SME Plans – Full Details

Consultation Coverage

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

Region of cover

Nigeria

Annual benefit limits per individual

N500,000

N750,000

N1,000,000

N2,000,000

.

GENERAL CONSULTATION (OUTPATIENT CASES)

This involves treatment of basic medical and surgical (minor) outpatient cases.

N100,000

N150,000

N250,000

N400,000

.

SPECIALIST CONSULTATION: This includes all specialist fees. The list of diagnosis under this plan is inexhaustive

O and G specialist

General Surgeon

Cardiologist

Pediatrician

Pediatric surgeon

Dermatologist

Endocrinologist

Hematologist

Cardiothoracic surgeon

ENT Surgeon

Urologist

Orthopaedic Surgeon

Gastroenterologist

Psychiatrist

Neurosurgeon

Neurologist

Nephrologist

Pulmonologist/Respiratory Physician

Oncologist

Pathologist

Family Physician

Dietician (strictly for newly diagnosed Diabetes)

Oral and Maxillofacial Surgeon

Neonatologist

Screening and Diagnostics

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

LABORATORY

Hematology

Haemoglobin

Packed Cell Volume

White cell differential count

Full Blood Count and differentials

White Blood Cell count

Red Blood Cell count

Grouping and Cross Matching

Erythrocyte Sedimentation Rate (ESR)

MCHC

MCH

MCV

Blood Film

Blood Pregnancy (Beta HCG) Test

Clotting Time

Bleeding Time

.

ADVANCED & COMPLEX INVESTIGATIONS

Limit to 1 session Annually

CT Scan, MRI Scan and echocardiograph

CT scan only

.

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)

2 Hours Post-prandial Blood Sugar

Oral Glucose Tolerance Test (OGTT)

Glucose Challenge Test

Lipid Profile (Fasting) (Cholesterol, HDL, LDL, Triglyceride Profile)

Serum Sodium

Serum Calcium

Serum Magnesium

Serum Potasium

Serum Lithium

Serum Chloride

Serum Bicarbonate

Serum Alkaline Phosphate

Serum Acid Phosphate

Serum Inorganic Phosphate

Serum Lactate Dehydrogenase

Serum Gamma Glutamyl Transferase

Prothrombin time (PT/INR)

Urine Pregnancy Test

Blood urea Nitrogen

HBA1C

G-6PD Screening

Thyroid Function Tests

Serum Uric Acid

Creatinine phosphokinase

Pap Smear and Cytology

Prostate Specific Antigen

Protein Electrophoresis

Serum Creatinine Phosphokinase

Serum Iron

24 Hour Creatinine Clearance

Coomb’s Test (Indirect)

Coomb’s Test (Direct)

Osmotic Fragility Test

D-Dimer

Admission and Accommodation

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

ADMISSIONS AND ACCOMMODATION

N100,000

N150,000

N200,000

N250,000

Accommodation Type

General ward

Semi – private

Accommodation including nursing care and consumables (Annual limit)

15 days

17 days

20 days

25 days

Feeding on admission (covered only for the admitted enrollee)

Accommodation for parents whose infants are on admission

2 days

3 days

Inpatient /Hospitalization Benefit Abroad

.

INTENSIVE CARE UNIT

No of days applicable on the plan

3 days

Maternal & Infant Care

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

NEONATE CARE

N100,000

N150,000

N200,000

N250,000

Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan

N200,000

N250,000

N300,000

Post Natal care- 6 weeks

Congenital anomaly treatment (for children born on the plan). Limits per plan

N200,000

N300,000

.

IMMUNIZATIONS (0-5 YEARS)

Bacille Calmette-Guerin (BCG for Tuberculosis)

Oral Poliovirus Vaccines (OPV)

Pentavalent

Hepatitis B Vaccine (HBV)

Vitamin A

Measles

Yellow Fever

Meningitis Vaccine

Measles, Mumps, and Rubella (MMR)

Inactivated Polio Vaccine (IPV)

Rotavirus Vaccine

Diphtheria-Tetanus-Pertussis (DPT)

Pneumococcal Vaccine

Typhoid Vaccine

Human Papillomavirus Vaccine (HPV)

.

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 (subject to surgical limit)

Reimbursement for delivery abroad, limits per plan

Therapeutic Abortion (Manual Vacuum Aspiration)

Surgery, Dental, Eye, ENT, etc

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

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

N7,500

N10,000

N12,500

N15,000

Dental Consultation, Imaging, Endodontic treatment, Extraction

Preventive Treatment: Prophylactic Scaling and Polishing

Gum Treatment & Surgeries, Restorative Treatments

Pharmacy: Prescribed Drugs

Dental Crowning

Subject to the dental limit

Oral and Maxillofacial Surgery

Subject to the surgical limit

.

