Number of principals required to activate plans
3-19
3-19
3-19
3-19
INDIVIDUAL (Quarterly PAYMENT)
82,080
130,200
213,600
322,800
FAMILY (Quarterly PAYMENT)
278,400
456,000
778,200
1,778,400
INDIVIDUAL (BIANNUAL PAYMENT 15% DISCOUNT)
71,820
113,800
186,600
282,300
FAMILY (BIANNUAL PAYMENT 15% DISCOUNT)
243,600
398,562
679,832
1,555,273
INDIVIDUAL (ANNUAL PAYMENT 20% DISCOUNT)
68,400
108,300
1,777,00
268,850
FAMILY (ANNUAL PAYMENT 20% DISCOUNT)
232,000
380,000
638,400
1,482,000
HOSPITAL TIER(S)
Tier 4
Tier 3&4
Tier 2-4
Tier 1-4
TOTAL BENEFIT LIMITS PER ENROLLEE (NAIRA); NOT TRANSFERABLE
2,000,000
3,500,000
5,000,000
7,000,000
ACCIDENT AND EMERGENCY CARE
Covered
Covered
Covered
Covered
Resuscitative care for accident and emergency cases, including basic radiological and laboratory investigations needed to stabilize patient before specialized intervention, intensive care or surgery
Covered
Covered
Covered
Covered
ADMISSIONS AND ACCOMMODATION
Unlimited
Unlimited
Unlimited
Unlimited
Hospital Ward Care
Covered (GENERAL WARD ONLY)
Covered (SEMI-PRIVATE WARD)
Covered (PRIVATE WARD)
Covered (PRIVATE WARD)
Skilled medical and paramedical services
Covered
Covered
Covered
Covered
Supply of prescribed medications, medical & surgical consumables
Covered
Covered
Covered
Covered
Blood grouping, cross matching, and transfusion
Covered
Covered
Covered
Covered
Accommodation & feeding for in-patient care
Covered
Covered
Covered
Covered
Accommodation for parents/relatives of patients on admission (Excludes feeding for parents/relatives)
Covered (FOR 24 HOURS; LIMITED TO ICU AND NEONATAL CARE ONLY
Covered (FOR 48 HOURS; LIMITED TO ICU AND NEONATAL CARE ONLY
Covered (FOR 48 HOURS; LIMITED TO ICU AND NEONATAL CARE ONLY
Covered (FOR 48 HOURS; LIMITED TO ICU AND NEONATAL CARE ONLY
General practioner consultation
Covered
Covered
Covered
Covered
Specialist consultaiton (except rheumatologist)
Covered
Covered
Covered
Covered
Chronic disease medications
Covered
Covered
Covered
Covered
Non-chronic disease medications
Covered
Non-chronic disease medications
Non-chronic disease medications
Non-chronic disease medications
Free chats via telemedicinewith qualified and certified Doctors when in need of care during any medical emergency
Covered
Covered
Covered
Covered
GPS-enabled access to hospital directories when hospital information is needed
Covered
Covered
Covered
Covered
Free Telemedicine app with details of all covered benefits on the scheme
Covered
Covered
Covered
Covered
X-Rays (non-contrast)
Covered
Covered
Covered
Covered
Routine & non-interventional ultrasound Scans (Obstetrics; Abdominal, Pelvic, Breast, Testicular/Scrotal, Thyroid, Prostate, Bladder, and Brain)
Covered
Covered
Covered
Covered
Resting Electrocardiography (ECG)
Covered
Covered
Covered
Covered
CT Scan (contrast & non-contrast)
Covered (1 SESSION PER ANNUM)
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Covered (3 SESSIONS PER ANNUM)
MRI (contrast & non-contrast)
Covered (1 SESSION PER ANNUM)
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Covered (3 SESSIONS PER ANNUM)
2D transthoracic echocardiography (paediatric & adult)
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Covered (3 SESSIONS PER ANNUM)
Advanced non-interventional ultrasound imaging (Uroflowmetry, urodynamics)
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Contrast X-Ray procedures (Urogram, pyelogram, uroflowmetry, etc)
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Non-interventional endoscopy (colonoscopy, sigmoidoscopy, upper GI endosocopy, etc)
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Stress & ambulatory (Holter) ECG
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Electoencephalogram (EEG)
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
24-hour blood pressure monitoring
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Covered (2 SESSIONS PER ANNUM)
Doppler Ultrasound Scan
Not Covered
Not Covered
Not Covered
Covered (1 SESSION PER ANNUM)
Haematology I (FBC + differentials, blood film, RBC indices, ESR).
