BENEFITS RETAIL RED BERYL PLAN RETAIL ALEXANDRITE PLAN
PREMIUMS PER MONTH (NAIRA)
INDIVIDUAL 3,500.00 6,000.00
TOTAL BENEFIT LIMITS PER INDIVIDUAL PER MONTH (NAIRA) 100,000.00 150,000.00
TOTAL BENEFIT LIMITS PER INDIVIDUAL PER ANNUM (NAIRA) 1,200,000.00 1,800,000.00
ACCESSIBLE FROM DAY 1       GENERAL CONSULTATION COVERED (Outpatient and Inpatient) COVERED (Outpatient and Inpatient)
Treatment of basic medical and surgical (minor) outpatient and in-patient cases COVERED COVERED
      SPECIALIST CONSULTATION COVERED UP TO 3 SESSIONS PER ANNUM(Outpatient and Inpatient; Based on referral from Primary Provider) COVERED UP TO 5 SESSIONS PER ANNUM(Outpatient and Inpatient; Based on referral from Primary Provider)
O and G specialist COVERED COVERED
Pediatrician COVERED COVERED
General Surgeon COVERED COVERED
Cardiothoracic Surgeon COVERED COVERED
Neurosurgeon COVERED COVERED
Cardiologist COVERED COVERED
ENT Surgeon COVERED COVERED
Urologist COVERED COVERED
Orthopedic Surgeon COVERED COVERED
Gastroenterologist COVERED COVERED
Psychiatrist COVERED COVERED
Neonatologist For family plans ONLY For family plans ONLY
      24 HOURS FREE CHAT ACCESS TO HEALTHCARE PROFESSIONALS (INFOTECH-DRIVEN)
Free chats with Doctors and Nurses when in need of care during any medical emergency COVERED COVERED
Free chats with Doctors and Nurses when in need of any routine medical information COVERED COVERED
A GPS-enabled access to hospital directories when hospital information is needed COVERED COVERED
Free Telemedicine app COVERED COVERED
      ACCIDENT AND EMERGENCY CARE
Resuscitative care for accident and emergency cases, including basic radiological and laboratory investigations needed to stabilize patient before being moved to the ICU if need be. COVERED COVERED
·          Diagnostics and imaging
Chest X-Rays COVERED COVERED
Plain Abdominal X-Rays, COVERED COVERED
Limbs X-rays COVERED COVERED
Neck X-rays COVERED COVERED
Skull X-rays COVERED COVERED
Lumbosacral X-Rays COVERED COVERED
X-rays of Body Joints COVERED COVERED
Ultrasound Scan COVERED COVERED
Hematological tests
Hemoglobin COVERED COVERED
Packed Cell Volume COVERED COVERED
White cell differential count COVERED COVERED
Full Blood Count and differentials COVERED COVERED
White Blood Cell count COVERED COVERED
Red Blood Cell count COVERED COVERED
Chemistry
Fasting Blood Sugar COVERED COVERED
Random Blood Sugar COVERED COVERED
Electrolyte, Urea and Creatinine COVERED COVERED
Prostate Specific Antigen COVERED COVERED
Serum albumin COVERED COVERED
Serum ALT/SGPT COVERED COVERED
Serum AST/SGOT COVERED COVERED
Serum Bilirubin (Direct and Indirect) COVERED COVERED
·          Microbiology
  Malaria Parasite COVERED COVERED
  Widal COVERED COVERED
  Urine MCS COVERED COVERED
  Stool MCS COVERED COVERED
·          Serology
  Hepatitis B Screening (on request by clinician COVERED COVERED
  HIV Screening (on request by clinician COVERED COVERED
  Genotype (on request by clinician) COVERED COVERED
  Blood group (on request by clinician) COVERED COVERED
      NPI IMMUNIZATION (0-5 YEARS) FOR FAMILY PLAN ONLY FOR FAMILY PLAN ONLY
  BCG COVERED COVERED
  OPV COVERED COVERED
  DPT COVERED COVERED
     AMBULANCE SERVICES
Movement of patients to and fro Hospital COVERED (ROADSIDE TO HOSPITAL ONLY) COVERED (ROADSIDE TO HOSPITAL AND HOSPITAL TO HOSPITAL)
