PRIVATE HEALTH INSURANCE SCHEME (PHIS) / SECOND MEDICAL OPTION/ TRAVEL INSURANCE        
S/N Medical Benefits Emerald Ruby Pearl Diamond
Out-patient Services        
1 General Consultation Yes Yes Yes Yes
2 Specialist Consultation/Care Yes Yes Yes Yes
3 Routine Lab tests  & Plain X-Ray (Chest, Limb & Joint)        
a Basic Yes Yes Yes Yes
b Secondary No Yes Yes Yes
4 Prescribed Drugs Yes Yes Yes Yes
5 Physiotherapy (maximum sessions per annum) 4 sessions/yr 6 sessions/yr 8 sessions/yr 10 sessions/yr
6 Management of Chronic Conditions (Group Policy only, Retail – After 12months)        
i Hypertension Yes Yes Yes Yes
ii Diabetes Yes Yes Yes Yes
iii Sickle Anaemia Yes Yes Yes Yes
iv Asthma Yes Yes Yes Yes
           
7 Hospital Admission (21 Days)        
a General ward  Yes Yes Yes Yes
b Semi Private Ward  No Yes Yes Yes
c Private Ward  No Yes Yes Yes
           
8 Maternity Services (Including Antenatal Care, Normal Delivery & Ceasarean Section) 100,000 200,000 250,000 400,000
  Post Natal Care up to 6 weeks Yes Yes Yes Yes
           
9 Family Planning Services (Family Plan only)        
a Counselling only Yes Yes Yes Yes
b IUCDs Yes Yes Yes Yes
c Injectables No Yes Yes Yes
d Oral Contraception No No Yes Yes
e Implants No No No Yes
           
10 Child Health Services (Family Plan only)        
a Routine Immunization (NPI) Yes Yes Yes Yes
b Additional Childhood Immunization – Under 5 Years         
i Rotavirus No Yes Yes Yes
ii Varicella No Yes Yes Yes
iii Pneumococal No No Yes Yes
iv Meningitis No No No Yes
           
11 Emergency Services        
a Medical Emergencies Yes Yes Yes Yes
b Intensive Care/stabilization Yes Yes Yes Yes
c Local Evacuation to Hospital Yes Yes Yes Yes
d Accident & Emergency.   Yes Yes Yes Yes
           
12 Surgical Procedures – Minor, intermediate, Major 100,000 200,000 250,000 400,000
           
13 Advanced Radiological Services        
a ECG Yes Yes Yes Yes
b Echocardiography No Yes Yes Yes
c Mammogram No Yes Yes Yes
d CT Scan No Yes 1/yr 2/yr
e MRI (1 session/annum) No No No Yes
           
14 Optical Services        
a Consultation & Refraction, visual acquity, Routine Examination Yes Yes Yes Yes
b Treatment of Simple Infection Yes Yes Yes Yes
c Provision of lenses  :plain, bifocal& varifocal lenses subject to limit of coverage (1/year) 10,000 15,000 20,000 25,000
d Intraocular pressure test Yes Yes Yes Yes
e Eye Surgeries – Cataract No No No Total Limit: 80,000
           
15 Dental Services        
a Dental Care (Including Consultation and Treatment, Investigations, Surgical Extraction, Scaling & Polishing, Extraction, Amalgam Filling) Total Limit: 15,000 Total Limit: 20,000 Total Limit: 35,000 Total Limit: 50,000
b Root Canal No No No Yes
           
16 HIV/AIDS Support Services        
a Education & VCT Yes Yes Yes Yes
b ARV treatment referral to  diagnostic  centres Yes Yes Yes Yes
           
17 Additional Services        
a Cancer –screening & investigation  No No Yes Yes
b Fertility Treatment: basic investigation, non-hormonal drug treatment. No No No Yes
c Annual Basic Medical Examination (Principal Beneficiary Only) No 1/yr 1/yr 1/yr
d Comprehensive Medical Screening (Principal Beneficiary Only) No No No 1/yr
e Kidney dialysis (Principal Beneficiary Only) No No 2 sessions  3 sessions 
           
18 Mental Health Services        
a Initial Psychiatric Evaluation Yes Yes Yes Yes
           
19 International Travel Insurance (Worldwide)        
  Emergency Medical and Related Expenses Yes Yes Yes Yes
  Medical Transportation Yes Yes Yes Yes
  Medicines and Hospitalization Abroad Yes Yes Yes Yes
  Corpse Repartriation in the event of Death Yes Yes Yes Yes
  Legal Assistance Yes Yes Yes Yes
  Indemnity for Lost Luggage and Personal Effect Yes Yes Yes Yes
           
20 Second Medical Opinion        
  Medical Case Management Review Yes Yes Yes Yes
  Elite Medical Network Assessment Yes Yes Yes Yes
  Customized Report on Diagnosis/Recommendation of Treatment Plan Yes Yes Yes Yes
  Dedicated Helplines Yes Yes Yes Yes
           
  Group Annual Premium        
  Individual Premium  Emerald (Individual) N50,500.00  Ruby (Individual) N80,500.00 Pearl (Individual) N117,500.00 Diamond (Individual) N200,500.00
  Family Premium  Emerald (Family) N185,000.00 Ruby (Family) N273,000.00 Pearl (Family) N420,000.00 Diamond (Family) N635,000.00
  *Cover limit for both Corporate & Retail plans – 65 years      
  *Family = Principal, Spouse and a maximum of 4 biological children under 18 years, with due Management approval, waivers & concessions are permissible         
  *Benefit limits are not transferable          
  *Premium and benefits are subject to change