| COVERED SERVICES |
PEARL |
EMERALD |
RUBY |
DIAMOND |
| Outpatient Services |
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| General Consultation |
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| Specialist Consultation/Care |
Routine |
Routine |
Routine |
Tertiary |
| Routine Lab tests |
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| Prescribed Drugs |
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| Physiotherapy (maximum sessions per annum) |
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| Management of Chronic Conditions |
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| Inpatient Services |
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| General ward (15 Days) |
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| Semi Private Ward (30 Days) |
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| Private Ward (45 Days) |
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| Routine Lab Investigations |
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| Drugs and Infusions |
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| Maternity Services (Family Plan only) |
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| Antenatal Care (from 12 weeks) |
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| Normal Delivery |
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| Induction of Labour and Assisted Delivery,forceps delivery |
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| S (Emergency & Medically Indicated Electives) |
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| Post Natal Care up to 6 weeks |
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| Family Planning Services |
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| Counseling only |
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| IUCDs, Injectables, Oral contraception & Norplant |
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| Child Health Services |
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| Routine Immunization (Childhood polio, BCG, DPT, HBV) |
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| Additional Childhood Immunization – Under 5 Years (Hib & Rotavirum) |
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| Non-NPI Immunization |
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| MMR, Hepatitis B, Hib, Varicella, Rotavirum, Pneumococcal |
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| Emergency Services |
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| Local Evacuation to Hospital |
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| Accident & Emergency. (Cover the immediate life saving /resuscitative). Secondary care in this care is subject to Plan covered |
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| Surgical Services |
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| Minor Surgeries Procedures |
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| Intermediate |
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| Major Surgeries Procedures |
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| Radiological Services |
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| Plain X-Ray (Chest, Limb. & Joint) |
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| Ultrasound Scans |
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| Mammogram |
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| CT Scan |
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| MRI |
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| Eye Care |
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| Consultation & Refraction, visual acquity, Routine Examination |
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| Treatment of Simple Infection |
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| Intraocular pressure test |
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| Eye Care & Surgeries ( pterygium excision, cataract extraction & Claucoma Treatment) |
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| Provision of lenses :plain, bifocal& varifocal lenses subject to limit of coverge |
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| Dental Services |
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| Consultation & Treatment of simple infection |
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| Dental X-Ray, Prescribed Drugs, pain therapy & simple extraction |
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| Surgical Extraction & Amalgam filling |
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| Gingival debridement |
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| Scaling & Polishing (Once per annum) |
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| Root Canal (once per annum) |
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| HIV/AIDS Support Services |
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| Education & VCT |
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| ARV treatment referral to diagnostic centres in Nigeria |
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| Annual Basic medical examination |
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| Additional Services |
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| Cancer care -screening, investigation & Radiotherapy |
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| Fertility Treatment: basic investigation, non-hormonal drug treatment, therapeutic surgeries e.g. uterine adhesiolysis |
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| INDIVIDUAL PREMIUM |
Call in |
Call in |
Call in |
Call in |
| FAMILY PREMIUM |
Call in |
Call in |
Call in |
Call in |
GENERAL EXCLUSIONS
Dialysis
Specific Treatment for HIV/AIDS
Cosmetic / Plastic surgeries
Prosthesis and other fitting
Treatment of infertility
Denture and special dental procedures
Cytotoxic treatment
Pre-existing medical conditions
Chronic Conditions end stage diseases including renal failure, kidney failure, liver failure
Certain injuries,- old sport injuries, self inflicted injuries
Overseas treatment and transplant surgery
Investigations and treatment for problems relating to fertility e.g: hormone profiles, hydrotubation, laparoscopy
Epidemics.
