Frequently asked questions

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If I do not exhaust my maximum benefit limits in a year, will I get a refund?

For corporate organization if your utilization is well below 60% a rebate of 10% will be given as discount at renewal but individuals, this might not be applicable.

What happens if I attain my medical limit before the year runs out?

Although the possibility of this happening is very remote, but in such an event, you or your sponsor will be required to pay for the subsequent treatment or renew your plan

What happens if I fall ill while outside my locality and can’t reach my primary care provider, or get involved in an accident and none of your hospitals is nearby?

In cases of emergencies and out of station, you are advised to access care at the nearest hospital. However a call or notification must be placed to us in 24hours, also the receipt of care accessed and a medical report should be forwarded to us for a refunds.

What happens if I am not satisfied with the quality of care from a particular hospital?

Should you be dissatisfied with the services received at your healthcare provider, kindly reach us through all our communication channels, this will be duly looked into and changes will be made where

How often can I visit the hospital?

As much as care is needed

Can I choose other hospitals apart from those on your network?

We do not allow our enrollees to choose other hospitals not on our network that we do not have any contractual agreement with. However should you be interested in using an hospital not on our network, kindly notify us or request that the provider send us an application letter. We shall carry out an accreditation exercise and if successful, the provider will be included in our network.

How do you ensure that only hospitals of high standards are on your network?

A rigorous selection process is usually adopted in signing up hospitals on our network. This involves a review of credentials and certification of the intending healthcareas well as the inspection of the facility.

How do you monitor the activities of the hospitals on the scheme?

We have a medical services team which consists of qualified and experienced medical officers that carried out quality assurance on the hospitals on our network.

The Wellness Health Plan is a healthcare program developed by Wellness Healthcare Management Services

The Health Plan is based on the Managed Care Concept – the most advanced and effective method of financing and delivering medical services. Under the Wellness Health Plan, you or your employer pay a certain premium based on the choice of the hospital you will like to access care from as well as the health benefits you will like to have. In addition you also enjoy preventive and health promotion services that will not only keep you fit, strong and happy but will reduce unnecessary visits to the hospital.

What is the difference between the HMO system, retainership or pay – out – of -pocket system

The HMO system takes sole responsibility of your healthcare needs after you must have paid a certain premium. Pay-out-of pocket is the system of paying for your healthcare at every visit made to the hospital. While retainership is where there is a contractual agreement between you and the provider to treat and send a bill to you on the later date.

Are your premiums paid monthly or annually?

Premiums can be paid annually or on an agreed installment term.

Can I get pricing for the different plans

Wellness Health Plan consists of Corporate family and individual plans, Retail plans, SME plans .Simply Click here to see our different plans.

Can I pay for my health insurance by installment

Premiums can be paid annually or on an agreed installment terms.

I made payment out of pocket at the hospitals how can I get my refund

For all out of pocket payment, you would have to notifiy us within 24 hours of payment, a reimbursement form will be provided to you. Kindly fill all important informtion, with evidence of payment.

How soon can I use the hospital after payment for insurance has been made

For corporate Health insurance plan, access to care starts after payment has been confirmed. The retail plans requires a waiting period of 1 month for general care, 6 months for maternity and 1 year for surgical care. The waiting period starts once we have received full payment and all required registration document.

What is telemedicine

Telemedicine is the delivery of Healthcare using a telecommunication device.

How those telemedicine work

Telemedicine allows a patient/Enrollee to consult or speak to a doctor via a toll free number through their mobile phone.

What type of care can I get from telemedicine

Wellness offers telemedicine for basic and primary care.

Will my health insurance pay for the telemedicine appointment

Your wellness health plan covers all telemedicine care you receive with no additional cost.

What device or technology will I need for telemedicine

A mobile phone (with or without internet access) is all you need to speak to a doctor.

Are intensive treatment provided during telemedicine appointment?

Emergency treatment, treatments including injections, extensive investigations, secondary care treatments can not be given via our telemedicine platform.

Can my spouse or dependent use telemedicine

Enrollees under family plan are allowed access to our telemedicine platform. Spouses and Dependent of Enrollees on individual plans are not allowed access to telemedicine.

Is there a waiting time for me to speak to a doctor

There is no waiting time for you to speak to a doctor.

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