Health Insurance Cover

Corporate
Health Plan

From

30,000

Yearly

Medical Check-upMedical Check-up

Voluntary Annual Comprehensive Medical Check-up

Consultation

General Outpatient Consultation

Specialist Consultation

Dental careDental care

Primary and Secondary Dental care

Physiotherapy

Physiotherapy Services (Up to approved limits)

Eye Surgeries

Eye Surgeries

Maternity

Maternity Care (Family plan only)

Pharmacy Benefit

Pharmacy Benefit Scheme

TelemedicineTelemedicine

Telemedicine

Drugs

Pharmacy Benefit

Pharmacy Benefit Scheme

Optical Care

HOSPITALIZATION

Hospitalisation (Accommodation and Feeding)

Immunization

Primary Immunisations

VACCINATION

Adult Vaccination

MENTAL HEALTHMENTAL HEALTH

Mental Health

General Sugery

Obstectrics/Gynecological Maternity Services

[pff-paystack id="1992"]

CONTACT US

GET A QUOTE NOW

HMO PLANS

Family & Personal
Health Plan

This is a tailored to suit specific health needs of individuals and families with benefits structured to ensure your Wellness all year round (for ages 59 years and below)​

Wellness
on the Go

You have the choice to access healthcare on the go at any time and pay for just the care you need even if you don’t have a health insurance plan

BENEFITS

GUARD

SHIELD

PREMIUM

PREMIUM+

EXCLUSIVE

HOSPITALIZATION (ACCOMMODATION & FEEDING)

  • Private Room

Not Covered

Not Covered

Covered

Covered

Covered

PRIMARY IMMUNISATIONS (BASED ON NPI SCHEDULE)

BCG

Covered

Covered

Covered

Covered

Covered

OPV

Covered

Covered

Covered

Covered

Covered

DPT

Covered

Covered

Covered

Covered

Covered

Measles

Covered

Covered

Covered

Covered

Covered

Yellow Fever

Covered

Covered

Covered

Covered

Covered

Vitamin A

Covered

Covered

Covered

Covered

Covered

Hepatitis B

Covered

Covered

Covered

Covered

Covered

SECONDARY IMMUNISATION

Not Covered

Not Covered

Covered

Covered

Covered

ADULT VACCINATION

Not Covered

Not Covered

Not Covered

Not Covered

Covered

LABORATORY INVESTIGATIONS

DIAGNOSTICS INVESTIGATIONS

Covered

Covered

Covered

Covered

Covered

DRUGS

Supply of Drugs Prescribed

Covered

Covered

Covered

Covered

Covered

PHYSIOTHERAPY

5 SESSIONS

7 SESSIONS

10 SESSIONS

12 SESSIONS

15 SESSIONS

MENTAL HEALTH

Covered

Covered

Covered

Covered

Covered

DENTAL CARE ( LIMIT PER SINGLE/FAMILY APPLIES)

N10,000/N25,000

N15,000/N35,000

N25,000/N55,000

N30,000/N75,000

N40,000/N85,000

Dental Consultation

Scaling & Polishing (limit of two years yearly)

Covered

Covered

Covered

Covered

Covered

OPTICAL CARE

Covered

Covered

Covered

Covered

Covered

Lenses (Either Unifocal, bifocal, or varifocal lenses and frame with a limit of once every 2 years)

Covered (Principal only with a Limit of N10,000)

Covered (Principal only with a Limit of N15,000)

Covered (Principal, Spouse & four Children each with a family limit of N80,000)

Covered (Principal, Spouse & four Children each with a family limit of N120,000)

Covered (Principal, Spouse & four Children each with a family limit of N150,000)

OPTHALMOLOGY SURGICAL PROCEDURES (limit applies)

N30,000

N50,000

N70,000

N80,000

N120,000

Limit on Terminal illness (Cancer, Kidney, Stroke and Liver disease)

N200,000

N300,000

N500,000

N100,000,000

N200,000,000

EMERGENCY SERVICES


Ambulance (Hospital-to-Hospital transfer)(For Immobile Enrollees Only)