ACCESSIBLE AFTER 3 MONTHS       ADMISSIONS AND ACCOMMODATION
  Feeding for enrollees on admission COVERED COVERED
  Hospital Ward Care COVERED (GENERAL WARD ONLY) COVERED (SEMI PRIVATE WARD ONLY)
  Skilled medical and paramedical services COVERED COVERED
  Supply of prescribed intravenous/intramuscular, oral and topical drugs COVERED COVERED
  Supply of all medical and surgical consumables COVERED COVERED
Accommodation for in-patient care COVERED (20 DAYS/ANNUM) COVERED (30 DAYS/ANNUM)
      MINOR SURGERIES
  Wound dressing COVERED COVERED
  Incision & drainage of acute and chronic abscesses COVERED COVERED
  Suturing of minor wounds COVERED COVERED
  Suturing of lacerations COVERED COVERED
  Ear piercing COVERED COVERED
  Male circumcision COVERED COVERED
ACCESSIBLE AFTER 6 MONTHS       PRIMARY DENTAL CARE
  Specialist Consultation COVERED COVERED
  Routine dental examination COVERED COVERED
  Preventive dental care and counselling COVERED COVERED
  Dental pain therapy COVERED COVERED
  Pharmacological treatment of acute and chronic dental infections COVERED COVERED
  Access to prescribed drugs COVERED COVERED
  Scaling and Polishing (COVERED UP TO 5,000 Naira ANNUAL LIMIT) (COVERED UP TO 7,500 Naira ANJUAL LIMIT)
      PHYSIOTHERAPY CARE
  Specialist Consultation COVERED COVERED
  Routine fitness examination COVERED COVERED
  Preventive Counselling on referral COVERED COVERED
  Pain therapy COVERED COVERED
  Access to prescribed drugs COVERED COVERED
Number of Sessions COVERED (UP TO 3 SESSIONS) COVERED (UP TO 5 SESSIONS)
     PSYCHIATRY CARE
Mental illnesses COVERED (OUTPATIENT CASES ONLY; UP TO 4 WEEKS LIMIT) COVERED (OUTPATIENT CASES ONLY; UP TO 6 WEEKS LIMIT)
ACCESSIBLE AFTER 9 MONTHS       EYE CARE COVERED UP TO A GLOBAL ANNUAL LIMIT OF 15,000 NAIRA COVERED UP TO A GLOBAL ANNUAL LIMIT OF 25,000 NAIRA
  Specialist Consultation COVERED COVERED
  Routine ocular examinations COVERED COVERED
  Pharmacological treatment of acute and chronic ocular infections COVERED COVERED
  Lenses and Frames (ONCE EVERY 2 YEARS) COVERED (UP TO 5,000 ANNUAL LIMIT) COVERED (UP TO 10,000 ANNUAL LIMIT)
ACCESSIBLE AFTER 12 MONTHS       INTERMEDIATE SURGERIES (Covered up to 150,000 Naira Annual GLOBAL limit) (Covered up to 300,000 Naira Annual GLOBAL limit)
  Adenoidectomy NOT COVERED NOT COVERED
  Appendicectomy COVERED COVERED
  Cholecystectomy NOT COVERED NOT COVERED
  Fistulectomy NOT COVERED NOT COVERED
  Ganglionectomy NOT COVERED COVERED
  Hernioraphy NOT COVERED COVERED
  Herniotomy NOT COVERED COVERED
  Lumpectomy COVERED COVERED
  Manual Vacuum Aspiration COVERED COVERED
  Pterygium Excision NOT COVERED NOT COVERED
  Repair of penile avulsion NOT COVERED NOT COVERED
  Surgical drainage of anal abscesses NOT COVERED COVERED
  Varicocelectomy NOT COVERED NOT COVERED
  Wedge resection of ingrowing toe nail NOT COVERED COVERED
ACCESSIBLE AFTER 18 MONTHS       MAJOR SURGERIES (Covered up to 300,000 Naira Annual GLOBAL limit)
  Open reduction and internal fixation NOT COVERED NOT COVERED
  Thyroidectomy NOT COVERED COVERED
  Hysterectomy NOT COVERED NOT COVERED
  Mastectomy NOT COVERED COVERED
  Repair of ruptured uterus NOT COVERED NOT COVERED
      GYM
  Fitness programmes a the gym COVERED (1 SESSION PER WEEK) COVERED (2 SESSIONS PER WEEK)
      SPA
  Body massage NOT COVERED COVERED (1 SESSION PER YEAR)