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| SERVICE BENEFITS | |
|---|---|
| Choice of Hospitals | Band A |
| OUT-PATIENT CARE | |
| Registration | Covered |
| General Consultation | Covered |
| General Case Review | Covered |
| Specialist Consultation | Covered |
| Specialist Case Review | Covered |
| Routine Laboratory Services | Covered |
| HOSPITALIZATION/ADMISSIONS | |
| ACCOMODATION TYPE | (48 HRS) |
| General Ward | Covered |
| Nursing Care | Covered |
| Feeding | Covered |
| Admission In-Patient | Covered |
| Prescription of Drugs & Medications | Covered |
| ACCIDENTS AND EMERGENCY 24HRS SERVICES | |
| Local Evacuation and Stabilization | Covered |
| Emergency Drugs and Investigation | Covered |
| Ambulance Rescue Facilitation | Covered |
| INVESTIGATIONS | |
| Laboratory Investigations | Covered |
| Basic Radiological Investigations (X-rays, Scans) | Covered |
| ADVANCED & COMPLEX INVESTIGATIONS | |
| CT Scan | Covered (Max once yearly) |
| ECG | Covered (Max once yearly) |
| Echocardiogram (ECHO) | Covered (Max once yearly) |
| OBSTERICS & GYNAECOLOGY (FAMILY PLAN ONLY) | |
| Antenatal Care | Covered |
| Normal & Assisted delivery | Covered |
| FAMILY PLANNING (FAMILY PLAN ONLY) | Covered |
| Injectables and Drugs | Covered |
| PAEDIATRICS | |
| Neonatal care | Covered |
| Incubator care | Covered (48 HRS) |
| Phototherapy | Covered (48 HRS) |
| NPI Childhood Immunization | Covered |
| PHYSIOTHERAPY | Covered (MAX. 3 SESSIONS PER ANNUM) |
| SURGICAL PROCEDURES | |
| MINOR SURGERIES & PROCEDURES | Covered |
| Wound Dressing | Covered |
| Suturing of Minor Cut and Laceration | Covered |
| Incision and Drainage of Abscesses | Covered |
| INTERMEDIATE SURGERIES | Covered |
| Minor Lumpectomy (Removal of simple lump) | Covered |
| Cervical Laceration Repair | Covered |
| Closed reduction and manipulation of simple fractures | Covered |
| In Growing Nail (Excision) | Covered |
| Breast Lump Excision | Covered |
| CHRONIC AILMENT MANAGEMENT | |
| Diabetes | Covered |
| Hypertension | Covered |
| Osteoarthritis | Covered |
| Asthma & COPD | Covered |
| Peptic Ulcer Disease | Covered |
| Recurrent Seizure | Covered |
| Nebulization | Covered |
| Tuberculosis Investigation | Covered |
| HIV/AIDS SUPPORTIVE TREATMENT | Covered |
| HIV Screening, Voluntary Counselling and Testing | Covered |
| HIV/AIDS (Treatment at Govt. designated centers) | Covered |
| DENTAL CARE | |
| Dental Consultation and Routine Examination | Covered |
| Pain Therapy | Covered |
| Amalgam Filings | Covered |
| Composite Filings | Covered |
| Simple Extraction | Covered |
| Surgical Extraction | Covered |
| Scaling and Polishing | Covered |
| Root Canal Therapy | Covered |
| OPTICAL/OPTHALMOLOGICAL | |
| Optical and Routine Consultation | Covered |
| Treatment of Eye Infection (Conjunctivitis) | Covered |
| Optical Lenses and Frames | Covered |
| SERVICE BENEFITS | |
|---|---|
| Choice of Hospitals | Band A+B |
| OUT-PATIENT CARE | |
| Registration | Covered |
| General Consultation | Covered |
| General Case Review | Covered |
| Specialist Consultation | Covered |
| Specialist Case Review | Covered |
| Routine Laboratory Services | Covered |
| HOSPITALIZATION/ADMISSIONS | |
| ACCOMODATION TYPE | (72 HRS) |
| General Ward | Covered |
| Semi-Private | Covered |
| Nursing Care | Covered |
| Feeding | Covered |
| Admission In-Patient | Covered |
