| Plan Benefits | HyBrid Plan |
|---|---|
| Region of Cover | Local |
| Hospital Category | C-D |
| Inpatient Limit (₦) | 2,100,000.00 |
| Accidents & Emergencies: Resuscitative or lifesaving initial treatment | √ (Up to Inpatient Limit) |
| Accommodation (including feeding) | General Ward (30 Days/Annum) |
| Accommodation for Mothers Whose Dependents are on admission (excluding feeding) (Limited to SCBU/NICU Cases only) | General Ward 48 Hrs |
| Intensive Care Services | 48Hrs |
| Neonatal Care Services (Treatment of mild or moderate neonatal sepsis, Phototherapy, Incubator Care and Special Care Baby Unit)* | ₦200,000 |
| Psychiatric Hospitalization | – |
| Surgeries including day case procedures , minor, intermediate and major surgeries ,Caesarean Section Including Endoscopic Procedures (Therapeutic and Diagnostic) | ₦300,000 (Endoscopies not Covered) |
| Outpatient Limit(₦) | 750,000.00 |
| Advanced & Complex Investigations(limited To CT, Scan, MRI Scan and echocardiograph) | CT/M.R.I Scan Only (Emergency/once per annum) |
| Ambulance | Roadside/Hospital to Hospital |
| Antenatal Care + Normal Delivery+ Postnatal Care (6 Weeks) | ₦150,000 |
| Cancer Care: Oncology Tests, Drugs + Chemotherapy & Radiotherapy | ₦300,000 |
| Consultations | – |
| General Consultations (Initial and Follow-up) | √ (Up to Outpatient Limit) |
| Specialist Consultations (Initial and Follow-up) | √ (Up to Outpatient Limit) |
| Telemedicine | Covered |
| Dental Care (relief of pain, fillings, nonsurgical, extractions, preventive care, scaling and polishing, Dental Surgical Extraction & Root Canal Therapy, Dental Prosthetics) | ₦20,000 |
| Family Planning Services | IUCD (Intrauterine Contraceptive Device) e.g.Copper T, Injectibles |
| Global Refundable Limit for Cancer Care** | – |
| Global Refundable Limit for Surgery** | – |
| Global Refundable Limit for Maternity** | – |
| Immunizations | – |
| NPI Immunizations for 0- 5 years | BCG, Measles, DPT, Oral polio, Vitamin A supplementation, Pentavalent vaccine |
| Additional Immunizations for 0-5 years | Hepatitis B, HiB, Yellow Fever |
| Additional Immunizations for 6 yrs and above | Hepatitis B, Yellow Fever |
| Health Checks*** | Limited; Basic (Physical, BP, Urinalysis), Genotype, Blood Sugar, Blood Group, PCV, Pap Smear ,Prostate Specific Antigen and Mammography |
| HIV/AIDS Care & Treatment | ₦250,000 |
| Infertility Investigation | Fertility Consultations, Counselling, USS, SFA (₦35,000) |
| Inter-State Referral Services for services not available in State | √ (Up to Outpatient Limit) |
| Interstate travel by commercial airline, (economy category) | – |
| Medical enquiries | √ |
| Second opinion | √ |
| Hospital Accommodation(where medically necessary) | √ |
| Prescribed medicines and laboratory tests | √ |
| Kidney Dialysis | ₦70,000 |
| Laboratory tests (WHO list of essential in-vitro diagnostics) | √ (Up to Outpatient Limit) |
| Mortuary Services (Cleaning, Embalmment, Storage, Autopsy) | ₦50,000 |
| Neonatal Care Services (Male circumcision, Ear piercing) | √ (Up to Outpatient Limit) |
| Optical Care: Lenses, Frames & Contact, Lenses(Once in two years) | ₦7,500 |
| Optical care: Eye testing, Treatment of acute and chronic eye diseases | ₦50,000 |
| Physiotherapy | ₦50,000 |
| Psychiatric Treatment | Outpatient Only (6 Months) |
| Wellness Benefit(Gym/Spa)**** | – |
| X-Rays and Basic Diagnostic Tests | √ (Up to Outpatient Limit) |
| Pharmacy Benefit Limit(₦) | 150,000.00 |
| Chronic Disease Medication | ₦150,000 |
| Inpatient Prescription Medicines | ₦150,000 |
| Outpatient Prescription Medicines | ₦150,000 |
| Other Benefits | – |
| Critical Illness + Death Cover***** | ₦200,000 |
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