Benefits
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General Consultation
• Specialist Consultation
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**Second Opinion Care
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Health awareness program
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Drugs and medications for acute illnesses and injuries
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Laboratory
• Basic (MP, FBC, Widal, PCV, etc)
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X-ray
• Basic (Plain, Abdominal etc.)
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Ultrasound Scan
• Basic (Abdominal, pelvic etc)
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Hospitalization
• Standard ward - Covered -
Dental Care ***
• Primary dental care - treatment for pain with PCP < -
Emergency
• Accident/Emergency Stabilization - first 24 hrs post emergency. subsequent cover is to benefit limit
• Emergency road Ambulance Services
• ***Intensive Care Unit - covered for first 3 - days -
Maternity Care
• Antenatal Care
• Medical expenses for delivery(normal, assisted delivery, caesarian section only) - Normal Delivery
• Post natal check-up, first 6wks( for family plan holder only).
• Child Welfare Clinic Circumcision, ear piercing.
• Routine Neo-natal immunization (NPI)-TO LIST
• Ceasarean section - Up to surgery limit
• Local Travel Care -
Surgeries ***
• Minor (Primary suture, lipoma excision, ganglion excision, incision and drainage, keloid excision, minor burns, wound debridement etc.) - within limit.
• ***Intermediate--(Hernioraphy, colostomy, tenoplasty, diaphragmatic hernia repair, gastroenterostomy, splenorraphy etc.) - within limit.
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Special Procedures ***
• Blood Transfusion - Covered (up to 2 pints)
• P.O.P - 1st cast
• HIV Counselling, testing and drugs from local centers - Covered in Govt. NACA Centers only
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Immunization
• Basic (NPI) - Tetanous only
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Disease management program
• Health information
• Treatment and monitoring of Chronic Illnesses.
Exclusion
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• Occupational/Industrial injuries are excluded and continue to be covered under the workman compensation Act.
• Cosmetic surgery
• Brain surgery
• High technology investigation e.g. MRI, unless covered by your chosen plan.
• Injuries resulting from Natural disasters, Conflicts, Social unrest, riots, wars and injuries from nuclear disasters.
• Epidemics
• All forms of Family planning
• Injuries arising from extreme sports
• Injuries related to intoxication
• Drug abuse/addiction
• Terminal illness including cancers, stroke (cancer treatment may be covered by your plan up to a limit).
• All cases of infertility
• All prostheses
• Optional abortion or Pregnancy termination, other than miscarriage