Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
Region of cover | Nigeria | Nigeria | Nigeria | Nigeria | Nigeria & India | Nigeria & India | Nigeria & India |
Annual benefit limits per individual | N500,000 | N750,000 | N1,000,000 | N1,500,000 | N2,500,000 | N3,500,000 | N5,000,000 |
GENERAL CONSULTATION (OUTPATIENT CASES) | |||||||
This involves treatment of basic medical and surgical (minor) outpatient cases. | N100,000 | N150,000 | N250,000 | N350,000 | N500,000 | N750,000 | N1,000,000 |
SPECIALIST CONSULTATION: This includes all specialist fees. The list of diagnosis under this plan is exhaustive | |||||||
O and G specialist | |||||||
General Surgeon | |||||||
Cardiologist | |||||||
Pediatrician | |||||||
Pediatric surgeon | |||||||
Dermatology | |||||||
Endocrinology | |||||||
Hematology | |||||||
cardiothoracic surgeon | |||||||
ENT Surgeon | |||||||
Urologist | |||||||
Orthopaedic Surgeon | |||||||
Gastroenterologist | |||||||
Psychiatrist | |||||||
Neonatologist | |||||||
ANNUAL WELLNESS SCREENING | |||||||
Physical examination | |||||||
Visual Acuity | |||||||
Blood pressure | |||||||
Fasting Blood Sugar | |||||||
Full blood count | |||||||
Urinalysis | |||||||
serum cholesterol | |||||||
ALT / AST | |||||||
ECG | |||||||
E/U/Cr | |||||||
Breast scan, cervical smears every 2 years for women > 35 years, |
|||||||
PSA for men above 40 yrs |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
ADVANCED & COMPLEX INVESTIGATIONS | |||||||
CT, Scan, MRI Scan and echocardiograph | CT scan only | ||||||
Laboratory | |||||||
Chest X-Rays | |||||||
Plain Abdominal X-Rays | |||||||
Limbs X-Rays | |||||||
Neck X-Rays | |||||||
Skull X-Rays | |||||||
Lumbosacral X-Rays | |||||||
X-Rays of Body Joints | |||||||
Ultrasound Scan | |||||||
Haematological tests | |||||||
Haemoglobin | |||||||
Packed Cell Volume | |||||||
White cell differential count | |||||||
Full Blood Count and differentials | |||||||
White Blood Cell count | |||||||
Red Blood Cell count | |||||||
CHEMISTRY | |||||||
Fasting Blood Sugar | |||||||
Random Blood Sugar | |||||||
Electrolyte, Urea and Creatinine | |||||||
Prostate Specific Antigen | |||||||
Serum albumin | |||||||
Serum ALT/SGPT | |||||||
Serum AST/SGOT | |||||||
Serum Bilirubin (Direct and Indirect) | |||||||
Microbiology | |||||||
Malaria Parasite | |||||||
Widal | |||||||
Urine MCS | |||||||
Stool MCS | |||||||
Serology | |||||||
Hepatitis B Screening | |||||||
HIV Screening | |||||||
Genotype | |||||||
Blood group |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
INTENSIVE CARE UNIT | |||||||
No of days applicable on the plan | 1 day | 2 days | 3 days | 5days | 7 days | ||
ADMISSIONS AND ACCOMMODATION | N100,000 | N200,000 | N300,000 | N400,000 | N500,000 | N650,000 | 800,000 |
Accomodation Type | General ward | General ward | General ward | Semi – private | Semi – private | Private | Private |
Accommodation including nursing care and consumables | 3 days | 5 days | 7 days | 15 days | 20 days | 25 days | 30 days |
Feeding on admission | |||||||
Accommodation for parents whose infants are on admission | 1 day | 2 days | 3 days | 3 days | 5 days | 7 days | |
Inpatient /Hospitalization Benefit Abroad |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
NEONATE CARE | |||||||
Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan | 3 days | 5 days | 10 days | ||||
Congenital anomaly treatment (for children born on the plan). Limits per plan | N100,000 | N200,000 | N300,000 | ||||
IMMUNIZATIONS (0-5 YEARS) Adults (5 – 18 ) | |||||||