Covered

Covered

Covered

Covered

Covered

Ambulance (Site-to-Hospital transfer)(For Immobile Enrollees Only)

Covered

Covered

Covered

Covered

Covered

Emergency Stabilization and Resuscitation Management only

Covered

Covered

Covered

Covered

Covered

NEONATAL SERVICES (limit applies)

N35,000

N50,000

N75,000

N75,000

N100,000

Surgical Procedure (LIMIT APPLIES)

GENERAL SURGERY

N100,000

N200,000

N400,000

N600,000

N750,000

OBSTECTRICS/GYNEACOLOGICAL

MATERNITY SERVICES

Covered

Covered

Covered

Covered

Covered

GROUP DISCOUNT PREMIUM IN NAIRA

INDIVIDUAL/FAMILY

INDIVIDUAL/FAMILY

INDIVIDUAL/FAMILY

INDIVIDUAL/FAMILY

INDIVIDUAL/FAMILY

40-100

38,200/191,000

51,300/256,500

85,500/427,500

140,000/700,000

215,000/1,075,000

101-250

35,200/176,000

48,500/242,500

82,500/412,500

135,000/675,000

210,000/1,050,000

251 – 500

32,200/161,000

45,850/229,250

79,500/397,500

130,000/650,000

205,000/1,025,000

ABOVE 500

30,000/150,000

42,000/210,000

75,500/377,500

125,000/625,000

200,000/1,000,000

Oga Protect
Plan

This is a unique premium healthcare solution created specifically for business owners and entrepreneurs

Family & Personal
Health Plan

This is a tailored to suit specific health needs of individuals and families with benefits structured to ensure your Wellness all year round

Senior Citizen
Plan

This plan provide quality health care for the peculiar health needs of our loved ones from the age of 60 to 85 through our nationwide hospital network.

Oga Protect Plan

From

1,200,000

Yearly

Get Eyecare (lenses, glasses and frames covered) up to₦15,000

Treatment of Everyday illnesses

Free 24-hour online chat with Doctor

Access to Antenantal and Maternity care*

Access to 111 hospitals.

Dental care*

Consultation with Specialist (e.g. Paediatrician, Obsterician, Gynaecologist, Urologist etc)*

...More

[pff-paystack id="1998"]

Benefit Breakdown

DETAILED BENEFITS

SCOPE

Emergency Care & Stabilization: Ambulance transport, Emergency room stabilization

Covered

Intensive Care Services

Covered

General Consultation :Periodic health evaluation, Diagnostic,

Covered

X-rays

Covered

Specialist Consultation: Cardiologist, O& G, Paediatrician, Urology, Dermatology, Endocrinology, Neurology, Nero-surgeon, Ent, Oncologist, Cardiothoracic, Orthopaedic

Covered

Supply of Drugs

Covered

Child Care and Immunisation : BCG, Measles, DPT, OPV, HBV, Yellow Fever, Measles ,NPI+Extended

Covered

Ward Admissions :30 days P/A, including drug, test/diagnostics, Services of a dietician

Covered

Gynaecological Care

Covered

Maternity Care: Pre-natal care, Normal Delivery, Assisted, Caesarean, Post natal, Termination of pregnancy for life endangering condition, Neonatal Services

Covered

Ophthalmic Services: Surgical Services, Non-Surgical, Optical (Limit Apply)

Covered

Dental Care: Consultation and treatment

Covered

General Surgery (Caesarean Section inclusive)

Covered

Voluntary Annual Medical Check-up : Physical Examination, Organs screening, Mammogram, Lipid profile, ECG, X- CT Scan (Principal Only)

Covered

HIV Care: Preventive, Counselling and provision of ARV’s at designated centres only

N40,000

Behavioural Services: Assessment and treatment (8 OPD consults per annum)

Covered

Physiotherapy Services

Covered

Infertility Management: Testing and Diagnosis, IVF ( T & C Apply)

Covered

Dialysis Centre: Treatment of Renal Failure & Dialysis (Subject to Limit)

Private

Health Club: Subsidized Use of Gym & SPA

Covered

Personal Health Equipment (Principal Only)

