PRECIOUS HMO BENEFIT PACKAGE/ PREMIUM COVERED SERVICES

PRECIOUS HMO BENEFIT PACKAGE/ PREMIUM COVERED SERVICESPRECIOUSDIAMONDSTAROLIVEOLIVE EXECUTIVE
INDIVIDUAL (PER ANNUM)30, 000.0050, 000.0080, 000.00150, 000.00200, 000.00
FAMILY (PRINCIPAL, SPOUSE & 4 CHILDREN)100, 000.00150, 000.00200, 000.00400, 000.00550, 000.00
COVERED MEDICAL SERVICES
PREVENTIVE SERVICES
AEROBICScovered   covered   covered   covered   covered   
PICNICScovered   covered   covered   covered   covered   
ABUJA CENTRAL PARK (25% Discount with Precious ID on all Games.)covered   covered   covered   covered   covered   
GYM SERVICEScovered   covered   
OUTPATIENT SERVICES
General Consultationcovered   covered   covered   covered   covered   
Specialist Consultation/Care (On referral)covered   covered   covered   covered   covered   
OPD Procedures (Non-invasive care)covered   covered   covered   covered   covered   
PRESCRIBED MEDICATIONS/ APPLIANCES
Supply of drugs and medication as recommended in the course or treatment for covered services onlycovered   covered   covered   covered   covered   
HOSPITALIZATION
Number of days per annum7 Days10 Days15 Days21 Days25Days
General Wardcovered   covered   covered   covered   covered   
Semi-Private Wardcovered   covered   covered   
Private Wardcovered   covered   
Skilled nursing care and inpatient medical services, including Supply of drugs, dressings, medical & surgical consumables, for covered services only.covered   covered   covered   covered   covered   
Intensive Care Unit1 Day3 Days5 Days7Days10Days
LABORATORY & DIAGNOSTIC SERVICES
The under listed laboratory investigations and diagnostic
services will be carried out based on
the clinician's judgment
HAEMATOLOGY.
Basic / Primary investigations
Haemoglobin (hb)covered   covered   covered   covered   covered   
Packed cell volume(pcv)covered   covered   covered   covered   covered   
Differential countcovered   covered   covered   covered   covered   
Full blood countcovered   covered   covered   covered   covered   
White cell count(wbc)covered   covered   covered   covered   covered   
Red blood count(rbc)covered   covered   covered   covered   covered   
Erythrocyte, sedimentation rate (esr) wester green covered   covered   covered   covered   covered   
Platelets countcovered   covered   covered   covered   covered   
Genotypecovered   covered   covered   covered   covered   
Blood groupcovered   covered   covered   covered   covered   
Malaria parasitescovered   covered   covered   covered   covered   
Cross matchingcovered   covered   covered   covered   covered   
Secondary investigations
Reticulocytescovered   covered   covered   covered   covered   
Mean Corpuscular haemoglobin concentration nachccovered   covered   covered   covered   covered   
Mean corpuscular volume (mcv)covered   covered   covered   covered   covered   
Mean corpuscular haemoglobin (mch)covered   covered   covered   covered   covered   
Direct coomb's testcovered   covered   covered   covered   covered   
Indirect coomb's testcovered   covered   covered   covered   covered   
Bleeding timecovered   covered   covered   covered   covered   
Clotting timecovered   covered   covered   covered   covered   
Prothrombin time (pt)covered   covered   covered   covered   covered   
Sickling testcovered   covered   covered   covered   covered   
CLINICAL CHEMISTRY
Basic/Primary Investigations
Fasting blood sugarcovered   covered   covered   covered   covered   
Random blood sugarcovered   covered   covered   covered   covered   
Ureacovered   covered   covered   covered   covered   
Creatininecovered   covered   covered   covered   covered   
Electrolyte & Ureacovered   covered   covered   covered   covered   
Calciumcovered   covered   covered   covered   covered   
Phosphoruscovered   covered   covered   covered   covered   
Sodiumcovered   covered   covered   covered   covered   
Potassiumcovered   covered   covered   covered   covered   
Chloride bicarbonatecovered   covered   covered   covered   covered   
Secondary investigations.