BCG | |||||||
OPV | |||||||
PENTAVALENT | |||||||
HBV | |||||||
VITAMIN A | |||||||
MEASLES | |||||||
YELLOW FEVER | |||||||
MENINGITIS VACCINE | |||||||
MMR | |||||||
IPV | |||||||
ROTAVIRUS VACCINE | |||||||
PNEUMOCOCCAL VACCINE | |||||||
TYPHOID VACCINE | |||||||
HPV VACCINE | |||||||
OBSTETRICS AND GYNAECOLOGY | N70,000 | N200,000 | N200,000 | N300,000 | N300,000 | N350,000 | N400,000 |
Antenatal care | |||||||
Induction of labour & Normal delivery | |||||||
Assisted delivery | |||||||
Emergency or Elective Caesarean Section | |||||||
Post Natal care- 6 weeks | |||||||
Family Planning Services – Pills, Injectables, Copper IUCD, tubal ligation and Vasectomy | Only Pills & IUCD | Only Pills & IUCD | |||||
Reimbursement for delivery abroad, limits per plan | Normal -$70, CS- $100 | Normal -$100, CS- $150 | Normal -$150, CS- $250 |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
Surgeries (Minor, Intermediate and Major) | N100,000 | N200,000 | N300,000 | N400,000 | N500,000 | N750,000 | N1,000,000 |
ENT (Part of Surgical Limits) | |||||||
Treatment of ENT diseases and removal of foreign bodies | |||||||
ENT Surgeries – (part of the surgical limit) | |||||||
DENTAL CARE | N10,000 | N15,000 | N25,000 | N45,000 | N75,000 | N100,000 | N150,000 |
Dental Consultation, Imaging, Endodontic treatment, Extraction | |||||||
Preventive Treatment: Prophylaxis | |||||||
Gum Treatment & Surgeries, Restorative Treatments | |||||||
Pharmacy: Prescribed Drugs | |||||||
Orthodontic Treatment | |||||||
EYE CARE | |||||||
Primary Eye Care- Consultation, Examination, primary infections, and Medications | |||||||
Eye Surgeries covered as part of over all surgerical limit | |||||||
Biennial Optical Lenses and Frames covered up to limit per plan | N5,000 | N7,500 | N10,000 | N15,000 | N20,000 | N30,000 | N45,000 |
PHYSIOTHERAPY CARE | |||||||
Number of sessions limit per plan | 2 sessions | 5 sessions | 10 sessions | 15 sessions | 20 sessions | 25 sessions | 30 sessions |
Specialist Consultation | |||||||
Pain therapy |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
ACCIDENT AND EMERGENCY CARE | N100,000 | N200,000 | N300,000 | N400,000 | N500,000 | N650,000 | N800,000 |
Care for accident and emergency cases, Ambulance transfer from roadside to hospital and hospital to hospital | |||||||
Stabilization, Emergency drugs and Investigations | |||||||
FERTILITY SERVICES | |||||||
Investigation and treatment at limits per plan | N10,000 | N15,000 | N25,000 | N45,000 | N75,000 | N100,000 | N200,000 |
HIV / AIDS TREATMENT (at designated approved centres) | |||||||
CANCER CARE | |||||||
Consultation, Admission, Counselling, Hospice Care , Surgical – Chemotherapy – Radiotherapy; limits per plan | N100,000 | N200,000 | N300,000 | N500,000 | |||
RENAL CARE | |||||||
Dialysis sessions limit per plans | 2 sessions | 3 sessions | 3 sessions | 5 sessions | |||
CHRONIC DISEASE MANAGEMENT / PHARMACY BENEFIT | |||||||
Drug delivery and pick up at partner pharmacies | N50,000 | N80,000 | N100,000 | ||||
Personal health equipment – BP machine, Glucometer, Trackers |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
TELEMEDICINE AND HEALTH COACH | |||||||
Telemedicine app – chat with a doctor consultation online 24/7 | |||||||
ANNUAL WELLNESS SCREENING | |||||||
Physical examination | |||||||
Visual Acuity | |||||||
Blood pressure | |||||||
Fasting Blood Sugar | |||||||
Full blood count | |||||||
Urinalysis | |||||||
serum cholesterol | |||||||
ALT / AST | |||||||
ECG | |||||||
E/U/Cr | |||||||