Covered

Critical Illness

Covered

Travel Insurance (Principal Only)

Covered

Permanent Disability Benefit

Death Benefit (Principal Only)

N165,000

Burial Expenses Benefit (Principal Only)

N650,000

International Treatment: Only for Treatment of condition that is above local capacity

Scope : Principal, Spouse, 6 Dependants

BUY PLAN

Annual Premium

N1,200,000

BENEFITS:

1. Emergency Medical Services

a. Ambulance transport:

Covered

i. Roadside to hospital

Covered

ii. Hospital to hospital

Covered

b. Emergency room stabilization

Covered

2. Intensive care (subject to the limits of N500,000

Covered

3. Physician Services

a. General outpatient/inpatient consultation

Covered

b. Specialist outpatient/inpatient consultation

Covered

c. Routine or periodic health evaluation

Covered

d. Well-baby care

Covered

e. Well-child care

Covered

f. Diagnostic X-rays

i. Upper Limb

1. Hand/Wrist

Covered

2. Forearm (Radius/Ulna)

Covered

3. Elbow

Covered

4. Humerus

Covered

5. Shoulder

Covered

6. Clavicle

Covered

ii. Lower Limb

1. Foot/Toe

Covered

2. Ankle

Covered

3. Leg (Tibia/Fibula)

Covered

4. Knee

Covered

5. Femur or Thigh

Covered

6. Hip (Single)

Covered

7. Pelvis (AP)

Covered

8. Pelvis & Hip

Covered

iii. Thorax

1. Chest (PA/AP)

Covered

2. Chest (PA/Lateral)

Covered

3. Chest (Oblique)

Covered

4. Apical/Lordotic

Covered

5. Sternum

Covered

6. Thoracic Inlet

Covered

iv. Vertebral Spine

1. Cervical Spine

Covered

2. Lateral Neck (Soft Tissue)

Covered

3. Thoracic Spine

Covered

4. Thoracic-lumbar Spine

Covered

5. Lumbosacral Spine

Covered

v. Abdomen

1. Abdomen (Plain)

Covered

2. Abdomen (Erect/Supine)

Covered

g. Diagnostic Laboratory Tests

i. Haematology

1. ESR

Covered

2. Full Blood Count (FBC)

Covered

3. Haemoglobin

Covered

4. Malaria

Covered

5. PCV

Covered

6. RBC

Covered

7. Reticulocyte count

Covered

8. WBC

Covered

9. Platelets

Covered

10. Prothrombin time

Covered

11. Microfilaria

Covered

12. Bleeding Time

Covered

13. Clotting time

Covered

ii. Serology

1. ASO Titer

Covered

2. Coombs test

Covered

3. Heaf test

Covered

4. Other Hepatitis Strains

Covered

5. Pregnancy (blood)

Covered

6. Pregnancy (urine)

Covered

7. Rheumatoid factor

Covered

8. VDRL

Covered

iii. Blood Chemistry


1. Glucose

Covered

2. Calcium

Covered

3. Phosphorus

Covered

4. Urea

Covered

5. Creatinine

Covered

6. Uric acid

Covered

7. Albumin

Covered

8. Cholesterol

Covered

9. Triglyceride

Coveredv

10. HDL

Covered

11. LDL

Covered

12. SGOT

Covered

13. SGPT

Covered

14. Alkaline Phosphate

Covered

15. Bilirubin

Covered

16. Sodium

Covered

17. Potassium

Covered

18. Bicarbonate

Covered

19. Chloride

Covered

iv. Urine Chemistry

1. Creatinine Clearance

Covered

v. Microbiology

1. Stool Microscopy

Covered

2. Stool Occult Blood

Covered

3. Sputum ZN stain

Covered

4. Urine Microscopy, Culture & Sensitivity

Covered

5. Stool Microscopy, Culture & Sensitivity

Covered

6. Swab Microscopy, Culture & Sensitivity

Covered

7. Sputum Microscopy, Culture & Sensitivity

Covered

4. SPECIALIST CONSULTATION:

8 Visits

a. Common Specialist


1. Cardiologist/Physician

Covered

2. O & G

Covered

3. Paediatrician

Covered

b. Rare Specialist


1. Urology

Covered

2. Dermatology

Covered

3. Endocrinology

Covered

4. Neurology

Covered

5. Nero-Surgeon

Covered

6. ENT

Covered

7. Oncologist

Covered

8. Cardiothoracic

Covered

9. Orthopaedic

Covered

5. Rehabilitation Services (Outpatient Short Term Therapy)

a. Physical

12 Sessions

6A. Immunization for ages 0-5 (NPI for all plans)