| Prescription of Drugs & Medications | Covered |
| ACCIDENTS AND EMERGENCY 24HRS SERVICES | |
| Local Evacuation and Stabilization | Covered |
| Emergency Drugs and Investigation | Covered |
| Ambulance Rescue Facilitation | Covered |
| EEG Electroencephalogram | Covered |
| INVESTIGATIONS | |
| Laboratory Investigations | Covered |
| Basic Radiological Investigations (X-rays, Scans) | Covered |
| ADVANCED & COMPLEX INVESTIGATIONS | |
| CT Scan | Covered (Max once yearly) |
| ECG | Covered (Max once yearly) |
| Echocardiogram (ECHO) | Covered (Max once yearly) |
| Mammogram | Covered (Max once yearly) |
| PSA Test & Biopsy | Covered (Max once yearly) |
| OBSTERICS & GYNAECOLOGY (FAMILY PLAN ONLY) | |
| Antenatal Care | Covered |
| Normal & Assisted delivery | Covered |
| FAMILY PLANNING (FAMILY PLAN ONLY) | Covered |
| Injectables and Drugs | Covered |
| Intra Uterine Contraceptive Device (IUCD) | |
| Nexplanon | Covered |
| Vasectomy | Covered |
| Barriers (Diaphragms) | Covered |
| PAEDIATRICS | |
| Neonatal care | Covered |
| Incubator care | Covered (72 HRS) |
| Phototherapy | Covered (72 HRS) |
| NPI Childhood Immunization | Covered |
| Supplementary Childhood Immunization (Typhoid, Rotavirus, MMR, pneumococcal) | Covered |
| PHYSIOTHERAPY | Covered (MAX. 5 SESSIONS PER ANNUM) |
| SURGICAL PROCEDURES | |
| MINOR SURGERIES & PROCEDURES | Covered |
| Wound Dressing | Covered |
| Suturing of Minor Cut and Laceration | Covered |
| Incision and Drainage of Abscesses | Covered |
| INTERMEDIATE SURGERIES | Covered |
| Minor Lumpectomy (Removal of simple lump) | Covered |
| Cervical Laceration Repair | Covered |
| Closed reduction and manipulation of simple fractures | Covered |
| In Growing Nail (Excision) | Covered |
| Breast Lump Excision | Covered |
| MAJOR SURGERIES | Covered |
| Caesarean Section | Covered |
| Repair of Ruptured Uterus | Covered |
| Ectopic Pregnancy | Covered |
| Hysterectomy | Covered |
| Myomectomy | Covered |
| Ovariectomy/ovarian cysts | Covered |
| CHRONIC AILMENT MANAGEMENT | |
| Diabetes | Covered |
| Hypertension | Covered |
| Osteoarthritis | Covered |
| Asthma & COPD | Covered |
| Peptic Ulcer Disease | Covered |
| Recurrent Seizure | Covered |
| Nebulization | Covered |
| Tuberculosis Investigation | Covered |
| HIV/AIDS SUPPORTIVE TREATMENT | Covered |
| HIV Screening, Voluntary Counselling and Testing | Covered |
| HIV/AIDS (Treatment at Govt. designated centers) | Covered |
| DENTAL CARE | |
| Dental Consultation and Routine Examination | Covered |
| Pain Therapy | Covered |
| Amalgam Filings | Covered |
| Composite Filings | Covered |
| Simple Extraction | Covered |
| Surgical Extraction | Covered |
| Scaling and Polishing | Covered |
| Root Canal Therapy | Covered |
| OPTICAL/OPTHALMOLOGICAL | |
| Optical and Routine Consultation | Covered |
| Treatment of Eye Infection (Conjunctivitis) | Covered |
| Optical Lenses and Frames | Covered |
| SERVICE BENEFITS | |
|---|---|
| Choice of Hospitals | Band A+B+C |
| OUT-PATIENT CARE | |
| Registration | Covered |
| General Consultation | Covered |
| General Case Review | Covered |
| Specialist Consultation | Covered |
| Specialist Case Review | Covered |
| Routine Laboratory Services | Covered |
| HOSPITALIZATION/ADMISSIONS | |
| ACCOMODATION TYPE | (5 DAYS) |
| General Ward | Covered |
| Semi-Private | Covered |
| Private Ward | Covered |
| Nursing Care | Covered |
| Feeding | Covered |