Breast scan, cervical smears every 2 years for women > 35 years, |
|||||||
PSA for men above 40 yrs |
|||||||
LIFESTYLE MANAGEMENT | |||||||
Subsidized Fitness/ nutritional club membership (for non-network gym) | 5% | 7% | 10% | ||||
Network Gym Access | |||||||
Covid Home Care Kit | |||||||
SECOND OPINION ABROAD | |||||||
MORTUARY SERVICES FOR FAMILY |
Benefit Sub-Categories | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
Premium | Jade | Beryl | Ruby | Sapphire | Emerald | Diamond | Crimson |
Annual premium per individual | 27,500 | 60,838 | 88,048 | 109,391 | 161,631 | 309,577 | 515,625 |
Family of 2 | 53,900 | 119,243 | 172,574 | 214,406 | 316,797 | 606,771 | 1,010,625 |
Family of 3 | 80,438 | 177,952 | 257,541 | 319,968 | 472,771 | 905,513 | 1,508,203 |
Family of 4 | 107,250 | 237,269 | 343,388 | 426,624 | 630,362 | 1,207,351 | 2,010,938 |
Family of 5 | 133,375 | 295,066 | 427,033 | 530,546 | 783,912 | 1,501,449 | 2,500,781 |
Family of 6 | 159,225 | 352,253 | 509,799 | 633,373 | 935,845 | 1,792,452 | 2,985,469 |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Region of cover | Nigeria | Nigeria | Nigeria |
Inpatient Overall Limit | N800,000 | N1,500,000 | N2,000,000 |
Outpatient | N300,000 | N500,000 | N1,000,000 |
Hospital Category | Standard Network | Selected Networks | Exclusive Networks |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Outpatient Care Benefits | N300,000 | N500,000 | N1,000,000 |
General Consultations | up to out patient limit | up to out patient limit | up to out patient limit |
Specialist Consultations | up to out patient limit | up to out patient limit | up to out patient limit |
Telemedicine & Health Coach : Chat and cosusult online 24/7 with a doctor | |||
Adult Immunizations (Yellow Fever, Hepatitis B & Meningitis Vaccine) | |||
Ambulance & Emergencies (Hospital to Hospital) and (Home/ Road Side to Hospital) | 1 per annum | 2 times per annum | 3 times per annum |
Advanced & Complex Investigations (CT/MRI Scans) | N50,000 | N75,000 | N100,000 |
Dental Care | N30,000 | N50,000 | N80,000 |
Eye Care- Consultation, Examination, primary infections, and Medications | N40,000 (Lens N30,000) | N50,000 (Lens N35,000) | N80,000 (Lens N45,000) |
ENT (Part of Surgical Limit) | |||
Cancer Care: Surgical – Chemotherapy – Radiotherapy ( 10 months waiting period) | N150,000 | N300,000 | N500,000 |
Renal Dialysis ( 10 months waiting period) | 2 session | 3 sessions | 5 sessions |
Physiotheraphy Care | N30,000 | N40,000 | N50,000 |
Chronic Disease Management/Pharmacy Benefit | N150,000 | N250,000 | N350,000 |
Death & Funeral which is only by natural & accidental cause | N50,000 | N75,000 | N100,000 |
SPA- as applicable on the plan ( 9 months waiting period) | Body Massage/ 1 session per annnum | Body Massage/ 2 session per annnum | |
Chemistry/Heath Checks ( 3 months waiting period) | N75,000 | N100,000 | N150,000 |
Fasting Blood Sugar | |||
Random Blood Sugar | |||
Electrolyte, Urea and Creatinine | |||
Prostate Specific Antigen | |||
Serum albumin | |||
Serum ALT/SGPT | |||
Serum AST/SGOT | |||
Serum Bilirubin (Direct and Indirect) | |||
Microbiology | |||
Malaria Parasite | |||
Widal | |||
Urine MCS | |||
Stool MCS | |||
Serology | |||
Hepatitis B Screening | |||
HIV Screening | |||
Genotype | |||
Blood group | |||
PAP's Smear | |||
Mammogram | |||
Basic Diagnostics | N50,000 | N75,000 | N120,000 |
Chest X-Rays | |||
Plain Abdominal X-Rays | |||
Limbs X-Rays | |||
Neck X-Rays | |||
Skull X-Rays | |||
Lumbosacral X-Rays | |||
X-Rays of Body Joints | |||