EYE CARE

Primary Eye Care- Consultation, Examination, primary infections, and Medications

Advanced Ocular tests (Central Visual Field, Depth Perception Test, Schirmer Tear Test, Amsler Test, Retina Photography, OCT Scan, A Scan, B Scan)

Limit to N30,000 per annum

Eye Surgeries covered as part of over all surgerical limit

Biennial Optical Lenses and Frames covered up to annual 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 and Preventive Counselling

Pain therapy

Access to prescribed drugs

Cervical Collar, Lumber Corsets, Knee and Ankle Braces (on prescription)

.

Surgeries (Minor, Intermediate and Major)

N100,000

N150,000

N200,000

N350,000

Chronic Treatments- Accident, Fertility, HIV, etc

Benefit Sub-Categories

Smart Lite

Smart Care

Smart Plus

Smart Pearl

FERTILITY SERVICES

Investigation limits per plan

N10,000

N15,000

N20,000

.

HIV / AIDS TREATMENT (at designated referral centres)

Covered

.

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

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 and Glucometer (to be picked up at our partner pharmacies, subject to the subsidized annual limit, being an enrollee for a minimum period of 9 months and confirmation from Bastion’s quality assurance team)

.

ACCIDENT AND EMERGENCY CARE

Care for accident and emergency cases, Ground Ambulance transfer from the roadside to hospital,hospital to hospital

Stabilization, Emergency Care,drugs and Investigations

Preventive care, Mental Health & Wellness

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 (at designated facilities)

Physical examination (BMI)

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 above 35 years,

PSA for men above 40 yrs

Pap Smear (to be done once in 3 years)

.

LIFESTYLE MANAGEMENT

Network Gym Access

.

MENTAL HEALTH

Specialist Consultations on Outpatient Cases Only; limited based on type of plans

1 sessions per year

2 sessions per year

Inpatient Psychiatry Cover

.

SECOND OPINION CONSULTATION

Second opinion diagnosis and treatment from providers within Bastion’s network

Line of treatment confirmation from Internationally Certified Medical and Surgical Specialists Outside Africa

.

MORTUARY SERVICES FOR FAMILY

N5,000

N7,500

N10,000

N20,000

Premium

Smart Lite

Smart Care

Smart Plus

Smart Pearl

Annual premium per individual

41,230.00

55,007.28

66,245.00

78,061.00

Family of 2

78,936.00

105,801.70

126,984.00

144,144.00

Family of 3

117,796.80

157,888.68

189,499.20

215,107.20

Family of 4

157,062.40

210,518.25

252,665.60

286,809.60

Family of 5

195,316.00

261,791.38

314,204.00

356,664.00

Family of 6

233,164.80

312,521.93

375,091.20

425,779.20

.

Consultation Coverage

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	CONSULTATION (OUTPATIENT CASES)
GENERAL CONSULTATION

This involves treatment of basic medical and surgical (minor) outpatient cases.	₦100,000	₦150,000	₦250,000	₦400,000

HOSPITAL NETWORKS

Hospital Category Accessible
	COVER AND LIMIT
COVER AND LIMIT
	Region of Cover
Region of Cover	Nigeria	Nigeria	Nigeria	Nigeria
	Annual benefit limits per individual
Annual benefit limits per individual	₦500,000	₦750,000	₦1,000,000	₦2,000,000
	GENERAL CONSULTATION
SPECIALIST CONSULTATION
	O and G specialist, General Surgeon, Cardiologist, Pediatrician, Pediatric surgeon, Dermatology, Endocrinology, Hematology, cardiothoracic surgeon, ENT Surgeon, Urologist Orthopaedic Surgeon, Gastroenterologist, Psychiatrist, Neonatologist
O and G specialist, Pediatrician, Hematology, Endocrinology, Urologist, Dermatology, Cardiologist, General Surgeon, Gastroenterologist, Psychiatrist, Pediatric surgeon, Orthopedic Surgeon, ENT Surgeon, Neonatologist, Cardiothoracic surgeon	✔	✔	✔	✔

Screening and Diagnostics

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	LABORATORY
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
Skull X-Rays, Red Blood Cell count, Ultrasound Scan, White Blood Cell count, Limbs X-Rays, Neck X-Rays, Packed Cell Volume, Hematological tests, Full Blood Count and differentials, Lumbosacral X-Rays, White cell differential count, Hemoglobin, Plain Abdominal X-Rays, Chest X-Rays, X-Rays of Body Joints.	✔	✔	✔	✔
	ADVANCED & COMPLEX INVESTIGATIONS
COMPLEX INVESTIGATIONS
	CT, Scan, MRI Scan and echocardiograph
CT, Scan, MRI Scan and echocardiograph	✖	✖	✖	CT scan only
	CHEMISTRY
CHEMISTRY