Covered
Covered
Covered
Covered
Haematology II (Pregnancy test (qualitative Beta HCG), blood group & genotype, PT/INR, clotting profile)
Covered
Covered
Covered
Covered
Chemistry I (Fasting, random, OGTT & post-prandial blood sugar)
Covered
Covered
Covered
Covered
Chemistry II (Electrolytes, Urea & Creatinine/Kidney function test, Lipid Profile, Liver function)
Covered
Covered
Covered
Covered
Microbiology and Parasitology (Malaria parasite, MCS, Hepatitis B Surface Antigen (HBSAg), Hepatitis C screening, HIV I & II screening & VDRL)
Covered
Covered
Covered
Covered
H.pylori, Stool Occult Blood
Covered
Covered
Covered
Covered
Blood culture, Mantoux/Heaf's Test, HIV Confirmatory Test
Covered
Covered
Covered
Covered
Thyroid Function Tests, Serum Uric Acid, Prostate Specific Antigen (PSA)
Covered
Covered
Covered
Covered
24Hours Creatinine Clearance
Covered
Covered
Covered
Covered
Pap smear and cytology
Covered
Covered
Covered
Covered
Trypanosomes, leishmania & toxoplasma screening
Covered
Covered
Covered
Covered
Skin snip for microfilaria, skin scrapping for fungi
Covered
Covered
Covered
Covered
Sputum acid-fast bacilli (AFB), QBC Malaria Concentration and fluorescent Staining
Covered
Covered
Covered
Covered
HBA1C, Coomb's test (direct & indirect)
Not Covered
Covered
Covered
Covered
Cardiac markers (CK-MB, Troponin I & T), serum kinase & phosphokinase, D-dimer
Not Covered
Covered
Covered
Covered
Iron studies (serum iron, ferritin, TIBC),
Not Covered
Covered
Covered
Covered
Seminal fluid analysis (SFA)
Not Covered
Covered
Covered
Covered
Protein Electrophoresis, Chlamydia Screening
Not Covered
Not Covered
Not Covered
Not Covered
Serum immunoglobulins/Antibodies, immunofluorescence assay
Not Covered
Not Covered
Not Covered
Not Covered
ICU, HDU, Step-down unit, ICU-related care
Covered (for 24 hours)
Covered (for 48 hours)
Covered (for 72 hours)
Covered (for 7 days)
Specialist Ophthalmologist Consultation
Covered
Covered
Covered
Covered
Basic Ocular Test (Tonometry/Intra-Ocular Pressure (IOP), Refraction)
Covered
Covered
Covered
Covered
Basic Ocular Test (Direct ophthalmoscopy or Fundoscopy, Pachymetry, and Slit Lamp)
Covered
Covered
Covered
Covered
Advanced Ocular Test (Central Visual Field, Indirect Opthalmoscopy, Depth Perception Test)
Not Covered
Not Covered
Covered (1 session each per annum)
Covered (2 sessions each per annum)
Advanced Ocular Test (Shirmer's Tear Test, Amsler Test, Retina Photography, OCT Scan, A Scan, B Scan)
Not Covered
Not Covered
Covered (1 session each per annum)
Covered (2 sessions each per annum)
Lenses and Frames (Including Contact lenses)
Covered (Up to N10,000 annual limit)
Covered (Up to N15,000 annual limit)
Covered (Up to N30,000 annual limit)
Covered (Up to N40,000 annual limit)
Specialist Consultation & routine dental examination
All dental care covered up to annual limit of N15,000
All dental care covered up to annual limit of N30,000
All dental care covered up to annual limit of N75,000
All dental care covered up to annual limit of N100,000
Preventive dental care and counselling - Scaling and Polishing
All dental care covered up to annual limit of N15,000
All dental care covered up to annual limit of N30,000
