| | | | | |
INDIVIDUAL (PER ANNUM) | 30, 000.00 | 50, 000.00 | 80, 000.00 | 150, 000.00 | 200, 000.00 |
FAMILY (PRINCIPAL, SPOUSE & 4 CHILDREN) | 100, 000.00 | 150, 000.00 | 200, 000.00 | 400, 000.00 | 550, 000.00 |
| | | | | |
| | | | | |
COVERED MEDICAL SERVICES | | | | | |
PREVENTIVE SERVICES | | | | | |
AEROBICS | covered | covered | covered | covered | covered |
PICNICS | covered | covered | covered | covered | covered |
ABUJA CENTRAL PARK (25% Discount with Precious ID on all Games.) | covered | covered | covered | covered | covered |
GYM SERVICES | | | | covered | covered |
| | | | | |
OUTPATIENT SERVICES | | | | | |
General Consultation | covered | 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 only | covered | covered | covered | covered | covered |
| | | | | |
HOSPITALIZATION | | | | | |
Number of days per annum | 7 Days | 10 Days | 15 Days | 21 Days | 25Days |
General Ward | covered | covered | covered | covered | covered |
Semi-Private Ward | | | covered | covered | covered |
Private Ward | | | | covered | 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 Unit | 1 Day | 3 Days | 5 Days | 7Days | 10Days |
| | | | | |
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 count | covered | covered | covered | covered | covered |
Full blood count | covered | 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 count | covered | covered | covered | covered | covered |
Genotype | covered | covered | covered | covered | covered |
Blood group | covered | covered | covered | covered | covered |
Malaria parasites | covered | covered | covered | covered | covered |
Cross matching | covered | covered | covered | covered | covered |
| | | | | |
Secondary investigations | | | | | |
Reticulocytes | covered | covered | covered | covered | covered |
Mean Corpuscular haemoglobin concentration nachc | covered | 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 test | covered | covered | covered | covered | covered |
Indirect coomb's test | covered | covered | covered | covered | covered |
Bleeding time | covered | covered | covered | covered | covered |
Clotting time | covered | covered | covered | covered | covered |
Prothrombin time (pt) | covered | covered | covered | covered | covered |
Sickling test | covered | covered | covered | covered | covered |
| | | | | |
CLINICAL CHEMISTRY | | | | | |
Basic/Primary Investigations | | | | | |
Fasting blood sugar | covered | covered | covered | covered | covered |
Random blood sugar | covered | covered | covered | covered | covered |
Urea | covered | covered | covered | covered | covered |
Creatinine | covered | covered | covered | covered | covered |
Electrolyte & Urea | covered | covered | covered | covered | covered |
Calcium | covered | covered | covered | covered | covered |
Phosphorus | covered | covered | covered | covered | covered |
Sodium | covered | covered | covered | covered | covered |
Potassium | covered | covered | covered | covered | covered |
Chloride bicarbonate | covered | covered | covered | covered | covered |
| | | | | |
Secondary investigations. | | | | | |
2 hrs. post prandial | covered | covered | covered | covered | covered |
Creatinine clearance | covered | covered | covered | covered | covered |
Oral glucose tolerance test | covered | covered | covered | covered | covered |
Total bilirubin | covered | covered | covered | covered | covered |
Direct bilirubin | covered | covered | covered | covered | covered |
Indirect bilirubin | covered | covered | covered | covered | covered |
Sgot & sgpt (each) | covered | covered | covered | covered | covered |
Alkaline phosphatase | covered | covered | covered | covered | covered |
Liver function test (Ift) | covered | covered | covered | covered | covered |
Total protein | covered | covered | covered | covered | covered |
Albumin | covered | covered | covered | covered | covered |
Uric acid | covered | covered | covered | covered | covered |
Prostatic acid phosphotase | covered | covered | covered | covered | covered |
Total acid phosphotase | covered | covered | covered | covered | covered |
Amylase | covered | covered | covered | covered | covered |
Cholesterol | covered | covered | covered | covered | covered |
Tryglyceride | covered | covered | covered | covered | covered |
Csf glucose | covered | covered | covered | covered | covered |
Csf protein | covered | covered | covered | covered | covered |
Csf chloride | covered | covered | covered | covered | covered |
Hdl/ldl cholesterol | covered | covered | covered | covered | covered |
Protein electrophoresis + report | covered | covered | covered | covered | covered |
Gamma gt | covered | covered | covered | covered | covered |
Ck amylase | covered | covered | covered | covered | covered |
| | | | | |
Microbiology | | | | | |
Urinalysis | covered | covered | covered | covered | covered |
Pregnancy test urine | covered | covered | covered | covered | covered |