i. BCG

Covered

ii. Measles

Covered

iii. DPT

Covered

iv. Oral Polio(OPV)

Covered

v. HBV

Covered

vi. Yellow fever

Covered

vii. Measles

Covered

Immunization (NPI + Extended for exclusive plan only )


viii. Meningococcal meningitis

Covered

ix. Typhoid

Covered

x. Pneumococcal (pneumovax)

Covered

xi. Rotavirus

Covered

xii. HIB

Covered

xiii. Chicken Pox

Covered

xiii Well Child Evacuation/Child Health Supervision Services

Covered

6B. Maternity Care

a. Pre-natal care

Covered

b. Normal delivery

Covered

c. Assisted delivery

Covered

d. Caesarean Section

Covered

e. Postnatal care

Covered

f. Puerperal infection

Covered

g. Physician-prescribed bed rest during pregnancy

Covered

h. Preeclampsia during the prenatal period

Covered

i. Termination of pregnancy for life-endangering conditions

Covered

j. Room and board, special diets, the services of a dietician, and skilled nursing in connection with childbirth for the mother or new-born child a vaginal delivery or a caesarean section delivery

Covered

7. Neonatal Services

Limit on incubator & phototherapy care:

N200,000

a. Incubator care:

Covered

i. Term delivery

Covered

ii. Preterm delivery

Covered

b. Phototherapy

Covered

c. Exchange blood transfusion

Covered

8. Ophthalmic Services

a. Ophthalmology:

Surgical Services(Limit)

N100,000

i. Pterygium excision

Covered

ii. Stye incision/drainage

Covered

iii. Chalazion incision/drainage

Covered

iv. Pterygium excision

Covered

v. Trabeculectomy

Covered

vi. Cataract surgery

Covered

Non-Surgical Services

vii. Consultation

Covered

viii. Follow-up

Covered

ix. Foreign body removal

Covered

x. Refraction

Covered

xi. CVF/ Glaucoma screening and treatment

Covered

xii. Intra-Ocular Pressure

Covered

xiii. Dilated fundoscopy

Covered

xiv. Diabetic & hypertensive retinopathy

Covered

b. Optical (principal only):

i. Primary care

Covered

ii. Provision of lenses viz.: unifocal, bifocal, varifocal,

contact

Covered

iii. Provision of optical frames

N25,000

Please note that unless otherwise mutually agreed by parties, these benefits shall not be transferred to spouse or dependants.

9. Dental Care

a. Simple extraction

Covered

b. Surgical extraction

Covered

c. Amalgam filling

Covered

d. Composite filling

Covered

e. Scaling & polishing (Therapeutic) (Preventive:1 per 6 months)

Covered

f. Pain therapy

Covered

g. Root Canal Therapy

Covered

Dental financial limits

Individual

=N35,000

Family = N70,000

10. Ear, Nose and Throat Care:

Primary ENT

i. Consultation

Covered

Secondary ENT

i. Foreign Body Removal

Covered

ii. Otitis

Covered

iii. Ear Syringing

Covered

11. SURGERY (Limits)

N400,000

Minor surgeries:


