Family (Maximum of 6)
COVERED SERVICES | TOPAZ | SAPPHIRE | EMERALD | RUBY | DIAMOND |
Medical emergency services | Covered | Covered | Covered | Covered | Covered |
Outpatient services | General consultation + one specialist | General + Specialist consultation (5) | General + Specialist consultation (10) | General + Specialist consultation (15) | General + Specialist consultation |
Inpatient medical services | General ward (10) | General ward (12 days cumulative) | General ward semi private ward (15 days cumulative) | Semi private ward (18 days cumulative) | Private ward |
Malaria | Covered | Covered | Covered | Covered | Covered |
- TYPHOID | Covered | Covered | Covered | Covered | Covered |
- ENDOCRINE / METABOLIC DISORDERS | Covered | Covered | Covered | Covered | Covered |
- MEASLES | Covered | Covered | Covered | Covered | Covered |
- ALLERGIES | Covered | Covered | Covered | Covered | Covered |
- CHICKEN POX | Covered | Covered | Covered | Covered | Covered |
- URINARY TRACT INFECTION | Covered | Covered | Covered | Covered | Covered |
Uncomplicated urinary tract infection | Covered | Covered | Covered | Covered | Covered |
- PEPTIC ULCER DISEASE | Covered | Covered | Covered | Covered | Covered |
Acute exacerbation of peptic ulcer disease | Covered | Covered | Covered | Covered | Covered |
- INDIGESTION | Covered | Covered | Covered | Covered | Covered |
- UPPER AND LOWER RESPIRATORY TRACT INFECTION | Covered | Covered | Covered | Covered | Covered |
Pneumonia | Covered | Covered | Covered | Covered | Covered |
Bronchitis | Covered | Covered | Covered | Covered | Covered |
Influenza | Covered | Covered | Covered | Covered | Covered |
Viral Croup | Covered | Covered | Covered | Covered | Covered |
Bronchiolitis | Covered | Covered | Covered | Covered | Covered |
Tonsillitis | Covered | Covered | Covered | Covered | Covered |
- ASTHMA | Covered | Covered | Covered | Covered | Covered |
Catarrh and cold | Covered | Covered | Covered | Covered | Covered |
HIV/AIDS investigation for confirmation | Covered | Covered | Covered | Covered | Covered |
PCV | Covered | Covered | Covered | Covered | Covered |
MP | Covered | Covered | Covered | Covered | Covered |
WIDAL | Covered | Covered | Covered | Covered | Covered |
FBC + DIFF | Covered | Covered | Covered | Covered | Covered |
SERUM PREGNANCY TEST (BLOOD) | Covered | Covered | Covered | Covered | Covered |
URINE PREGNANCY TEST (URINE) | Covered | Covered | Covered | Covered | Covered |
ESR | Covered | Covered | Covered | Covered | Covered |
RBS/FBS | Covered | Covered | Covered | Covered | Covered |
URINALYSIS | Covered | Covered | Covered | Covered | Covered |
M/C/S (URINE, SPUTUM, CSF, WOUND SWAB) | Covered | Covered | Covered | Covered | Covered |
E/U/CR | Covered | Covered | Covered | Covered | Covered |
BLOOD GROUP AND GENOTYPE | Covered | Covered | Covered | Covered | Covered |
HBSAg | Not Covered | Covered | Covered | Covered | Covered |
HBV / HCV | Not Covered | Not Covered | Covered | Covered | Covered |
H. PYLORI | Not Covered | Not Covered | Covered | Covered | Covered |
COOMB’S TEST | Not Covered | Not Covered | Covered | Covered | Covered |
BLOOD CULTURE | Not Covered | Not Covered | Covered | Covered | Covered |
PERIPHERAL BLOOD FILM | Not Covered | Not Covered | Covered | Covered | Covered |
CLOTTING PROFILE | Not Covered | Not Covered | Covered | Covered | Covered |
BLEEDING TIME | Not Covered | Not Covered | Covered | Covered | Covered |
INR | Not Covered | Not Covered | Covered | Covered | Covered |
D- DIMER | Not Covered | Not Covered | Covered | Covered | Covered |
FECAL OCCULT BLOOD | Not Covered | Not Covered | Covered | Covered | Covered |
FERRITIN LEVELS | Not Covered | Not Covered | Covered | Covered | Covered |
HbA1c | Not Covered | Not Covered | Covered | Covered | Covered |
LFT | Not Covered | Covered | Covered | Covered | Covered |
KFT | Not Covered | Covered | Covered | Covered | Covered |
Confirmation of pregnancy | Covered | Covered | Covered | Covered | Covered |
Antenatal Care (from 12 weeks) | Covered | Covered | Covered | Covered | Covered |