Ultrasound Scan | |||
Haematological tests | |||
Haemoglobin | |||
Packed Cell Volume | |||
White cell differential count | |||
Full Blood Count and differentials | |||
White Blood Cell count | |||
Red Blood Cell count |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Inpatient Care Benefits | N800,000 | N1,500,000 | N2,000,000 |
Inpatient medication | |||
Accidents and Emergencies : Stabilization, Emergency drugs | N150,000 | N300,000 | N450,000 |
Intensive Care unit | 1 day | 2 days | 3 days |
Admission and Accomodations including feeding | General ward (15 days) | Semi- private ward (20 days) | Private ward (30 days) |
Surgeries includes minor, intermediate and major – (5 months waiting period) | N170,000 | N280,000 | N450,000 |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Outpatient Care Benefits | N300,000 | N500,000 | N1,000,000 |
General Consultations | up to out patient limit | up to out patient limit | up to out patient limit |
Specialist Consultations | up to out patient limit | up to out patient limit | up to out patient limit |
Telemedicine & Health Coach : Chat and cosusult online 24/7 with a doctor | |||
Adult Immunizations (Yellow Fever, Hepatitis B & Meningitis Vaccine) | |||
Ambulance & Emergencies (Hospital to Hospital) and (Home/ Road Side to Hospital) | 1 per annum | 2 times per annum | 3 times per annum |
Advanced & Complex Investigations (CT/MRI Scans) | N50,000 | N75,000 | N100,000 |
Dental Care | N30,000 | N50,000 | N80,000 |
Eye Care- Consultation, Examination, primary infections, and Medications | N40,000 (Lens N30,000) | N50,000 (Lens N35,000) | N80,000 (Lens N45,000) |
ENT (Part of Surgical Limit) | |||
Cancer Care: Surgical – Chemotherapy – Radiotherapy ( 10 months waiting period) | N150,000 | N300,000 | N500,000 |
Renal Dialysis ( 10 months waiting period) | 2 session | 3 sessions | 5 sessions |
Physiotheraphy Care | N30,000 | N40,000 | N50,000 |
Chronic Disease Management/Pharmacy Benefit | N150,000 | N250,000 | N350,000 |
Death & Funeral which is only by natural & accidental cause | N50,000 | N75,000 | N100,000 |
SPA- as applicable on the plan ( 9 months waiting period) | x | Body Massage/ 1 session per annum | Body Massage/ 2 session per annum |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Inpatient Care Benefits | N800,000 | N1,500,000 | N2,000,000 |
Inpatient medication | |||
Accidents and Emergencies : Stabilization, Emergency drugs | N150,000 | N300,000 | N450,000 |
Intensive Care unit | 1 day | 2 days | 3 days |
Admission and Accomodations including feeding | General ward (15 days) | Semi- private ward (20 days) | Private ward (30 days) |
Surgeries includes minor, intermediate and major – (5 months waiting period) | N170,000 | N280,000 | N450,000 |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Telemedcine & Health Coach : Chat and cosusult online 24/7 with a doctor | |||
Death & Funeral which is only by natural & accidental cause | N50,000 | N75,000 | N100,000 |
SPA- as applicable on the plan ( 9 months waiting period) | x | Body Massage/ 1 session per annnum | Body Massage/ 2 session per annnum |
Sub- Categories | OAK | BLOSSOM | GOLDEN |
Annual Premium | N159,000 | N285,000 | N570,550 |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
Region of cover | Nigeria | Nigeria | Nigeria | Nigeria & India | Nigeria & India | Nigeria & India |
Annual benefit limits per individual | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited |
GENERAL CONSULTATION (OUTPATIENT CASES) | ||||||