| Admission In-Patient | Covered |
| Prescription of Drugs & Medications | Covered |
| ACCIDENTS AND EMERGENCY 24HRS SERVICES | |
| Local Evacuation and Stabilization | Covered |
| Emergency Drugs and Investigation | Covered |
| Ambulance Rescue Facilitation | Covered |
| Intensive Care Unit (ICU) | Covered (24 HRS) |
| EEG Electroencephalogram | Covered |
| INVESTIGATIONS | |
| Laboratory Investigations | Covered |
| Basic Radiological Investigations (X-rays, Scans) | Covered |
| ADVANCED & COMPLEX INVESTIGATIONS | |
| CT Scan | Covered (Max once yearly) |
| MRI | Covered (Max once yearly) |
| DOPPLER SCAN | Covered (Max once yearly) |
| ECG | Covered (Max once yearly) |
| Echocardiogram (ECHO) | Covered (Max once yearly) |
| Mammogram | Covered (Max once yearly) |
| PSA Test & Biopsy | Covered (Max once yearly) |
| OBSTERICS & GYNAECOLOGY (FAMILY PLAN ONLY) | |
| Antenatal Care | Covered |
| Normal & Assisted delivery | Covered |
| FAMILY PLANNING (FAMILY PLAN ONLY) | Covered |
| Injectables and Drugs | Covered |
| Intra Uterine Contraceptive Device (IUCD) | |
| Nexplanon | Covered |
| Vasectomy | Covered |
| Barriers (Diaphragms) | Covered |
| PAEDIATRICS | |
| Neonatal care | Covered |
| Incubator care | Covered (4 DAYS) |
| Phototherapy | Covered (4 DAYS) |
| NPI Childhood Immunization | Covered |
| Supplementary Childhood Immunization (Typhoid, Rotavirus, MMR, pneumococcal) | Covered |
| PHYSIOTHERAPY | Covered (MAX. 7 SESSIONS PER ANNUM) |
| SURGICAL PROCEDURES | |
| MINOR SURGERIES & PROCEDURES | Covered |
| Wound Dressing | Covered |
| Suturing of Minor Cut and Laceration | Covered |
| Incision and Drainage of Abscesses | Covered |
| INTERMEDIATE SURGERIES | Covered |
| Minor Lumpectomy (Removal of simple lump) | Covered |
| Cervical Laceration Repair | Covered |
| Closed reduction and manipulation of simple fractures | Covered |
| In Growing Nail (Excision) | Covered |
| Breast Lump Excision | Covered |
| MAJOR SURGERIES | Covered |
| Caesarean Section | Covered |
| Repair of Ruptured Uterus | Covered |
| Ectopic Pregnancy | Covered |
| Hysterectomy | Covered |
| Myomectomy | Covered |
| Ovariectomy/ovarian cysts | Covered |
| CHRONIC AILMENT MANAGEMENT | |
| Diabetes | Covered |
| Hypertension | Covered |
| Osteoarthritis | Covered |
| Asthma & COPD | Covered |
| Peptic Ulcer Disease | Covered |
| Recurrent Seizure | Covered |
| Nebulization | Covered |
| Tuberculosis Investigation | Covered |
| HIV/AIDS SUPPORTIVE TREATMENT | Covered |
| HIV Screening, Voluntary Counselling and Testing | Covered |
| HIV/AIDS (Treatment at Govt. designated centers) | Covered |
| DENTAL CARE | |
| Dental Consultation and Routine Examination | Covered |
| Pain Therapy | Covered |
| Amalgam Filings | Covered |
| Composite Filings | Covered |
| Simple Extraction | Covered |
| Surgical Extraction | Covered |
| Scaling and Polishing | Covered |
| Root Canal Therapy | Covered |
| OPTICAL/OPTHALMOLOGICAL | |
| Optical and Routine Consultation | Covered |
| Treatment of Eye Infection (Conjunctivitis) | Covered |
| Optical Lenses and Frames | Covered |
| FERTILITY SERVICES - Counselling and Consultation | Covered |
| SERVICE BENEFITS | |
|---|---|
| Choice of Hospitals | Band A+B+C+D |
| OUT-PATIENT CARE | |
| Registration | Covered |
| General Consultation | Covered |
| General Case Review | Covered |
| Specialist Consultation | Covered |
| Specialist Case Review | Covered |