Surgical drainage of breast abscesses

Covered

Surgical drainage of galactocele

Covered

Sub-periosteal drainage for acute osteomyelitis

Covered

Drainage for septic arthritis

Covered

Intercostal drainage insertion

Covered

Aspiration of joints

Covered

Debridement of wounds

Covered

Surgical repair of simple wounds

Covered

Biopsy of breast lump

Covered

Tracheostomy

Covered

Thoracotomy

Covered

Drainage of paronychia

Covered

Proctoscopy

Covered

Evacuation of impacted feces

Covered

Closed reduction of fractures

Covered

Exostectomy

Covered

Chondromectomy

Covered

Ganglionectomy

Covered

Temporary diversion of urine

Covered

Circumcision

Covered

Electro fulguration of condylomataacuminata

Covered

Injection sclerotherapy of varicose veins

Covered

Incision of Accessory sinuses, mouth, salivary glands, or ducts

Covered

The reduction or manipulation of fractures of facial bones

Covered

Intermediate Surgeries:(Limit)

Tonsillectomy for children (less than 12yrs)

Covered

Vasectomy

Covered

Excision of tumor on abdominal wall

Covered

Excision-biopsy of breast mass

Covered

Biopsy of tumor on abdominal wall

Covered

Biopsy of bone tumor

Covered

Inguinal herniorraphy

Covered

Femoral herniorraphy

Covered

Excision of lesions, cysts, tumors of the mandible, mouth, lip, or tongue

Covered

Ventral herniorraphy

Covered

Appendectomy

Covered

Major Surgeries:(Limit)

Caesarean section delivery

Covered

Biopsy of thyroid gland

Covered

Oophorectomy

Covered

Surgical drainage of hematoma of rectus abdominus

Covered

Surgical drainage of peritoneal abscess

Covered

Laparotomy

Covered

Laparotomy and biopsy of disease viscera in abdominal cavity

Covered

Repair of colostomy

Covered

Anal sphincteroplasty

Covered

Excision-Ligation Hemorrhoidectomy

Covered

Milligan’s procedure

Covered

Surgical drainage of anal abscess

Covered

Polypectomy

Covered

Sequesrectomy

Covered

Saucerization of chronically infected bone

Covered

Surgical excision of soft tissue tumor

Covered

Excision-biopsy of soft tissue tumors

Covered

Surgical drainage of hand abscess

Covered

Orchidopexy

Covered

Hydroceleoctomy

Covered

Excision of Intrascrotal mass

Covered

Surgery for torsion of spermatic cord

Covered

Varicocelectomy

Covered

Sigmoidoscopy

Covered

Theirsch’s procedure

Covered

Lord’s procedure

Covered

Epigasticherniorraphy

Covered

Dissection of femoral triangle

Covered

Dissection of inguinal nodes

Covered

Venoplasty

Covered

Division of perforating veins

Covered

Prostatectomy

Covered

Myomectomy

Covered

Hysterectomy

Covered

Thyroidectomy

Covered

Surgical Services and related Diagnostic Services for the treatment of Temporomandibular Joint Dysfunction (TMJ) or other deformities of the jaw, including orthognathic surgery, osteotomy, or any surgical repositioning of portions of the upper or lower jaws or the bodily repositioning of entire jaws

Covered

12. Health Maintenance and preventive services

a. Annual comprehensive Medical Examination

i. Physical Examination

Covered

ii. Full blood count

Covered

iii. Urinalysis

Covered

iv. Blood sugar test

Covered

v. Chest X-ray

Covered

vi. Cervical Screening

Covered

vii. Prostate Screening (age 40 and above)

Covered

viii. Mammogram (age 35 and above) OR breast scan (age 30 and above)

Covered

ix. Lipid profile

Covered

x. ECG

Covered

b. Annual Basic Medical Examination (All plans)

i. Physical Examination

Covered

ii. Full blood count

Covered

iii. Urinalysis

Covered

iv. Blood sugar test

Covered

v. Chest X-ray

Covered

13. HIV Prevention & Counselling

Covered

1. Preventive and Counselling

Provision of ARV’s at designated centres only

14. Hospital Inpatient Services

Ward Eligibility: (30 days per year)

Private

a. Special diets

Covered

b. Services of a dietician

Covered

c. Skilled nursing

Covered

d. Use of operating, delivery, cast, and treatment rooms and equipment

Covered

e. Prescribed drugs administered while the Enrolees is an Inpatient.