This involves treatment of basic medical and surgical (minor) outpatient cases. | ||||||
SPECIALIST CONSULTATION: This includes all specialist fees. The list of diagnosis under this plan is exhaustive | ||||||
O and G specialist | ||||||
General Surgeon | ||||||
Cardiologist | ||||||
Pediatrician | ||||||
Pediatric surgeon | ||||||
Dermatology | ||||||
Endocrinology | ||||||
Hematology | ||||||
cardiothoracic surgeon | ||||||
ENT Surgeon | ||||||
Urologist | ||||||
Orthopaedic Surgeon | ||||||
Gastroenterologist | ||||||
Psychiatrist | ||||||
Neonatologist |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
ADVANCED & COMPLEX INVESTIGATIONS | ||||||
CT, Scan, MRI Scan and echocardiograph | Only emergency cases for CT scan | CT scan only and emergency cases for MRI | CT scan only and emergency cases for MRI | |||
Laboratory | ||||||
Chest X-Rays | ||||||
Plain Abdominal X-Rays | ||||||
Limbs X-Rays | ||||||
Neck X-Rays | ||||||
Skull X-Rays | ||||||
Lumbosacral X-Rays | ||||||
X-Rays of Body Joints | ||||||
Ultrasound Scan | ||||||
Haematological tests | ||||||
Haemoglobin | ||||||
Packed Cell Volume | ||||||
White cell differential count | ||||||
Full Blood Count and differentials | ||||||
White Blood Cell count | ||||||
Red Blood Cell count | ||||||
CHEMISTRY | ||||||
Fasting Blood Sugar | ||||||
Random Blood Sugar | ||||||
Electrolyte, Urea and Creatinine | ||||||
Prostate Specific Antigen | ||||||
Serum albumin | ||||||
Serum ALT/SGPT | ||||||
Serum AST/SGOT | ||||||
Serum Bilirubin (Direct and Indirect) | ||||||
Microbiology | ||||||
Malaria Parasite | ||||||
Widal | ||||||
Urine MCS | ||||||
Stool MCS | ||||||
Serology | ||||||
Hepatitis B Screening | ||||||
HIV Screening | ||||||
Genotype | ||||||
Blood group |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
INTENSIVE CARE UNIT | ||||||
No of days applicable on the plan | 2 days | 2 days | 3 days | 5 days | 7 days | 10 days |
ADMISSIONS AND ACCOMMODATION | ||||||
Accommodation Type | General ward | General ward | Semi – private | Private | Private | Private |
Accommodation including nursing care and consumables | ||||||
Feeding on admission | ||||||
Accommodation for parents whose infants are on admission | 2 days | 2 days | 3 days | 5 days | 7 days | |
Inpatient /Hospitalization Benefit Abroad | N250,000 | N350,000 | N450,000 |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
NEONATE CARE | ||||||
Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan | 2 days | 5 days | 10 days | 18 days | 25 days | 35 days |
Congenital anomaly treatment (for children born on the plan). Limits per plan | N100,000 | N200,000 | N300,000 | N500,000 | N750,000 | N1,000,000 |
IMMUNIZATIONS (0-5 YEARS) Adults (5 – 18 ) | ||||||
BCG | ||||||
OPV | ||||||
PENTAVALENT | ||||||
HBV | ||||||
VITAMIN A | ||||||
MEASLES | ||||||
YELLOW FEVER | ||||||
MENINGITIS VACCINE | ||||||
MMR | ||||||
IPV | ||||||
ROTAVIRUS VACCINE | ||||||
PNEUMOCOCCAL VACCINE | ||||||
TYPHOID VACCINE | ||||||
HPV VACCINE | ||||||
OBSTETRICS AND GYNAECOLOGY | ||||||
Antenatal care | ||||||
Induction of labour & Normal delivery | ||||||
Assisted delivery | ||||||
Emergency or Elective Caesarean Section | ||||||
Post Natal care- 6 weeks | ||||||
Family Planning Services – Pills, Injectables, Copper IUCD, tubal ligation and Vasectomy | Only Pills & IUCD | |||||
Reimbursement for delivery abroad, limits per plan | Normal -$150, CS- $250 | Normal -$180, CS- $300 | Normal -$210, CS- $350 |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