2 hrs. post prandialcovered   covered   covered   covered   covered   
Creatinine clearancecovered   covered   covered   covered   covered   
Oral glucose tolerance testcovered   covered   covered   covered   covered   
Total bilirubincovered   covered   covered   covered   covered   
Direct bilirubincovered   covered   covered   covered   covered   
Indirect bilirubincovered   covered   covered   covered   covered   
Sgot & sgpt (each)covered   covered   covered   covered   covered   
Alkaline phosphatasecovered   covered   covered   covered   covered   
Liver function test (Ift)covered   covered   covered   covered   covered   
Total proteincovered   covered   covered   covered   covered   
Albumincovered   covered   covered   covered   covered   
Uric acidcovered   covered   covered   covered   covered   
Prostatic acid phosphotasecovered   covered   covered   covered   covered   
Total acid phosphotasecovered   covered   covered   covered   covered   
Amylasecovered   covered   covered   covered   covered   
Cholesterolcovered   covered   covered   covered   covered   
Tryglyceridecovered   covered   covered   covered   covered   
Csf glucosecovered   covered   covered   covered   covered   
Csf proteincovered   covered   covered   covered   covered   
Csf chloridecovered   covered   covered   covered   covered   
Hdl/ldl cholesterolcovered   covered   covered   covered   covered   
Protein electrophoresis + reportcovered   covered   covered   covered   covered   
Gamma gtcovered   covered   covered   covered   covered   
Ck amylasecovered   covered   covered   covered   covered   
Microbiology
Urinalysiscovered   covered   covered   covered   covered   
Pregnancy test — urinecovered   covered   covered   covered   covered   
Stool occult bloodcovered   covered   covered   covered   covered   
Urine m/ c/ scovered   covered   covered   covered   covered   
Aspirate pus m/ c/ scovered   covered   covered   covered   covered   
Hvs m/c/scovered   covered   covered   covered   covered   
Urethral & wound m/c/scovered   covered   covered   covered   covered   
Stool m/ c/ scovered   covered   covered   covered   covered   
Sputum m/c/scovered   covered   covered   covered   covered   
Mantoux/heaf testcovered   covered   covered   covered   covered   
Semen culture & sensitivitycovered   covered   covered   covered   covered   
Microfilariacovered   covered   covered   covered   covered   
Skin snipcovered   covered   covered   covered   covered   
Skin scrapping for fungal elementscovered   covered   covered   covered   covered   
Sputum afb for tuberculosiscovered   covered   covered   covered   covered   
Blood culturecovered   covered   covered   covered   covered   
C.s.f. m/c/scovered   covered   covered   covered   covered   
Semen analysiscovered   covered   covered   covered   covered   
H.pylori assaycovered   covered   covered   covered   covered   
Serology
Widalcovered   covered   covered   covered   covered   
Hiv 1 & 2 Screening. (At designated Centres).covered   covered   covered   covered   covered   
Pregnancy test hcg (blood)covered   covered   covered   covered   covered   
Hepatitis b. surface antigencovered   covered   covered   covered   covered   
Clamydia screeningcovered   covered   covered   covered   covered   
Vdrl testcovered   covered   covered   covered   covered   
Aso tirecovered   covered   covered   covered   covered   
Rheumatoid factorcovered   covered   covered   covered   covered   
Viral load (At designated Centres).covered   covered   covered   
Cd4 count (At designated Centres).covered   covered   covered   
IMMUNOLOGY (PRE-AUTHORIZATION CODE REQUIRED)Limited to 40kLimited to 60kLimited to 80kLimited to 100k
Cortisol
Follicle Stimulating Hormone
Growth Hormone (HGH
HCG level (Molar Pregnancy)
Insulin
Leutenizing Hormone (HLSH)
Oestriol
Oestradiol
Prolactin
Progesterone.