Covered

f. Medical and surgical dressings, supplies, casts, and splints that have been ordered by a Physician for Covered Services

Covered

g. Oxygen and administration of oxygen

Covered

h. Basic imaging (including X-rays)

Covered

i. Basic Serologic Investigations

Covered

· Full blood count

· Erythrocyte sedimentation rate

· Urinalysis

· Widal

· Malaria parasite

· Fasting blood sugar

· Blood grouping

· Genotype

· HIV test

· Hepatitis B serum antigen test

j. Intermediate Imaging Investigations – CT Scan, ECG, Breast scan

Covered

. Intermediate Serologic Tests

Covered

· Hormone profiling

· Hepatitis panel

· E/U/Cr

· Lipid profile

· H-Pylori test

· PSA

· Liver Function Tests

· Sputum tests

· Other general blood tests

· Swab MCS

k. Advanced Investigations:

· MRI

Covered

· Echocardiogram

Covered

· Mammogram

Covered

15. Behavioural Health Services

a. valuation and treatment of conditions, which are responsive to Time Limited Treatment.

Covered

b. Severe Mental Illness i.e. any of the following:

Covered

i. Schizophrenia

Covered

ii. Bipolar disorder (manic-depressive illness)

Covered

iii. Major depressive disorder

Covered

iv. Panic disorder

Covered

v. Obsessive-compulsive disorder

Covered

vi. Schizoaffective disorder

Covered

c. Individual Psychotherapy

Covered

d. Group Psychotherapy

Covered

e. Psychological Testing

Covered

f. Family Counselling – Counselling with family members to aid diagnosis and treatment

Covered

g. Outpatient Psychiatric Care Services( 8 OPD Consult)

Covered

16. Infertility Services (Testing and Diagnosis Only)

a. Consultation with a reproductive endocrinology/infertility specialist

Covered

b. Complete semen analysis

Covered

c. Hysterosalpingogram, as an initial test of tubal patency, unless contraindicated

Covered

d. Medically Necessary laboratory testing to determine cause of infertility

Covered

e. Hysteroscopy

Covered

f. Mid-luteal endometrial biopsy

Covered

g. In Vitro Fertilization (IVF)

Available ( T & C Apply)

17. Family Planning/Birth Control

a. Depo Provera (injection)

Covered

b. IUDs

Covered

c. Norplant insertion

Covered

d. Norplant removal

Covered

e. Oral contraceptives

Covered

18. Dialysis Hospital/Dialysis Centre

a. In-patient treatment of Acute renal disease subject to bed-day limits indicated in schedule of benefit above

3 Dialysis

b. Chronic renal disease (subject to limits per plan as stated above)

3 Dialysis

19. Patient Education

Patient education classes are covered for the following diagnoses:

Covered

a. Prenatal childbirth – for pregnant mothers

Covered

b. Diabetes

Covered

c. Asthma

Covered

20. Health Club: Subsidized Use of Gym & SPA

Covered

use of GYM (Limit: 100,000.00)

24 Sessions

use of SPA (50,000.00)

2 Per annum

21. Personal Health Equipment (Principal Only)

Covered

22. Critical Illness (N3,000,000.00)

Covered

23. Travel Insurance (Principal Only) (Limit: 2 Months)

worldwide

24. Permanent Disability Benefit: (Limit:N1,500,000.00)

Covered

25. Death Benefit (Principal Only) (Limit: N1,500,000.00)

Covered

26. Burial Expenses Benefit (Principal Only)(Limit: N 500,000.00)

Covered

27. International Treatment: Only for Treatment of condition that is above local capacity

Available ( T & C Apply)

Annual PREMIUM

1,200,000.00

Family & Personal Health Plan

From

32,500

Yearly

Emergency Care & stabilization

Pharmacy Benefit Scheme

Special Baby Care unit

Intensive Care Services

Routine Laboratory Investigations

Routine Immunization

General Outpatient Consult

Advanced Investigation

Infertility Management

Specialist Consultation

Gynecological Care

Primary Eye Care

Supply of Drugs

Maternity Care (family plan only)