Surgeries (Minor, Intermediate and Major) | N200,000 | N300,000 | N500,000 | N1,500,000 | N2,500,000 | N3,500,000 |
ENT | ||||||
Treatment of ENT diseases and removal of foreign bodies | ||||||
ENT Surgeries – (part of the surgical limit) | ||||||
DENTAL CARE: All care covered under the plan up to the limits | N20,000 | N30,000 | N50,000 | N80,000 | N150,000 | N200,000 |
Dental Consultation, Imaging, Endodontic treatment, Extraction | ||||||
Preventive Treatment: Prophylaxis | ||||||
Gum Treatment & Surgeries, Restorative Treatments | ||||||
Pharmacy: Prescribed Drugs | ||||||
Orthodontic Treatment | ||||||
EYE CARE | ||||||
Primary Eye Care- Consultation, Examination, primary infections, and Medications | ||||||
Eye Surgeries covered as part of over all surgerical limit | ||||||
Biennial Optical Lenses and Frames covered up to limit per plan | N10,000 | N15,000 | N20,000 | N30,000 | N45,000 | N55,000 |
PHYSIOTHERAPY CARE | ||||||
Number of sessions limit per plan | 5 sessions | 10 sessions | 15 sessions | 20 sessions | 30 sessions | 40 sessions |
Specialist Consultation | ||||||
Pain therapy |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
ACCIDENT AND EMERGENCY CARE | ||||||
Care for accident and emergency cases, Ground Ambulance transfer from roadside to hospital and hospital to hospital | ||||||
Stabilization, Emergency Care,drugs and Investigations | ||||||
FERTILITY SERVICES | ||||||
Investigation and treatment at limits per plan | N15,000 | N25,000 | N45,000 | N75,000 | N100,000 | N200,000 |
HIV / AIDS TREATMENT (at designated approved centres) | ||||||
CANCER CARE | ||||||
Consultation, Admission, Counselling, Hospice Care , Surgical – Chemotherapy – Radiotherapy; limits per plan | N300,000 | N500,000 | N750,000 | N1,000,000 | N2,000,000 | N3,000,000 |
RENAL CARE | ||||||
Dialysis sessions limit per plans | 3 sessions | 3 sessions | 6 sessions | 12 sessions | 20 sessions | 25 sessions |
CHRONIC DISEASE MANAGEMENT / PHARMACY BENEFIT | ||||||
Drug delivery and pick up at partner pharmacies | ||||||
Personal health equipment – BP machine, Glucometer, Trackers |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
TELEMEDICINE AND HEALTH COACH | ||||||
Telemedicine app – chat with a doctor consultation online 24/7 | ||||||
ANNUAL WELLNESS SCREENING (Principal & Spouse) | ||||||
Physical examination | ||||||
Visual Acuity | ||||||
Blood pressure | ||||||
Fasting Blood Sugar | ||||||
Full blood count | ||||||
Urinalysis | ||||||
serum cholesterol | ||||||
ALT / AST | ||||||
ECG | ||||||
E/U/Cr | ||||||
Mammogram- Breast scan, cervical smears every 2 years for women > 35 years, |
||||||
PSA for men above 40 yrs |
||||||
LIFESTYLE MANAGEMENT | ||||||
Subsidized Fitness/ nutritional club membership (for non-network gym) | 5% | 10% | 10% | 15% | 20% | |
Network Gym Access | ||||||
On-site Health Checks , Health Talks/ Education forum or wellness fairs | ||||||
MENTAL HEALTH | ||||||
Specialist Consultations on Outpatient Cases Only; limited based on type of plans | 4 weeks | 4 weeks | 6 weeks | 8 weeks | 12 weeks | 12 weeks |
Employee Assistance Program / Stress Management | ||||||
Covid Home Care Kit – up to limit on the plan | ||||||
Health Talks/ Education forum or wellness fairs | ||||||
SECOND OPINION ABROAD | ||||||
MORTUARY SERVICES FOR FAMILY | N20,000 | N50,000 | N75,000 | N100,000 | N150,000 | N250,000 |
Benefit Sub-Categories | Standard | Essential | Bloom | Classic | Prime | Vintage |
Premium | Standard | Essential | Bloom | Classic | Prime | Vintage |
