premature Babies.

at Selected Hospitals

Covered- Max of 5 days
Covered – Max of 7 days
Covered
Covered
Phototherapy for Babies
Not Covered
Not Covered
Covered –Max of 1 week
Covered – Max of 2 weeks

Exchange Blood Transfusion for Neonates.

at Selected Hospitals

Covered
Covered
Covered
Covered
Normal Delivery
Covered
Covered
Covered
Covered
Conduction of Labor and Assisted Delivery
Covered
Covered
Covered
Covered
C/S (Emergency and Medically Indicated Electives)

Covered (Limit of N100,000)

Covered
Covered
Covered
Family Planning Services

Covered (For Counseling Only)

Covered (For Counseling Only)

Covered (For Injectables & IUCDs & Implants)

Covered (For Injectables & IUCDs only)

CHILD HEALTH SERVICES

Routine Immunization (NPI) – From Birth to 9 Months
Covered
Covered
Covered
Covered
Additional Immunization – (HIB and Booster Dose of DPT, OPV & MMR at 18 Months) IPV at Selected Hospitals
Not Covered
Not Covered
Covered
Covered
Pediatric Surgery

Covered for Minor Surgery only

  • Limit N20,000

Covered for Minor & Intermediate Surgery only

  • Limit N35,000

Covered for Minor, Intermediate & Major Surgery

Covered for Minor, Intermediate & Major Surgery

SURGICAL SERVICES

Minor Procedures
Covered
Covered
Covered
Covered
Intermediate Procedures

Covered

  • Limit N50,000

Covered

  • Limit N80,000
Covered
Covered
Major Procedures
Not covered

Covered

  • Limit N100,000
Covered
Covered

RADIOLOGICAL SERVICES

Plain X-Ray and Ultrasound Scans
Covered
Covered
Covered
Covered
CT Scan (With clear indication and recommendation by attending Doctor)
Not Covered
Covered 50% (Max of 1per year) – For Principals only
Covered (Max of 1per year)
Covered (Max of 2 per year)
MRI (With clear indication and recommendation by attending Doctor)
Not Covered
Covered 50% (Max of 1per year) – For Principals only
Covered (Max of 1 per year)
Covered (Max of 2 per year)

EYE CARE

Routine Examination
Covered
Covered
Covered
Covered
Treatment of Infection
Covered
Covered
Covered
Covered
Simple Eye Surgery
Not Covered
Not Covered

Covered

  • Limit of N40,000
Covered
Biennial Optical Lens Limit

Covered. Optical Lens Limit of N8,000

Covered. Optical Lens Limit of N12,000

Covered Optical Lens Limit of N20,000

Covered Optical Lens Limit of N30,000

DENTAL CARE

Routine Examination
Covered
Covered
Covered
Covered
Treatment of Infection
Covered
Covered
Covered
Covered
Simple Extraction
Covered
Covered
Covered
Covered
Surgical Extraction
Not Covered
Covered 50%
Covered
Covered
Dental Fillings:
Amalgam Fillings (Classes 1 & 5)
Covered
Covered
Covered
Covered
GIC Fillings
Not Covered
Not Covered
Covered
Covered
Composite Filling
Not Covered
Not Covered
Covered
Covered
Crowns, Bridges, Bleaching, Root Canal and Implant
Not Covered
Not Covered
Not Covered
Covered
Scaling and Polishing (For Medical Reasons Only)
Not Covered

Covered

(Max 1 session per annum) - for principals only

Covered

(Max 2 session per annum) - for principals only

Covered

MEDICAL CHECK-UP

Routine physicals (no investigations)
Covered
Covered
Covered
Covered
Annual Medical Examination (with SPECIFIED Investigations as stated below) For Principal Only, In Selected Hospitals.
Not Covered
Not Covered
Covered
Covered

MENTAL HEALTH SERVICES

Counseling
Covered
Covered
Covered
Covered
Out Patient Consultation and Treatment (up to 4 weeks)
Not Covered
Not Covered
Covered – ECT/EEG maximum of 1 session per annum, annum & Drug treatment (AT SELECTED HOSPITALS)
Covered –ECT/EEG -maximum of 2 sessions per annum. Drug treatment & toxicology screening (AT SELECTED HOSPITALS)

FERTILITY SERVICES (Counseling Only)

General exclusion of provision of Condoms, Hormonal Tests/ Treatment, Tubal Ligation, Vasectomy, Erectile Dysfunction, Artificial Insemination including IVF and ICSI etc.

CANCER CARE

Cancer Screening (Limited to Clinical Examination of Breast, Cervix and Prostate Cancer)
Covered
Covered
Covered
Covered
Diagnostic Investigation
Not Covered
Not Covered

Covered for USS Scan & E/U/Cr, Only

(Max of 1 Per annum)

Covered for:

  1. USS Scan & E/U/Cr (Max of 3 Per annum)
  1. Mammography, PSA and Pap Smear (Max of one per annum each).
Surgical treatment for Cancer of the Breast, Cervix & Prostate
Not Covered
Not Covered
Not Covered
Covered

Note:

A.

- Individual Plan Covers the Principal Only

- Family Plan Covers the Principal, Spouse and 4 Biological Children under Age 21

 

B.

* Annual Medical Examination (with investigations) consists of the following:

 

  1. General Physical Examination:
  • Consultation with General Examination
  • Height & Weight Assessment with BMI Calculation
  • Blood Pressure Measurement
  • Healthy Lifestyles Advice

 

  1. Laboratory and Imaging Investigations
  • FBC, Urine test, stool test
  • Kidney and Liver Function Tests
  • FBS and Lipid Profile