Management of labour and delivery | Not Covered | Covered | Covered | Covered | Covered |
Surgical intervention | Not Covered | Covered | Covered | Covered | Covered |
Postnatal care | Not Covered | Not Covered | Covered | Covered | Covered |
Febrile convulsions | Covered | Covered | Covered | Covered | Covered |
Routine immunization services | Covered | Covered | Covered | Covered | Covered |
ICU/SCBU (1st 24Hrs and monetary limit 50,000) | Not Covered | Covered | Covered | Covered | Covered |
Minor Procedures | Covered | Covered | Covered | Covered | Covered |
Intermediate procedures | Not Covered | Covered | Covered | Covered | Covered |
Major procedures | Not Covered | Surgical limit = 150,000 for individual | Surgical limit = 200,000 for individual | Surgical limit = 400,000.00 for individual | Surgical Unlimited |
Basic eye examination (only) | Covered | Covered | Covered | Covered | Covered |
Stye | Covered | Covered | Covered | Covered | Covered |
Conjunctivitis | Covered | Covered | Covered | Covered | Covered |
Ocular allergies | Covered | Covered | Covered | Covered | Covered |
keratitis | Covered | Covered | Covered | Covered | Covered |
Optical Lens Limit (Biennial) | 5000 | 10000 | 15000 | 30000 | 50000 |
Eye surgeries (minor) | Not Covered | Covered | Covered | Covered | Covered |
Eye surgery (intermediate) | Not Covered | Covered | Covered | Covered | Covered |
Eye surgeries (Major) | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
TREATMENT OF MINOR AILMENTS | Covered | Covered | Covered | Covered | Covered |
Gingivitis | Covered | Covered | Covered | Covered | Covered |
Scurvy | Covered | Covered | Covered | Covered | Covered |
Tooth pain | Covered | Covered | Covered | Covered | Covered |
Simple Extraction | Covered | Covered | Covered | Covered | Covered |
Routine pain management | Covered | Covered | Covered | Covered | Covered |
Amalgam filling | Not Covered | Covered | Covered | Covered | Covered |
Scaling and polishing | Not Covered | Covered | Covered | Covered | Covered |
Denture and bridges | Not Covered | Not Covered | 50% Covered | 60% Covered | 80% Covered |
RCT | Not Covered | Not Covered | Covered | Covered | Covered |
Surgical extraction | 5000 | 10000 | 15000 | 30000 | 50000 |
X-rays and Ultrasound | Covered | Covered | Covered | Covered | Covered |
CT Scan & MRI (50% co-payment) | Not Covered | Emergency Only | Emergency + Once | Emergency + Once | Twice |
Echocardiography | Not Covered | Covered | Covered | Covered | Covered |
Electrocardiography | Not Covered | Not Covered | Not Covered | 50% Covered | 70% Covered |
Doppler scan | Not Covered | Not Covered | 30% Covered | 50% Covered | 70% Covered |
Sessions | 0 | 3 | 5 | 10 | 15 |
Annual Medical Examination | Not Covered | 50% copayments on investigation | 45% copayment on investigations | 35% copayment on investigations | 15% copayment on investigations |
PRESCRIBE MEDICATION | Generic | Generic | Generic | Branded | Branded |
Family planning services | Covered | Covered | Covered | Covered | Covered |
Renal dialysis (Monetary limit of 30,000) | Not Covered | Not Covered | Not Covered | Covered | Covered |
Infertility consultation, investigation and non-hormonal drug management | Not Covered | Not Covered | Not Covered | Covered | Covered |
Blood pressure, diabetes and sickle cell anaemia can be managed based on the plan of choice. | Not Covered | Covered | Covered | Covered | Covered |
Feeding (N1500.00 Per day) | Covered | Covered | Covered | Covered | Covered |
Gym services | Not Covered | Not Covered | Once a week | Twice a week | Thrice a week |
Ambulance services | Not Covered | Hospital to Hospital only | Hospital, accident scene | Home, accident scene, and Hospital to Hospital | All services within the country |
Mortuary services | Not Covered | Five Days | Ten Days | Fifteen days | Twenty days |
Family (Maximum of 6) | ₦102,000 | ₦140,000 | ₦260,000 | ₦600,000 | ₦1,000,000 |
ADDITIONAL DEPENDANT EACH | ₦20,000 | ₦30,000 | ₦55,000 | ₦140,000 | ₦240,000 |
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