Fasting Blood Sugar
	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
Microbiology, Urine MCS, HIV Screening, Prostate Specific Antigen, Random Blood Sugar, Blood group, Serology, Stool MCS, Serum AST/SGOT, Serum albumin, Fasting Blood Sugar, Malaria Parasite, Genotype, Widal, Hepatitis B Screening, Electrolyte, Urea and Creatinine, Serum ALT/SGPT, Serum Bilirubin (Direct and Indirect).	✔	✔	✔	✔

Admission and Accommodation

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	ADMISSIONS AND ACCOMMODATION
ADMISSIONS AND ACCOMMODATION
	Limit per plan
Limit per plan	₦100,000	₦150,000	₦200,000	₦250,000
	Accommodation Type
Accommodation Type	General Ward	General Ward	Semi-private	Semi-private
	Accomodation including nursing care and consumables
Accomodation including nursing care and consumables	15 days	17 days	20 days	25 days
	Feeding on admission
Feeding on admission	✔	✔	✔	✔
	Accommodation for parents whose infants are on admission
Accomodation for parents whose infants are on admission	2 days	2 days	2 days	3 days
	Inpatient /Hospitalization Benefit Abroad
Inpatient /Hospitalization Benefit Abroad	✖	✖	✖	✖
	INTENSIVE CARE UNIT
INTENSIVE CARE UNIT
	No of days applicable on the plan
No of days applicable on the plan	✖	✖	✖	3 days

Maternal & Infant Care

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	NEONATE CARE
NEONATE CARE
	Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan
Special Baby Care Unit (Intensive care Unit-including life support, Phototherapy & Incubator care). limit per plan	✖	2 days	3 days	5 days
	Congenital anomaly treatment (for children born on the plan). Limits per plan
Congenital anomaly treatment (for children born on the plan). Limits per plan	✖	₦200,000	₦300,000	₦300,000
	IMMUNIZATIONS (0-5 YEARS) ADULTS (5 – 18 YEARS)
IMMUNIZATIONS (0-5 YEARS) ADULTS (5 – 18 YEARS)
	BCG, OPV.
BCG, OPV.	✔	✔	✔	✔
	PENTAVALENT
PENTAVALENT	✖	✔	✔	✔
	HBV, VITAMIN A, MEASLES, YELLOW FEVER, MENINGITIS VACCINE, MMR.
HBV, VITAMIN A, MEASLES, YELLOW FEVER, MENINGITIS VACCINE, MMR.	✔	✔	✔	✔
	IPV, ROTAVIRUS VACCINE, PNEUMOCOCCAL VACCINE, TYPHOID VACCINE, HPV VACCINE
PNEUMOCOCCAL VACCINE.	✖	✖	✖	✖
	OBSTETRICS AND GYNAECOLOGY
OBS AND GYN

Limits per plan	₦150,000	₦200,000	₦250,000	₦300,000
	Antenatal care, Induction of labour & Normal delivery, Assisted delivery, Emergency or Elective Caesarean Section, Post Natal care- 6 weeks
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
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
Reimbursement for delivery abroad, limits per plan	✖	✖	✖	✖

Surgery, Dental, Eye, ENT, etc

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	ENT (Part of Surgical Limits)
ENT
	Treatment of ENT diseases and removal of foreign bodies
ENT Surgeries (part of surgical limit)	✖	✔	✔	✔
	ENT Surgeries – (part of the surgical limit)
Treatment of ENT diseases and removal of foreign bodies	✖	✔	✔	✔
	DENTAL CARE
DENTAL CARE	₦7,500	₦10,000	₦12,500	₦15,000
	Dental Consultation, Imaging, Endodontic treatment, Extraction, Preventive Treatment: Prophylaxis, Gum Treatment & Surgeries, Restorative Treatments, Pharmacy: Prescribed Drugs, Orthodontic Treatment
All dental care covered up to the limit per plan	✔	✔	✔	✔
	EYE CARE
EYE CARE
	Primary Eye Care- Consultation, Examination, primary infections and Medications
Primary Eye Care- Consultation, Examination, primary infections and Medications	✔	✔	✔	✔
	Eye Surgeries covered as part of over all surgerical limit
Eye Surgeries	✔	✔	✔	✔
	Biennial Optical Lenses and Frames covered up to limit per plan
Biennial Optical Lenses and Frames covered up to limit per plan	₦5,000	₦7,500	₦10,000	₦12,500
	PHYSIOTHERAPY CARE
PHYSIOTHERAPY CARE
	Specialist Consultation
Specialist Consultation	✖	✖	✔	✔
	Number of sessions limit per plan
Number of sessions limit per plan	✖	✖	3 sessions	5 sessions
	Pain therapy
Pain therapy	✖	✖	✔	✔
	SURGERY
SURGERY
	Surgeries (Minor, Intermediate and Major)
Surgeries (Minor, Intermediate and Major)	₦100,000	₦150,000	₦200,000	₦350,000