Annual premium per individual | 52,789 | 63,967 | 87,116 | 158,059 | 278,309 | 567,890 |
Family of 2 | 102,412 | 124,096 | 169,005 | 306,635 | 539,919 | 1,101,707 |
Family of 3 | 152,825 | 185,185 | 252,201 | 457,582 | 805,704 | 1,644,043 |
Family of 4 | 203,767 | 246,913 | 336,268 | 610,109 | 1,074,272 | 2,192,057 |
Family of 5 | 253,389 | 307,043 | 418,157 | 758,685 | 1,335,882 | 2,725,874 |
Family of 6 | 302,483 | 366,532 | 499,175 | 905,681 | 1,594,709 | 3,254,012 |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
Region of cover | Nigeria | Nigeria | Nigeria | Nigeria |
Annual benefit limits per individual | N500,000 | N750,000 | N1,000,000 | N2,000,000 |
CONSULTATION (OUTPATIENT CASES) | N100,000 | N150,000 | N250,000 | N400,000 |
General Consultation | ||||
O and G specialist | ||||
General Surgeon | ||||
Cardiologist | ||||
Pediatrician | ||||
Pediatric surgeon | ||||
Dermatology | ||||
Endocrinology | ||||
Hematology | ||||
cardiothoracic surgeon | ||||
ENT Surgeon | ||||
Urologist | ||||
Orthopaedic Surgeon | ||||
Gastroenterologist | ||||
Psychiatrist | ||||
Neonatologist |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
ADVANCED & COMPLEX INVESTIGATIONS | ||||
CT, Scan, MRI Scan and echocardiograph | CT scan only | |||
Laboratory | ||||
Chest X-Rays | ||||
Plain Abdominal X-Rays | ||||
Limbs X-Rays | ||||
Neck X-Rays | ||||
Skull X-Rays | ||||
Lumbosacral X-Rays | ||||
X-Rays of Body Joints | ||||
Ultrasound Scan | ||||
Haematological tests | ||||
Haemoglobin | ||||
Packed Cell Volume | ||||
White cell differential count | ||||
Full Blood Count and differentials | ||||
White Blood Cell count | ||||
Red Blood Cell count | ||||
CHEMISTRY | ||||
Fasting Blood Sugar | ||||
Random Blood Sugar | ||||
Electrolyte, Urea and Creatinine | ||||
Prostate Specific Antigen | ||||
Serum albumin | ||||
Serum ALT/SGPT | ||||
Serum AST/SGOT | ||||
Serum Bilirubin (Direct and Indirect) | ||||
Microbiology | ||||
Malaria Parasite | ||||
Widal | ||||
Urine MCS | ||||
Stool MCS | ||||
Serology | ||||
Hepatitis B Screening | ||||
HIV Screening | ||||
Genotype | ||||
Blood group |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
INTENSIVE CARE UNIT | ||||
No of days applicable on the plan | 3 days | |||
ADMISSIONS AND ACCOMMODATION | N100,000 | N150,000 | N200,000 | N250,000 |
Accomodation Type | General ward | General ward | Semi – private | Semi – private |
Accommodation including nursing care and consumables | 15 days | 17 days | 20 days | 25 days |
Feeding on admission | ||||
Accommodation for parents whose infants are on admission | 2 days | 2 days | 2 days | 3 days |
Inpatient /Hospitalization Benefit Abroad |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
NEONATE CARE | ||||
Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan | 2 days | 3 days | 5 days | |
IMMUNIZATIONS (0-5 YEARS) Adults (5 – 18 ) | ||||
BCG | ||||
OPV | ||||
PENTAVALENT | ||||
HBV | ||||
VITAMIN A | ||||
MEASLES | ||||
YELLOW FEVER | ||||
MENINGITIS VACCINE | ||||
MMR | ||||
IPV | ||||
ROTAVIRUS VACCINE | ||||
PNEUMOCOCCAL VACCINE | ||||
TYPHOID VACCINE | ||||
HPV VACCINE | ||||
OBSTETRICS AND GYNAECOLOGY | N150,000 | N200,000 | N250,000 | N300,000 |
Antenatal care | ||||
Induction of labour & Normal delivery | ||||
Assisted delivery | ||||
Emergency or Elective Caesarean Section | ||||
Post Natal care- 6 weeks | ||||
Family Planning Services – Pills, Injectables, Copper IUCD, tubal ligation and Vasectomy | Only Pills & IUCD | Only Pills & IUCD | Only Pills & IUCD | Only Pills & IUCD |