| Routine Laboratory Services | Covered |
| HOSPITALIZATION/ADMISSIONS | |
| ACCOMODATION TYPE | (5 DAYS) |
| General Ward | Covered |
| Semi-Private | Covered |
| Private Ward | Covered |
| Nursing Care | Covered |
| Feeding | Covered |
| Admission In-Patient | Covered |
| Prescription of Drugs & Medications | Covered |
| ACCIDENTS AND EMERGENCY 24HRS SERVICES | |
| Local Evacuation and Stabilization | Covered |
| Emergency Drugs and Investigation | Covered |
| Ambulance Rescue Facilitation | Covered |
| Intensive Care Unit (ICU) | Covered (2 DAYS) |
| EEG Electroencephalogram | Covered |
| INVESTIGATIONS | |
| Laboratory Investigations | Covered |
| Basic Radiological Investigations (X-rays, Scans) | Covered |
| ADVANCED & COMPLEX INVESTIGATIONS | |
| CT Scan | Covered (Max twice yearly) |
| MRI | Covered (Max twice yearly) |
| DOPPLER SCAN | Covered (Max twice yearly) |
| ECG | Covered (Max twice yearly) |
| Echocardiogram (ECHO) | Covered (Max twice yearly) |
| Mammogram | Covered (Max twice yearly) |
| PSA Test & Biopsy | Covered (Max twice yearly) |
| OBSTERICS & GYNAECOLOGY (FAMILY PLAN ONLY) | |
| Antenatal Care | Covered |
| Normal & Assisted delivery | Covered |
| FAMILY PLANNING (FAMILY PLAN ONLY) | Covered |
| Injectables and Drugs | Covered |
| HIV/AIDS SUPPORTIVE TREATMENT | Covered |
| Nexplanon | Covered |
| Vasectomy | Covered |
| Barriers (Diaphragms) | Covered |
| PAEDIATRICS | |
| Neonatal care | Covered |
| Incubator care | Covered (5 DAYS) |
| Phototherapy | Covered (5 DAYS) |
| NPI Childhood Immunization | Covered |
| Supplementary Childhood Immunization (Typhoid, Rotavirus, MMR, pneumococcal) | Covered |
| PHYSIOTHERAPY | Covered (MAX. 10 SESSIONS PER ANNUM) |
| SURGICAL PROCEDURES | |
| MINOR SURGERIES & PROCEDURES | Covered |
| Wound Dressing | Covered |
| Suturing of Minor Cut and Laceration | Covered |
| Incision and Drainage of Abscesses | Covered |
| INTERMEDIATE SURGERIES | Covered |
| Minor Lumpectomy (Removal of simple lump) | Covered |
| Cervical Laceration Repair | Covered |
| Closed reduction and manipulation of simple fractures | Covered |
| In Growing Nail (Excision) | Covered |
| Breast Lump Excision | Covered |
| MAJOR SURGERIES | Covered |
| Caesarean Section | Covered |
| Repair of Ruptured Uterus | Covered |
| Ectopic Pregnancy | Covered |
| Hysterectomy | Covered |
| Myomectomy | Covered |
| Ovariectomy/ovarian cysts | Covered |
| CHRONIC AILMENT MANAGEMENT | |
| Diabetes | Covered |
| Hypertension | Covered |
| Osteoarthritis | Covered |
| Asthma & COPD | Covered |
| Peptic Ulcer Disease | Covered |
| Recurrent Seizure | Covered |
| Nebulization | Covered |
| Tuberculosis Investigation | Covered |
| HIV Screening, Voluntary Counselling and Testing | Covered |
| HIV/AIDS (Treatment at Govt. designated centers) | Covered |
| DENTAL CARE | |
| Dental Consultation and Routine Examination | Covered |
| Pain Therapy | Covered |
| Amalgam Filings | Covered |
| Composite Filings | Covered |
| Simple Extraction | Covered |
| Surgical Extraction | Covered |
| Scaling and Polishing | Covered |
| Root Canal Therapy | Covered |
| OPTICAL/OPTHALMOLOGICAL | |
| Optical and Routine Consultation | Covered |
| Treatment of Eye Infection (Conjunctivitis) | Covered |
| Optical Lenses and Frames | Covered |
| FERTILITY SERVICES - Counselling and Consultation | Covered |
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