Chronic Treatments- Accident, Fertility, HIV, etc

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	FERTILITY SERVICES
FERTILITY SERVICES
	Consultation and basic Investigations only, limits per plan
Investigation and treatment at limits per plan	✖	₦10,000	₦15,000	₦20,000
	HIV / AIDS TREATMENT
HIV / AIDS TREATMENT
	HIV / AIDS TREATMENT (at designated approved centres)
HIV / AIDS TREATMENT (at designated approved centres)	✔	✔	✔	✔
	CANCER CARE
CANCER CARE
	Consultation, Admission, Counselling, Hospice Care , Surgical – Chemotherapy – Radiotherapy; limits per plan
Consultation, Admission, Counselling, Hospice Care , Surgical – Chemotherapy – Radiotherapy; limits per plan	✖	₦100,000	₦250,000	₦350,000
	RENAL CARE
RENAL CARE
	Dialysis sessions limit per plans
Dialysis sessions limit per plans	✖	2 sessions	2 sessions	4 sessions
	CHRONIC DISEASE MANAGEMENT / PHARMACY BENEFIT
CHRONIC DISEASE MANAGEMENT / PHARMACY BENEFIT
	Drug delivery and pick up at partner pharmacies
Drug delivery and pick up at partner pharmacies	₦10,000	₦20,000	₦30,000	₦50,000
	Personal health equipment – BP machine, Glucometer, Trackers
Personal health equipment – BP machine, Glucometer, Trackers	✖	✖	✖	✖
	ACCIDENT AND EMERGENCY CARE
ACCIDENT AND EMERGENCY CARE
	Care for accident and emergency cases, Ambulance transfer from roadside to hospital and hospital to hospital
Care for accident and emergency cases, Ambulance transfer from roadside to hospital and hospital to hospital	✔	✔	✔	✔
	Stabilization, Emergency drugs and Investigations
Stabilization, Emergency drugs and Investigations	✔	✔	✔	✔

Preventive care, Mental Health & Wellness

			Most Popular
	Smart Lite	Smart Care	Smart Plus	Smart Pearl
	Benefit Sub-Categories
Benefits
	TELEMEDICINE AND HEALTH COACH
TELEMEDICINE
	Telemedicine app – chat with a doctor consultation online 24/7
Telemedicine app – chat with a doctor consultation online 24/7	✔	✔	✔	✔
	ANNUAL WELLNESS SCREENING
ANNUAL WELLNESS SCREENING
	Physical examination, Visual Acuity, Blood presssure, Full blood count
Physical examination, Visual Acuity, Blood presssure, Full blood count	✖	✔	✔	✔
	Urinalysis
Urinalysis	✖	✖	✔	✔
	Serum cholesterol, ALT / AST, ECG, E/U/Cr.
Serum cholesterol, ALT / AST, ECG, E/U/Cr.	✖	✖	✖	✔
	LIFESTYLE MANAGEMENT
LIFESTYLE MANAGEMENT
	Subsidized Fitness/ nutritional club membership (for non-network gym)
Subsidized Fitness/ nutritional club membership (for non-network gym)	✖	✖	5%	7%
	Network Gym Access
Covid Home Care Kit – up to limit on the plan	✖	✖	✖	✖
	MENTAL HEALTH
MENTAL HEALTH
	Employee Assistance Program / Stress Management
Employee Assistance Program / Stress Management	✖	✖	✖	✔
	Specialist Consultations on Outpatient Cases Only; limited based on type of plans
Specialist Consultations on Outpatient Cases Only; limited based on type of plans	2 weeks	3 weeks	4 weeks	6 weeks
	Covid Home Care Kit – up to limit on the plan
	✔	✔	✔	✔

	SECOND OPINION ABROAD
	✖	✖	✖	✖

	MORTUARY SERVICES
MORTUARY SERVICES
	MORTUARY SERVICES (For Family Only)
MORTUARY SERVICES (For Family Only)	₦5,000	₦7,500	₦10,000	₦20,000