Testosterone
Thyroid Screen
Thyrotrophin
HISTOPATHOLOGY
Specimen from incisional biopsycovered   covered   covered   covered   covered   
Specimen from excisional biopsycovered   covered   covered   covered   covered   
Pap smearcovered   covered   covered   covered   covered   
Prostatic specific assay (psa)covered   covered   covered   covered   covered   
RADIOLOGICAL INVESTIGATIONS
PLAIN FILMS
Upper limbcovered   covered   covered   covered   covered   
Lower limbcovered   covered   covered   covered   covered   
Thoraxcovered   covered   covered   covered   covered   
Vertebraecovered   covered   covered   covered   covered   
Skull seriescovered   covered   covered   covered   covered   
Upper limbcovered   covered   covered   covered   covered   
BARIUM STUDIES
Ba mealcovered   covered   covered   
Ba enemacovered   covered   covered   
Hsgcovered   covered   covered   
ULTRASOUND SCAN
Obstetricscovered   covered   covered   covered   covered   
Abdominal scancovered   covered   covered   covered   covered   
Abdominopelviccovered   covered   covered   covered   covered   
Pelviccovered   covered   covered   covered   covered   
Breastcovered   covered   covered   
Prostatecovered   covered   covered   
Scrotumcovered   covered   covered   
Tetiscovered   covered   covered   
Thyroidcovered   covered   covered   
Transfrontalcovered   covered   covered   covered   covered   
Transvaginalcovered   covered   covered   covered   covered   
Follicular trackingcovered   covered   covered   covered   covered   
Tissuecovered   covered   covered   covered   covered   
OTHERS
E.C.G (resting)covered   covered   covered   covered   covered   
Spirometrycovered   covered   covered   covered   covered   
E.C. G (pre and post exercise/ stress)covered   covered   covered   covered   covered   
Mammogram1 session1 session
CT scan1 session2 sessions
MRI1 session2 sessions
PHYSIOTHERAPY
Basic physical therapy3 Sessions5 Sessions7 Sessions10 sessions12 sessions
Massages, shortwave, infra-red, radiation. 1 Session2 sessions2 sessions
Cervical collar1 Session1 session1 session
Lumbar corset1 session2 sessions
MANAGEMENT OF SPECIFIED CONDITIONS, CHRONIC CONDITIONSLimited to 50kLimited to 100kLimited to 200kLimited to 300k
Systemic hypertension
Diabetic mellitus
Chronic bronchitis
Bronchial asthma
Sickle cell disease
Peptic ulcer disease
Arthritis
Hyperlipidaemia
SURGICAL PROCEDURES: - Minor, intermediate, Major (Nigeria Only)
MINOR PROCEDURES
Circumcision of male infants/ Ear piercing for females.covered   covered   covered   covered   covered   
Excision of breast lumpcovered   covered   covered   covered   covered   
Ganglionectomycovered   covered   covered   covered   covered   
Lipectomycovered   covered   covered   covered   covered   
Marsupialisation (Bartholin’s cyst)covered   covered   covered   covered   covered   
Surgical drainage of abscesscovered   covered   covered   covered   covered   
Uterine evacuation of incomplete abortioncovered   covered   covered   covered   covered   
In-growing toenailcovered   covered   covered   covered   covered   
Minor wound debridementcovered   covered   covered   covered   covered   
Evacuation of impacted faecescovered   covered   covered   covered   covered   
Drainage of paronychiacovered   covered   covered   covered   covered   
Suturing of Minor Lacerationscovered   covered   covered   covered   covered   
INTRERMEDIATE SURGERYLimited to 100kLimited to 150kLimited to 200kLimited to 250kLimited to 300k
Appendicectomy
Endoscopies
Excision of intrascrotal mass
Haemorrhoidectomy (excluding 3rd degree haemorrhoids)
Herniorrhaphies
Herniotomy
Hydrocoelectomy
Low fistulectomy
Varicocoelectomy
Bougienage
Cervical cerclage
Manual removal of placenta
Caesarean Section.
MAJOR SURGERYLimited to 100kLimited to 150kLimited to 250kLimited to 350kLimited to 500k
Adenoidectomy/Tonsilectomy
Laparatomy for;
Ruptured ectopic gestation
Ovarian cyst
Ruptured Appendix
Myomectomy
Hysterectomy
Prostatectomy
Cholecystectomy, etc.
AMBULANCE EVACUATION IN ACCIDENTS & EMENGENCIES
Local Evacuation to Hospital in event of accident & emergency.covered   covered   covered   covered   covered   
PREVENTIVE HEALTHCARE/HEALTH PROMOTION
Provision of health education/counselling, disease prevention and health promotion information and materials. covered   covered   covered   covered   covered   
ANTENATAL CARE & DELIVERY SERVICES (FAMILY PLAN ONLY. )Limited to 100kLimited to 150kLimited to 250kLimited to 350kLimited to 500k
ANTENATAL CARE
Antenatal Services including consultation, examinations and supply of drugs for all antenatal visits
Delivery room services
Management of labour
Normal delivery
Assisted delivery
Laboratory tests limited to haemoglobin estimation or packed cell volume evaluation, HIV 1 & 2 evaluation, blood group and genotype evaluation, Hepatitis B surface tension, ultrasound scan examination (3 max), during the pregnancy period.