Stool occult blood | covered | covered | covered | covered | covered |
Urine m/ c/ s | covered | covered | covered | covered | covered |
Aspirate pus m/ c/ s | covered | covered | covered | covered | covered |
Hvs m/c/s | covered | covered | covered | covered | covered |
Urethral & wound m/c/s | covered | covered | covered | covered | covered |
Stool m/ c/ s | covered | covered | covered | covered | covered |
Sputum m/c/s | covered | covered | covered | covered | covered |
Mantoux/heaf test | covered | covered | covered | covered | covered |
Semen culture & sensitivity | covered | covered | covered | covered | covered |
Microfilaria | covered | covered | covered | covered | covered |
Skin snip | covered | covered | covered | covered | covered |
Skin scrapping for fungal elements | covered | covered | covered | covered | covered |
Sputum afb for tuberculosis | covered | covered | covered | covered | covered |
Blood culture | covered | covered | covered | covered | covered |
C.s.f. m/c/s | covered | covered | covered | covered | covered |
Semen analysis | covered | covered | covered | covered | covered |
H.pylori assay | covered | covered | covered | covered | covered |
| | | | | |
Serology | | | | | |
Widal | covered | 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 antigen | covered | covered | covered | covered | covered |
Clamydia screening | covered | covered | covered | covered | covered |
Vdrl test | covered | covered | covered | covered | covered |
Aso tire | covered | covered | covered | covered | covered |
Rheumatoid factor | covered | 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 40k | Limited to 60k | Limited to 80k | Limited 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 biopsy | covered | covered | covered | covered | covered |
Specimen from excisional biopsy | covered | covered | covered | covered | covered |
Pap smear | covered | covered | covered | covered | covered |
Prostatic specific assay (psa) | covered | covered | covered | covered | covered |
| | | | | |
RADIOLOGICAL INVESTIGATIONS | | | | | |
PLAIN FILMS | | | | | |
Upper limb | covered | covered | covered | covered | covered |
Lower limb | covered | covered | covered | covered | covered |
Thorax | covered | covered | covered | covered | covered |
Vertebrae | covered | covered | covered | covered | covered |
Skull series | covered | covered | covered | covered | covered |
Upper limb | covered | covered | covered | covered | covered |
| | | | | |
BARIUM STUDIES | | | | | |
Ba meal | | | covered | covered | covered |
Ba enema | | | covered | covered | covered |
Hsg | | | covered | covered | covered |
| | | | | |
ULTRASOUND SCAN | | | | | |
Obstetrics | covered | covered | covered | covered | covered |
Abdominal scan | covered | covered | covered | covered | covered |
Abdominopelvic | covered | covered | covered | covered | covered |
Pelvic | covered | covered | covered | covered | covered |
Breast | | | covered | covered | covered |
Prostate | | | covered | covered | covered |
Scrotum | | | covered | covered | covered |
Tetis | | | covered | covered | covered |
Thyroid | | | covered | covered | covered |
Transfrontal | covered | covered | covered | covered | covered |
Transvaginal | covered | covered | covered | covered | covered |
Follicular tracking | covered | covered | covered | covered | covered |
Tissue | covered | covered | covered | covered | covered |
| | | | | |
OTHERS | | | | | |
E.C.G (resting) | covered | covered | covered | covered | covered |
Spirometry | covered | covered | covered | covered | covered |
E.C. G (pre and post exercise/ stress) | covered | covered | covered | covered | covered |
Mammogram | | | | 1 session | 1 session |
CT scan | | | | 1 session | 2 sessions |
MRI | | | | 1 session | 2 sessions |
| | | | | |
PHYSIOTHERAPY | | | | | |
Basic physical therapy | 3 Sessions | 5 Sessions | 7 Sessions | 10 sessions | 12 sessions |
Massages, shortwave, infra-red, radiation. | | | 1 Session | 2 sessions | 2 sessions |
Cervical collar | | | 1 Session | 1 session | 1 session |
Lumbar corset | | | | 1 session | 2 sessions |
| | | | | |
MANAGEMENT OF SPECIFIED CONDITIONS, CHRONIC CONDITIONS | | Limited to 50k | Limited to 100k | Limited to 200k | Limited 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 lump | covered | covered | covered | covered | covered |
Ganglionectomy | covered | covered | covered | covered | covered |
Lipectomy | covered | covered | covered | covered | covered |
Marsupialisation (Bartholins cyst) | covered | covered | covered | covered | covered |
Surgical drainage of abscess | covered | covered | covered | covered | covered |
Uterine evacuation of incomplete abortion | covered | covered | covered | covered | covered |
In-growing toenail | covered | covered | covered | covered | covered |
Minor wound debridement | covered | covered | covered | covered | covered |