All dental care covered up to annual limit of N75,000
All dental care covered up to annual limit of N100,000
Dental pain therapy & pharmacological treatment of acute and chronic dental infections
All dental care covered up to annual limit of N15,000
All dental care covered up to annual limit of N30,000
All dental care covered up to annual limit of N75,000
All dental care covered up to annual limit of N100,000
Dental procedures - Surgical & non- surgical extraction, root canal therapy, operculectomy, gingival curettage, composite & amalgam filling, incision and drainage
All dental care covered up to annual limit of N15,000
All dental care covered up to annual limit of N30,000
All dental care covered up to annual limit of N75,000
All dental care covered up to annual limit of N100,000
Specialist consultation & examination, physical therapy
7 sessions per annum
10 sessions per annum
15 sessions per annum
25 sessions per annum
Access to prescribed drugs
Covered
Covered
Covered
Covered
Physiotherapy Devices ( Cervical collar, arm sling, knee & ankle brace, lumbar corset, crutches)
Not Covered
Covered
Covered
Covered
Special Walking Aids (Walker frame)
Not Covered
Not Covered
Covered
Covered
Antenatal Care (Specialist consultations, medictions, laboratory tests and scans)
Covered up to N80,000 Limit
Covered up to N100,000 Limit
Covered up to N120,000 Limit
Covered up to N150,000 Limit
Vaginal Delivery (Spontaneous, assisted, multiple)
Covered up to N80,000 Limit
Covered up to N100,000 Limit
Covered up to N120,000 Limit
Covered up to N150,000 Limit
Caesarean Section
Covered up to N80,000 Limit
Covered up to N100,000 Limit
Covered up to N120,000 Limit
Covered up to N150,000 Limit
Therapeutic Abortion (Manual Vacuum Aspiration)
Covered up to N80,000 Limit
Covered up to N100,000 Limit
Covered up to N120,000 Limit
Covered up to N150,000 Limit
Fertility Specialist Consultation and Counselling
Covered (1 SESSION ONLY)
Covered (1 SESSION ONLY)
Covered (1 SESSION ONLY)
Covered (1 SESSION ONLY)
Fertility Investigations
Not Covered (TPA)
Covered (Up to N30,000 limit)
Covered (Up to N60,000 limit)
Covered (Up to N100,000 limit)
Neonatal / Special Baby Care Unit
Covered (FOR UP TO 48 HOURS)
Covered (FOR 5 DAYS)
Covered (FOR 10 DAYS)
Covered (FOR 21 DAYS)
Support for premature neonate including incubator care & CPAP
Covered (FOR UP TO 48 HOURS)
Covered (FOR 5 DAYS)
Covered (FOR 10 DAYS)
Covered (FOR 21 DAYS)
Phototherapy
Covered (FOR UP TO 48 HOURS)
Covered (FOR 5 DAYS))
Covered (FOR 10 DAYS)
Covered (FOR 21 DAYS)
Care for babies not ACTIVELY on the plan only applies if the mother has an active policy and expires after 6 weeks of life
Covered up to N30,000 limit
Covered up to N40,000 limit
Covered up to N50,000 limit
Covered up to N60,000 limit
Vaccines under NPI (BCG, Polio (OPV/IPV), Diphtheria, Pertusis, Tetanus (DPT))
Covered
Covered
Covered
Covered
Vaccines under NPI (Pentavalent, Hepatitis B, Measles, Yellow fever, Vitamin A)
Covered
Covered
Covered
Covered
Vaccines outside NPI (Chicken pox (varicella), Measles Mump Rubella (MMR))
Covered
Covered
Covered
Covered
Meningitis/meningococcal & Hexavalent
Not Covered
Covered
Covered
Covered
Pneumococcal (PCV) & Rotavirus