Postnatal Carecoveredcoveredcoveredcovered
CHILD WELFARE CLINIC
Care of unregistered newborn within the first 6 weeks of life limited to routine primary health care, circumcision, treatment of minor infections and NPI immunization Limited to 100kLimited to 150kLimited to 200kLimited to 250k
The following services are additional covered services during the first four weeks of life; Neonatal Jaundice, Exchange Blood transfusion, Incubator Care (Covered only for the first day), severe infections, Neonatal Sepsis and Congenital abnormalities requiring medical or surgical intervention.Limited to 100kLimited to 150kLimited to 200kLimited to 250k
IMMUNIZATION
NPI (for children < 5years) BCG,covered   covered   covered   covered   covered   
·         DPTt,
·         Oral polio
·         Hepatitis b,
·         Measles,
·         Vitamins a supplementation,
·         Yellow fever,
·         Pentavalent
·         Haemophilus influenza b (HIB)
MMRcovered   covered   
Rotavirus
Meningitis
Pneumococcalcovered   covered   
Chicken pox
Neonatal care and Phototherapycoveredcoveredcovered   
Incubator care and ICU (Family plan only)2 Days5 Days8 Days10 Days15 Days
Well Baby Cliniccoveredcoveredcoveredcoveredcovered
FAMILY PLANNING
Counsellingcovered   covered   covered   covered   covered   
ImplantsLimited to 20kLimited to 30kLimited to 50k
Non - Hormonal contraceptivescoveredcoveredcoveredcoveredcovered
IUCDcoveredcoveredcoveredcoveredcovered
EYE CARE
Consultation (optometrist and ophthalmologist)covered   covered   covered   covered   covered   
Visual aculty assessmentcovered   covered   covered   covered   covered   
External examinationcovered   covered   covered   covered   covered   
Ophthalmoscopycovered   covered   covered   covered   covered   
Phoria testscovered   covered   covered   covered   covered   
Drug treatment of simple ocular infection e.g. Conjunctivitis, blepharitis, pinguecular, stye, etc. covered   covered   covered   covered   covered   
Refractioncovered   covered   covered   covered   covered   
Management of infections, allergies covered   covered   covered   covered   covered   
Lenses and frame5, 0008, 00012, 00020, 00030, 000
Intra-ocular pressure testsCoveredCoveredcoveredCoveredCovered
Visual field analysisCoveredCoveredcoveredCoveredCovered
Pterygium, Chalaon Limited to 50kLimited to 100kLimited to 150k
Cataract extraction.inclusive of 50k limitInclusive of 100k limitInclusive of 150k limit
Ocular scaninclusive of 50k limitInclusive of 100k limitInclusive of 150k limit
Foreign body removalInclusive of 50k limitInclusive of 100k limitInclusive of 150k limit
DENTAL CARE
Consultation with dentistcovered   covered   covered   covered   covered   
Routine dental examinationcovered   covered   covered   covered   covered   
Dental {x-ray}covered   covered   covered   covered   covered   
Drug treatment of oral paincovered   covered   covered   covered   covered   
Simple extraction1 session2 sessions3 sessions3 sessions
Scaling and polishing (l / annum principal and spouse)1 session1 session1 session2 sessions2session
Amalgam filling for dental caries (2 / annum)1 session2 sessions2 sessions2 sessions2 sessions
Surgical Extractioncovered   covered   covered   
Gum treatment1 session1 session2 sessions2 sessions
Root canal (l per annum)1 session2 sessions2 sessions
CANCER CARE
Cancer Screening (Examination of Breast, Cervix & Prostate)coveredcovered   coveredcovered
Mammogramcoveredcovered
PSA Testcoveredcovered
ANNUAL MEDICAL SCREENING
Routine physical examination (Principals & Spouse only)coveredcoveredcovered   coveredcovered
Annual screening with investigation (Principals & Spouse only)coveredcovered
HIV/AIDS MANAGEMENT
Counselling and testingcoveredcoveredcovered   coveredcovered
Treatment of opportunistic infectionscoveredcoveredcovered   coveredcovered
Treatment at designated approved health centres in Nigeriacoveredcoveredcovered   coveredcovered
INFERTILITY MANAGEMENT(COVERED WITH LIMIT)
Basic Investigations (HSG, Semen Analysis )coveredcovered
PREMIUM (INDIVIDUAL)
PREMIUM (FAMILY)