Sapphire Plan

SAPHIRE BENFITS PLAN

COVERED SERVICES

SAPHIRE

medical emmergency services

COVERED

outpatient services

General + Specialist consultation (5)

inpatient medical services

General ward 15 days cumulative)

malaria

COVERED

-       Typhoid

COVERED

-       ENDOCRINE / METABOLIC DISORDERS

COVERED

-       ALLERGIES

COVERED

-       MEASLES

COVERED

-       CHICKEN POX

COVERED

-       URINARY TRACT INFECTION

COVERED

. Uncomplicated urinary tract infection

COVERED

-       PEPTIC ULCER DISEASE

COVERED

. Acute exacerbation of peptic ulcer disease

COVERED

   -  INDIGESTION

COVERED

-       UPPER AND LOWER RESPIRATORY TRACT INFECTION

COVERED

. Pneumonia

COVERED

. Bronchitis

COVERED

. Influenza

COVERED

. Viral Croup

COVERED

. Bronchiolitis

COVERED

. Tonsillitis

COVERED

-       ASTHMA

COVERED

Catarrh and cold

COVERED

HIV/AIDS investigation for confirmation

COVERED

INVESTIGATIONS

. PCV

COVERED

. MP

COVERED

. WIDAL

COVERED

. FBC + DIFF

COVERED

. SERUM PREGNANCY TEST(BLOOD)

COVERED

. URINE PREGNANCY TEST (URINE)

COVERED

. ESR

COVERED

. RBS/FBS

COVERED

. URINALYSIS

COVERED

. M/C/S (URINE, SPUTUM, CSF, WOUND SWAB)

COVERED

. E/U/CR

COVERED

. BLOOD GROUP AND GENOTYPE

COVERED

. HBSAg

COVERED

. HBV / HCV

NOT COVERED

. H. PYLORI

NOT COVERED

. COOMB’S TEST

NOT COVERED

. BLOOD CULTURE

NOT COVERED

. PERIPHERIAL BLOOD FILM

NOT COVERED

. CLOTING PROFILE

NOT COVERED

. BLEEDING TIME

NOT COVERED

. INR

NOT COVERED

. D- DIMER

NOT COVERED

. FECAL OCCULT BLOOD

NOT COVERED

. FERRITIN LEVELS

NOT COVERED

. HbA1c

NOT COVERED

. LFT

COVERED 

. KFT

COVERED 

MATERNITY AND CHILD SERVICES

Confirmation of pregnancy

COVERED 

Antenatal Care (from 12weeks)

COVERED 

Management of labor and delivery

COVERED 

Surgical intervention

COVERED 

Postnatal care

NOT COVERED

Febrile convulsions

COVERED 

Routine immunization services

COVERED 

ICU/SCBU (1st 24Hrs and monetary limit 50,000)

COVERED 

SURGICAL SERVICES

Minor Procedures

COVERED

Intermediate procedures

COVERED

Major procedures

Surgical limit = 150,000 for individual

EYE SERVICES

Basic eye examination (only)

COVERED

. Stye

COVERED

. Conjunctivitis

COVERED

. ocular allergies

COVERED

. keratitis

COVERED

Optical Lens Limit (Biennial)

10,000

Eye surgeries (minor)

COVERED

Eye surgery (intermediate)

COVERED

Eye surgeries (Major)

NOT COVERED

DENTAL CARE

TREATMENT OF MINOR AILMENTS

COVERED

. Gingivitis

COVERED

. Scurvy

COVERED

. Tooth pain

COVERED

Simple Extraction

COVERED

Routine pain management

COVERED

Amalgam filling

COVERED

Scaling and polishing

COVERED

Denture and bridges

NOT COVERED

RCT

NOT COVERED

Surgical extraction

10,000

RADIOLOGICAL SERVICES

X-rays and Ultrasound

COVERED

CT Scan & MRI (50% co-payment)

EMERGENCY ONLY

Echocardiography

COVERED

Electrocardiography

NOT COVERED

Doppler scan

NOT COVERED

PHYSIOTHERAPHY

Sessions

3

MEDICAL CHECK UP

Annual Medical Examination

50% copayments on investigation

PRESCRIBE MEDICATION

Generic

ADDED BENEFITS

Family planning services

COVERED

Renal dialysis (Monetary limit of 30,000)

NOT COVERED

Infertility consultation, investigation and non-hormonal drug management

NOT COVERED

Blood pressure, diabetes and sickle cell anemia can be managed based on plan of choice.

COVERED

PREMIUM PER ANNUM

SINGLE INDIVIDUAL

N47,000.00

FAMILY (MAXIMUM OF 4 )

N180,000.00

ADDITIONAL DEPENDANT EACH

N30,000.00

ADDITIONAL BENEFITS

COVERED

Feeding (N1500.00 Per day)

Gym services

NOT COVERED

Ambulance services

Hospital to Hospital only

Mortuary services

Five days