Reimbursement for delivery abroad, limits per plan |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
Surgeries (Minor, Intermediate and Major) | N100,000 | N150,000 | N200,000 | N350,000 |
ENT (Part of Surgical Limits) | ||||
Treatment of ENT diseases and removal of foreign bodies | ||||
ENT Surgeries – (part of the surgical limit) | ||||
DENTAL CARE | N7,500 | N10,000 | N12,500 | N15,000 |
Dental Consultation, Imaging, Endodontic treatment, Extraction | ||||
Preventive Treatment: Prophylaxis | ||||
Gum Treatment & Surgeries, Restorative Treatments | ||||
Pharmacy: Prescribed Drugs | ||||
Orthodontic Treatment | ||||
EYE CARE | ||||
Primary Eye Care- Consultation, Examination, primary infections, and Medications | ||||
Eye Surgeries covered as part of over all surgerical limit | ||||
Biennial Optical Lenses and Frames covered up to limit per plan | N5,000 | N7,500 | N10,000 | N12,500 |
PHYSIOTHERAPY CARE | ||||
Number of sessions limit per plan | 3 sessions | 5 sessions | ||
Specialist Consultation | ||||
Pain therapy |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
ACCIDENT AND EMERGENCY CARE | ||||
Care for accident and emergency cases, Ambulance transfer from roadside to hospital and hospital to hospital | ||||
Stabilization, Emergency drugs and Investigations | ||||
FERTILITY SERVICES | ||||
Investigation and treatment at limits per plan | N10,000 | N15,000 | N20,000 | |
Congenital anomaly treatment (for children born on the plan). Limits per plan | N200,000 | N300,000 | N300,000 | |
HIV / AIDS TREATMENT (at designated approved centres) | ||||
CANCER CARE | ||||
Consultation, Admission, Counselling, Hospice Care , Surgical – Chemotherapy – Radiotherapy; limits per plan | N100,000 | N250,000 | N350,000 | |
RENAL CARE | ||||
Dialysis sessions limit per plans | 2 sessions | 2 sessions | 4 sessions | |
CHRONIC DISEASE MANAGEMENT / PHARMACY BENEFIT | ||||
Drug delivery and pick up at partner pharmacies | N10,000 | N20,000 | N30,000 | N50,000 |
Personal health equipment – BP machine, Glucometer, Trackers |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
TELEMEDICINE AND HEALTH COACH | ||||
Telemedicine app – chat with a doctor consultation online 24/7 | ||||
ANNUAL WELLNESS SCREENING | ||||
Physical examination | ||||
Visual Acuity | ||||
Blood pressure | ||||
Fasting Blood Sugar | ||||
Full blood count | ||||
Urinalysis | ||||
serum cholesterol | ||||
ALT / AST | ||||
ECG | ||||
E/U/Cr | ||||
Breast scan, cervical smears every 2 years for women > 35 years, | ||||
PSA for men above 40 yrs |
||||
LIFESTYLE MANAGEMENT | ||||
Subsidized Fitness/ nutritional club membership (for non-network gym) | 5% | 7% | ||
Network Gym Access | ||||
MENTAL HEALTH | ||||
Specialist Consultations on Outpatient Cases Only; limited based on type of plans | 2 weeks | 3 weeks | 4 weeks | 6 weeks |
Employee Assistance Program / Stress Management | ||||
Covid Home Care Kit – up to limit on the plan | ||||
SECOND OPINION ABROAD | ||||
MORTUARY SERVICES FOR FAMILY | N5,000 | N7,500 | N10,000 | N20,000 |
Benefit Sub-Categories | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
Premium | Smart Lite | Smart Care | Smart Plus | Smart Pearl |
Annual premium per individual | 40,480 | 54,257 | 65,120 | 73,920 |
Family of 2 | 78,936 | 105,802 | 126,984 | 144,144 |
Family of 3 | 117,797 | 157,889 | 189,499 | 215,107 |
Family of 4 | 157,062 | 210,518 | 252,666 | 286,810 |
Family of 5 | 195,316 | 261,791 | 314,204 | 356,664 |
Family of 6 | 233,165 | 312,522 | 375,091 | 425,779 |
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