Consultation Coverage

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 
         
HOSPITAL NETWORKS        
Hospital Category Accessible Smart Lite
hospitals		 Smart Care
hospitals		 Smart Plus
hospitals		 Smart Pearl
hospitals
         
CONSULTATION (OUTPATIENT CASES)  N100,000  N150,000  N250,000  N400,000
General Consultation ü ü ü ü
O and G specialist ü ü ü ü
General Surgeon ü ü ü ü
Cardiologist ü ü ü ü
Pediatrician ü ü ü ü
Pediatric surgeon ü ü ü ü
Dermatology  ü ü ü ü
Endocrinology ü ü ü ü
Hematology  ü ü ü ü
cardiothoracic surgeon  ü ü ü ü
ENT Surgeon ü ü ü ü
Urologist ü ü ü ü
Orthopaedic Surgeon ü ü ü ü
Gastroenterologist ü ü ü ü
Psychiatrist ü ü ü ü
Neonatologist ü ü ü ü

Screening and Diagnostics

Benefit Sub-Categories Smart Lite Smart Care Smart Plus Smart Pearl
Laboratory        
Chest X-Rays ü ü ü ü
Plain Abdominal X-Rays ü ü ü ü
Limbs X-Rays ü ü ü ü
Neck X-Rays ü ü ü ü
Skull X-Rays ü ü ü ü
Lumbosacral X-Rays ü ü ü ü
X-Rays of Body Joints ü ü ü ü
Ultrasound Scan ü ü ü ü
Haematological tests ü ü ü ü
Haemoglobin ü ü ü ü
Packed Cell Volume ü ü ü ü
White cell differential count ü ü ü ü
Full Blood Count and differentials ü ü ü ü
White Blood Cell count ü ü ü ü
Red Blood Cell count ü ü ü ü
         
ADVANCED & COMPLEX INVESTIGATIONS        
CT, Scan, MRI Scan and echocardiograph û û û CT scan only
         
CHEMISTRY        
Fasting Blood Sugar ü ü ü ü
Random Blood Sugar ü ü ü ü
Electrolyte, Urea and Creatinine ü ü ü ü
Prostate Specific Antigen ü ü ü ü
Serum albumin ü ü ü ü
Serum ALT/SGPT ü ü ü ü
Serum AST/SGOT ü ü ü ü
Serum Bilirubin (Direct and Indirect) ü ü ü ü
Microbiology ü ü ü ü
Malaria Parasite ü ü ü ü
Widal ü ü ü ü
Urine MCS ü ü ü ü
Stool MCS ü ü ü ü
Serology  ü ü ü ü
Hepatitis B Screening  ü ü ü ü
HIV Screening  ü ü ü ü
Genotype  ü ü ü ü
Blood group  ü ü ü ü

Admission and Accommodation

Benefit Sub-Categories Smart Lite Smart Care Smart Plus Smart Pearl
ADMISSIONS AND ACCOMMODATION        
Limits per plan  N100,000  N150,000  N200,000  N250,000
Accommodation 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  ü ü ü ü
Accommodation for parents
whose infants are on admission 		  2 days  2 days  2 days  3 days
Inpatient /Hospitalization
Benefit Abroad		 û û û û
         
INTENSIVE CARE UNIT        
No of days applicable
on the plan		 û û û 3 days

Maternal & Infant Care

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		 û 2 days 3 days 5 days
Congenital anomaly
treatment (for children born on the plan).
Limits per plan		 û   N200,000   N300,000  N300,000
         
IMMUNIZATIONS
(0-5 YEARS) Adults (5 – 18 )		        
BCG ü ü ü ü
OPV ü ü ü ü
PENTAVALENT û ü ü ü
HBV ü ü ü ü
VITAMIN A ü ü ü ü
MEASLES ü ü ü ü
YELLOW FEVER ü ü ü ü
MENINGITIS VACCINE ü ü ü ü
MMR ü ü ü ü
IPV û û û û
ROTAVIRUS VACCINE û û û û
PNEUMOCOCCAL VACCINE û û û û
TYPHOID VACCINE û û û û
HPV VACCINE û û û û
OBSTETRICS AND
GYNAECOLOGY 		  N150,000   N200,000   N250,000   N300,000 
Antenatal care ü ü ü ü
Induction of labour
& Normal delivery		 ü ü ü ü
Assisted delivery ü ü ü ü
Emergency or Elective
Caesarean Section		 ü ü ü ü
Post Natal care- 6 weeks ü ü ü ü
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		 û û û û

Surgery, Dental, Eye, ENT, etc

Benefit Sub-Categories Smart Lite Smart Care Smart Plus Smart Pearl
ENT (Part of Surgical Limits)        
Treatment of ENT
diseases and removal
of foreign bodies		 û ü ü ü
ENT Surgeries –
(part of the surgical limit)		 û ü ü ü
         
DENTAL CARE N7,500 N10,000 N12,500 N15,000
Dental Consultation,
Imaging, Endodontic treatment,
Extraction		 ü ü ü ü
Preventive Treatment: Prophylaxis ü ü ü ü
Gum Treatment &
Surgeries, Restorative Treatments		 ü ü ü ü
Pharmacy: Prescribed Drugs ü ü ü ü
Orthodontic Treatment ü ü ü ü
         
EYE CARE         
Primary Eye Care- Consultation,
Examination, primary infections,
and Medications		 ü ü ü ü
Eye Surgeries covered as part
of over all surgerical limit		 ü ü ü ü
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 û û  3 sessions  5 sessions
Specialist Consultation û û ü ü
Pain therapy û û ü ü
         
 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         
Consultation and basic
Investigations only,
limits per plan		 û   N10,000   N15,000  N20,000
         
HIV / AIDS TREATMENT
(at designated approved centres)		 ü ü ü ü
         
CANCER CARE         
Consultation, Admission,
Counselling, Hospice Care,
Surgical – Chemotherapy –
Radiotherapy; limits per plan		 û  N100,000  N250,000  N350,000
         
RENAL CARE        
Dialysis sessions limit per plans û 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 		 û û û û
         
ACCIDENT AND
EMERGENCY CARE		        
Care for accident and
emergency cases,
Ambulance transfer
from roadside to hospital
and hospital to hospital 		 ü ü ü ü
Stabilization, Emergency
drugs and Investigations 		 ü ü ü ü

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		 ü ü ü ü
         
ANNUAL WELLNESS SCREENING         
Physical examination û ü ü ü
Visual Acuity  û ü ü ü
Blood pressure û ü ü ü
Fasting Blood Sugar û ü ü ü
Full blood count û ü ü ü
Urinalysis  û û ü ü
serum cholesterol  û û û ü
ALT / AST  û û û ü
ECG û û û ü
E/U/Cr û û û ü
Breast scan,
cervical smears every 2 years for
women > 35 years, 		 û û û û
PSA for men
above 40 yrs		 û û û û
         
LIFESTYLE MANAGEMENT         
Subsidized Fitness/
nutritional club membership
(for non-network gym) 		 û û 5% 7%
Network Gym Access  û û û û
         
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 		 û û û ü
Covid Home Care Kit –
up to limit on the plan		 ü ü ü ü
         
SECOND OPINION ABROAD û û û û
         
MORTUARY SERVICES  FOR FAMILY  N5,000 N7,500 N10,000 N20,000

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

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