| Region of Cover |
Local |
| Hospital Category |
C-D |
| Inpatient Limit (₦) |
850,000 |
| Accidents & Emergencies: Resuscitative or lifesaving initial treatment |
√ (Up to Inpatient Limit) |
| Accommodation (including feeding) |
General Ward (20 Days/Annum) |
| Accommodation for Mothers Whose Dependents are on admission (excluding feeding) (Limited to SCBU/NICU Cases only) |
– |
| Intensive Care Services |
– |
| Neonatal Care Services (Treatment of mild or moderate neonatal sepsis, Phototherapy, Incubator Care and Special Care Baby Unit)* |
– |
| Psychiatric Hospitalization |
– |
| Surgeries including day case procedures , minor, intermediate and major surgeries ,Caesarean Section Including Endoscopic Procedures (Therapeutic and Diagnostic) |
₦100,000
(Endoscopies not Covered) |
| Outpatient Limit(₦) |
300,000.00 |
| Advanced & Complex Investigations(limited To CT, Scan, MRI Scan and echocardiograph) |
– |
| Ambulance |
– |
| Antenatal Care + Normal Delivery+ Postnatal Care (6 Weeks) |
₦150,000 |
| Cancer Care: Oncology Tests, Drugs +Chemotherapy & Radiotherapy |
– |
| 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) |
(Relief of pain,
fillings, nonsurgical,
extractions,
preventive
care, scaling
and polishing
Only) ₦10,000 |
| 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 |
– |
| Additional Immunizations for 6yrs and above |
– |
| Health Checks*** |
– |
| HIV/AIDS Care & Treatment |
₦100,000 |
| Infertility Investigation |
– |
| Inter-State Referral Services for services not available in State |
– |
| Interstate travel by commercial airline, (economy category) |
– |
| Medical enquiries |
– |
| Second opinion |
– |
| Hospital Accommodation(where medically necessary) |
– |
| Prescribed medicines and laboratory tests |
– |
| Kidney Dialysis |
– |
| Laboratory tests (WHO list of essential in-vitro diagnostics) |
√ (Up to Outpatient Limit) |
| Mortuary Services (Cleaning, Embalmment,Storage, Autopsy) |
– |
| Neonatal Care Services (Male circumcision, Ear piercing) |
√ (Up to Outpatient Limit) |
| Optical Care: Lenses, Frames & Contact, Lenses(Once in two years) |
₦5,000 (Lenses Only) |
| Optical care: Eye testing, Treatment of acute and chronic eye diseases. |
₦50,000 |
| Physiotherapy |
₦30,000 |
| Psychiatric Treatment |
– |
| Wellness Benefit(Gym/Spa)**** |
– |
| X-Rays and Basic Diagnostic Tests |
√ (Up to Outpatient Limit) |
| Pharmacy Benefit Limit(₦) |
80,000.00 |
| Chronic Disease Medication |
₦80,000 |
| Inpatient Prescription Medicines |
₦80,000 |
| Outpatient Prescription Medicines |
₦80,000 |
| Other Benefits |
– |
| Critical Illness + Death Cover***** |
₦100,000 |
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