...more

Benefit Breakdown

BENEFITS

GUARD

SHIELD

PREMIUM

EXCLUSIVE

Emergency Care and Stabilization

Covered

Covered

Covered

Covered

Intensive Care Services

Covered

Covered

Covered

Covered

General Out-Patient Consultation

Covered

Covered

Covered

Covered

Specialist Consultation

Covered

Covered

Covered

Covered

Supply of Drugs

Covered

Covered

Covered

Covered

Pharmacy Benefit Scheme

Covered

Covered

Covered

Covered

Routine Immunization (0-5years)

BCG

Measles DPT

Oral Polio(OPV)

HBV

Yellow fever

Covered

Covered

Covered

Covered

Additional Immunization

Meningococcal meningitis Typhoid

Pneumococcal Rotavirus

HIB

Chicken Pox

Not Covered

Not Covered

Covered

Covered

Routine Laboratory Investigations

Covered

Covered

Covered

Covered

Basic X-Rays

Covered

Covered

Covered

Covered

Advanced Investigation

CT Scan & ECG*

Covered

Covered

Covered

Covered

Maternity Care (FAMILY PLAN ONLY):Antenatal

Normal Delivery

Assisted Delivery

Post natal (6 weeks)

Cesarean Section

**not effective until after 12 months**

Covered

Covered

Covered

Covered

Primary Eye Care

Covered

Covered

Covered

Covered

Eye Surgery

Covered

Covered

Covered

Covered

Biennial Lens + Frame (Principal Only)

N10,000

N15,000

N25,000

N40,000

Primary Dental Care

Consultation

Scaling and Polishing

Pain Relief

Composite/Amalgam Filling

Covered

Covered

Covered

Covered

Secondary Dental Care

Surgical Extraction

Root Canal Therapy

Not Covered

Not Covered

Covered

Covered

General Surgery (applies per head)

**not effective until after 6months**

Covered

Covered

Covered

Covered

Ward Admission (including feeding)

Standard

Standard

Semi-Private

Private

Psychiatric Care (8 OPD consults per annum)

Covered

Covered

Covered

Covered

Physiotherapy Services (Up to approved limits)

Covered

Covered

Covered

Covered

Treatment of Renal Failure & Dialysis

Not Covered

Covered

Covered

Covered

Choice of Hospital

Guard Hospital

Shield Hospital

Premium Hospital

Exclusive Hospital

Mortuary Services (up to the limit of ₦50,000)

