Individual & Fam

Consultation Coverage

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

Screening and Diagnostics

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 

Admission and Accommodation

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

Maternal & Infant Care

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

Surgery, Dental, Eye, ENT, etc

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

Chronic Treatments- Accident, Fertility, HIV, etc

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 

Preventive care, Mental Health & Wellness

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

Premium

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

Seniors

Consultation Coverage

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

Screening and Diagnostics

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

Admission and Accommodation

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

Surgery, Dental, Eye, ENT, etc

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

Chronic Treatments- Accident, Fertility, HIV, etc

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

Preventive care, Mental Health & Wellness

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

Premium

Sub- Categories OAK BLOSSOM GOLDEN
Annual Premium N159,000 N285,000 N570,550

Corporate

Consultation Coverage

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

Screening and Diagnostics

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 

Admission and Accommodation

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

Maternal & Infant Care

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

Surgery, Dental, Eye, ENT, etc

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

Chronic Treatments- Accident, Fertility, HIV, etc

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 

Preventive care, Mental Health & Wellness

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

Premium

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

SMEs

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
         
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

Screening and Diagnostics

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 

Admission and Accommodation

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

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 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

Surgery, Dental, Eye, ENT, etc

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

Chronic Treatments- Accident, Fertility, HIV, etc

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 

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         
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

Premium

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