Not Covered
Not Covered
Covered
Covered
Hepatitis B
Covered
Covered
Covered
Covered
Yello Fever and Meningitis
Not Covered
Covered
Covered
Covered
Contraceptive Pills
Covered
Covered
Covered
Covered
Implants - Implanon, Norplant, Jadelle
Covered
Covered
Covered
Covered
Copper T Intrauterine Device, Injectibles (Depo Provera,Noristerat)
Not Covered
Covered
Covered
Covered
Access to gyms for regular exercise
Not Covered
Covered (1 SESSION PER WEEK)
Covered (2 SESSION PER WEEK)
Covered (3 SESSION PER WEEK)
Facials
Not Covered
Either facials or body massage covered
Covered (1 SESSION PER YEAR)
Covered (1 SESSION PER YEAR)
Body Massage
Not Covered
Either facials or body massage covered
Covered (1 SESSION PER YEAR)
Covered (2 SESSION PER YEAR)
Minor
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Intermediate
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Major
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Oncologist/ Cancer Specialist visits
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Cancer-related Radiological investigations
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Surgical cancer care & chemotherapy
Covered up to N100,000 per annum
Covered up to N150,000 per annum
Covered up to N300,000 per annum
Covered up to N500,000 per annum
Dialysis and all related care
Covered (2 SESSIONS PER YEAR)
Covered (3 SESSIONS PER YEAR)
Covered (4 SESSIONS PER YEAR)
Covered (5 SESSIONS PER YEAR)
BMI Check, General Physical Examination
Covered
Covered
Covered
Covered
Blood Pressure Check (Hypertension Screening)
Covered
Covered
Covered
Covered
Blood Sugar Check (Diabetes Screening), Urinalysis
Covered
Covered
Covered
Covered
Blood Cholesterol Check
Covered
Covered
Covered
Covered
Annual Visual Acuity Check (Using Snellen Chart)
Covered
Covered
Covered
Covered
Pap Smear
Covered
Covered
Covered
Covered
PSA Check (For Men ≥ 40 years of age)
Covered
Covered
Covered
Covered
Chest X-ray
Covered
Covered
Covered
Covered
Mammography (For Women ≥ 40 years of age)
Not Covered
Covered
Covered
Covered
Liver Function Test
Not Covered
Covered
Covered
Covered
Kidney Function Tests (E, U, and Cr)
Not Covered
Covered
Covered
Covered
Movement of patients to and fro Hospital
Covered (HOSPITAL TO HOSPITAL; ROADSIDE TO HOSPITAL)
Covered (HOSPITAL TO HOSPITAL; ROADSIDE TO HOSPITAL)
Covered (HOSPITAL TO HOSPITAL; ROADSIDE TO HOSPITAL; HOME TO HOSPITAL)
Covered (HOSPITAL TO HOSPITAL; ROADSIDE TO HOSPITAL; HOME TO HOSPITAL)
Mental illness consultation and psychotherapy
Covered (6 SESSIONS PER YEAR)
Covered (8 SESSIONS PER YEAR)
Covered (12 SESSIONS PER YEAR)
Covered (12 SESSIONS PER YEAR)
Specialist Consulltation and counselling session
Covered
Covered
Covered
Covered
Specialist Drug therapy
Covered
Covered
Covered
Covered
Diagnosis & treatment confirmation from secondary and tertiary care centres
Covered
Covered
Covered
Covered
Line of treatment confirmation from Internationally Certified Medical and Surgical Specialists Outside Africa
Not Covered
Not Covered
Covered, 1 case per year
Covered, 2 cases per year
After-demise compensation
Not Covered
Covered (UP TO 50,000 NAIRA LIMIT)
Covered (UP TO 100,000 NAIRA LIMIT)
Covered (UP TO200,000 NAIRA LIMIT)