Azul Shield

Benefits

Benefits

  • General Consultation

    • Specialist Consultation

  • **Second Opinion Care

  • Health awareness program

  • Drugs and medications for acute illnesses and injuries

  • Prescription drugs for pre-existing cases(cases declared pre-enrollment)

    • Covered within network only

  • Concierge Pharmacy (Medication pick-up and door to door delivery for Chronic and rare medications)

    • Covered

  • Laboratory

    • Basic (MP, FBC, Widal, PCV, etc)
    • Comprehensive ( Lipid profile, EUC ( Electrolyte urea cretinin),LFT( liver function test),

  • X-ray

    • Basic (Plain, Abdominal etc.)
    • Comprehensive

  • Ultrasound Scan

    • Basic (Abdominal, pelvic etc)
    • Comprehensive

  • Hospitalization

    • Standard ward - Covered 42 hospital days
    • 3-4 bedded ward
    • Semi-Private /standard private Ward - semi private ward only

  • Dental Care ***

    • Primary dental care - Treatment for pain with PCP.
    • Non-surgical Dental Care (All dentist visits require appointment authorization) - covered within network.

  • Eye Care

    • Primary eye care - Treatment for pain with PCP.
    • Drugs/Eye Tests/Refraction(Require appointment authorization) - within limit.
    • Lens and Frame - within limit yearly

  • 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 7-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.).
    • Intermediate--(Hernioraphy, colostomy, tenoplasty, diaphragmatic hernia repair, gastroenterostomy, splenorraphy etc.).

  • Special Procedures ***

    • Blood Transfusion - Covered (up to 2 pints)
    • P.O.P - 1st cast
    • Physiotherapy - Covered (10 sessions/annum)
    • Dialysis - 2 acute Sessions
    • HIV Counselling, testing and drugs from local centers - Covered in Govt. NACA Centers only
    • Cancer Therapy: oncology tests, drugs, chemotherapy - Cancer treatments - limited within network.

  • Extra Radiological

    • CT Scan, MRI - 1 full payment per annum

  • Immunization

    • Basic (NPI) - covered including Haptatitis B

  • Preventive and promotive health

    • Adult wellness Check(Annually) - Physical examination, Urinalysis, PCV, Blood pressure, Blood sugar, Lung/pulmonary function test, Chest X-ray, Serum cholesterol, cervical smears every 2years for women 30years and above, PSA for men above 40years.

  • Disease management program

    • Health information
    • Treatment and monitoring of Chronic Illnesses.

Exclusion

Exclusions
  • • 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

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