Evacuation of impacted faeces | covered | covered | covered | covered | covered |
Drainage of paronychia | covered | covered | covered | covered | covered |
Suturing of Minor Lacerations | covered | covered | covered | covered | covered |
| | | | | |
INTRERMEDIATE SURGERY | Limited to 100k | Limited to 150k | Limited to 200k | Limited to 250k | Limited 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 SURGERY | Limited to 100k | Limited to 150k | Limited to 250k | Limited to 350k | Limited 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 |
| | | | | |
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ANTENATAL CARE & DELIVERY SERVICES (FAMILY PLAN ONLY. ) | Limited to 100k | Limited to 150k | Limited to 250k | Limited to 350k | Limited 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 Care | covered | covered | covered | | covered |
| | | | | |
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 100k | Limited to 150k | Limited to 200k | Limited 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 100k | Limited to 150k | Limited to 200k | Limited 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) | | | | | |
MMR | | | | covered | covered |
Rotavirus | | | | | |
Meningitis | | | | | |
Pneumococcal | | | | covered | covered |
Chicken pox | | | | | |
Neonatal care and Phototherapy | | covered | covered | | covered |
Incubator care and ICU (Family plan only) | 2 Days | 5 Days | 8 Days | 10 Days | 15 Days |
Well Baby Clinic | covered | covered | covered | covered | covered |
| | | | | |
FAMILY PLANNING | | | | | |
Counselling | covered | covered | covered | covered | covered |
Implants | | | Limited to 20k | Limited to 30k | Limited to 50k |
Non - Hormonal contraceptives | covered | covered | covered | covered | covered |
IUCD | covered | covered | covered | covered | covered |
| | | | | |
EYE CARE | | | | | |
Consultation (optometrist and ophthalmologist) | covered | covered | covered | covered | covered |
Visual aculty assessment | covered | covered | covered | covered | covered |
External examination | covered | covered | covered | covered | covered |
Ophthalmoscopy | covered | covered | covered | covered | covered |
Phoria tests | covered | covered | covered | covered | covered |
Drug treatment of simple ocular infection e.g. Conjunctivitis, blepharitis, pinguecular, stye, etc. | covered | covered | covered | covered | covered |
Refraction | covered | covered | covered | covered | covered |
Management of infections, allergies | covered | covered | covered | covered | covered |
Lenses and frame | 5, 000 | 8, 000 | 12, 000 | 20, 000 | 30, 000 |
Intra-ocular pressure tests | Covered | Covered | covered | Covered | Covered |
Visual field analysis | Covered | Covered | covered | Covered | Covered |
Pterygium, Chalaon | | | Limited to 50k | Limited to 100k | Limited to 150k |
Cataract extraction. | | | inclusive of 50k limit | Inclusive of 100k limit | Inclusive of 150k limit |
Ocular scan | | | inclusive of 50k limit | Inclusive of 100k limit | Inclusive of 150k limit |
Foreign body removal | | | Inclusive of 50k limit | Inclusive of 100k limit | Inclusive of 150k limit |
| | | | | |
DENTAL CARE | | | | | |
Consultation with dentist | covered | covered | covered | covered | covered |
Routine dental examination | covered | covered | covered | covered | covered |
Dental {x-ray} | covered | covered | covered | covered | covered |
Drug treatment of oral pain | covered | covered | covered | covered | covered |
Simple extraction | | 1 session | 2 sessions | 3 sessions | 3 sessions |
Scaling and polishing (l / annum principal and spouse) | 1 session | 1 session | 1 session | 2 sessions | 2session |
Amalgam filling for dental caries (2 / annum) | 1 session | 2 sessions | 2 sessions | 2 sessions | 2 sessions |
Surgical Extraction | | | covered | covered | covered |
Gum treatment | | 1 session | 1 session | 2 sessions | 2 sessions |
Root canal (l per annum) | | | 1 session | 2 sessions | 2 sessions |
| | | | | |
CANCER CARE | | | | | |
Cancer Screening (Examination of Breast, Cervix & Prostate) | | covered | covered | covered | covered |
Mammogram | | | | covered | covered |
PSA Test | | | | covered | covered |
| | | | | |
ANNUAL MEDICAL SCREENING | | | | | |
Routine physical examination (Principals & Spouse only) | covered | covered | covered | covered | covered |
Annual screening with investigation (Principals & Spouse only) | | | | covered | covered |
| | | | | |
HIV/AIDS MANAGEMENT | | | | | |
Counselling and testing | covered | covered | covered | covered | covered |
Treatment of opportunistic infections | covered | covered | covered | covered | covered |
Treatment at designated approved health centres in Nigeria | covered | covered | covered | covered | covered |
| | | | | |
INFERTILITY MANAGEMENT(COVERED WITH LIMIT) | | | | | |
Basic Investigations (HSG, Semen Analysis ) | | | | covered | covered |
PREMIUM (INDIVIDUAL) | | | | | |
PREMIUM (FAMILY) | | | | | |