Covered

Covered

Covered

Covered

Individual Premium Per Year

N32,000

N45,000

N68,000

N165,000

Family Premium Per Year

N138,250

N191,250

N275,000

N650,000





BUY PLAN

Senior Citizen Plan​

From

250,000

Yearly

Outpatient consultation​

Accident an Emergency​

Intensive Care Unit​

Specialist Consultation​

In-patient Consultations​

Supply of drugs and Medications​

Basic X-rays and C. T. Scan​

Routine Laboratory Investigations​

Gynecology consultation​

Primary Eye Care​

Bi-ennial Eye lens​

Dental Care​

Dietary Consultation​

Ward Admission​

...More​

Benefit Breakdown

BENEFITGREENSPRINGZEST
Outpatient consultationCoveredCoveredCovered
1. Emergency Medical Services
a. Ambulance transport:CoveredCoveredCovered
i. Roadside to hospitalCoveredCoveredCovered
ii. Hospital to hospitalCoveredCoveredCovered
b. Emergency room stabilizationCoveredCoveredCovered
2. Intensive careCovered up to the limit of ₦75,000Covered up to the limit of ₦100,000Covered up to the limit of ₦150,000
3. Physician Services
a. General outpatient/inpatient consultationCoveredCoveredCovered
b. Specialist outpatient/inpatient consultationCoveredCoveredCovered
c. Diagnostic X- rays
i. Upper Limb
1. Hand/WristCoveredCoveredCovered
2. Forearm (Radius/Ulna)CoveredCoveredCovered
3. ElbowCoveredCoveredCovered
4. HumerusCoveredCoveredCovered
5. ShoulderCoveredCoveredCovered
6. ClavicleCoveredCoveredCovered
ii. Lower Limb
1. Foot/ToeCoveredCoveredCovered
2. AnkleCoveredCoveredCovered
3. Leg (Tibia/Fibula)CoveredCoveredCovered
4. KneeCoveredCoveredCovered
5. Femur or ThighCoveredCoveredCovered
6. Hip (Single)CoveredCoveredCovered
7. Pelvis (AP)CoveredCoveredCovered
8. Pelvis & HipCoveredCoveredCovered
iii. Thorax
1. Chest (PA/AP)CoveredCoveredCovered
2. Chest (PA/Lateral)CoveredCoveredCovered
3. Chest (Oblique)CoveredCoveredCovered
4. Apical/LordoticCoveredCoveredCovered
5. SternumCoveredCoveredCovered
6. Thoracic InletCoveredCoveredCovered
iv. Vertebral Spine
1. Cervical SpineCoveredCoveredCovered
2. Lateral Neck (Soft Tissue)CoveredCoveredCovered
3. Thoracic SpineCoveredCoveredCovered
4. Thoraco-lumbar SpineCoveredCoveredCovered
5. Lumboscaral SpineCoveredCoveredCovered
v. Abdomen
1. Abdomen (Plain)CoveredCoveredCovered
2. Abdomen (Erect/Supine)CoveredCoveredCovered
d. Diagnostic Laboratory Tests
i. Hematology
1. ESRCoveredCoveredCovered
2. Full Blood Count (FBC)CoveredCoveredCovered
3. HemoglobinCoveredCoveredCovered
4. MalariaCoveredCoveredCovered
5. PCVCoveredCoveredCovered
6. RBCCoveredCoveredCovered
7. Reticulocyte countCoveredCoveredCovered
8. WBCCoveredCoveredCovered
9. PlateletsCoveredCoveredCovered
10. Prothrombin timeCoveredCoveredCovered
11. MicrofilariaCoveredCoveredCovered
12. Bleeding TimeCoveredCoveredCovered
13. Clotting timeCoveredCoveredCovered
ii. Serology
1. ASO TiterCoveredCoveredCovered
2. Coombs testCoveredCoveredCovered
3. Heaf testCoveredCoveredCovered
4. Other Hepatitis StrainsCoveredCoveredCovered
5. Pregnancy (blood)CoveredCoveredCovered
6. Pregnancy (urine)CoveredCoveredCovered
7. Rheumatoid factorCoveredCoveredCovered
8. VDRLCoveredCoveredCovered
iii. Blood Chemistry
1. GlucoseCoveredCoveredCovered
2. CalciumCoveredCoveredCovered
3. PhosphorusCoveredCoveredCovered
4. UreaCoveredCoveredCovered
5. CreatinineCoveredCoveredCovered
6. Uric acidCoveredCoveredCovered
7. AlbuminCoveredCoveredCovered
8. CholesterolCoveredCoveredCovered
9. TriglycerideCoveredCoveredCovered
10. HDLCoveredCoveredCovered
11. LDLCoveredCoveredCovered
12. SGOTCoveredCoveredCovered
13. SGPTCoveredCoveredCovered
14. Alkaline PhosphateCoveredCoveredCovered
15. BilirubinCoveredCoveredCovered
16. SodiumCoveredCoveredCovered
17. PotassiumCoveredCoveredCovered
18. BicarbonateCoveredCoveredCovered
19. ChlorideCoveredCoveredCovered
iv. Urine Chemistry
1. Creatinine ClearanceCoveredCoveredCovered
v. Microbiology
1. Stool MicroscopyCoveredCoveredCovered
2. Stool Occult BloodCoveredCoveredCovered
3. Sputum ZN stainCoveredCoveredCovered
4. Urine Microscopy, Culture & SensitivityCoveredCoveredCovered
5. Stool Microscopy, Culture & SensitivityCoveredCoveredCovered
6. Swab Microscopy, Culture & SensitivityCoveredCoveredCovered
7. Sputum Microscopy, Culture & SensitivityCoveredCoveredCovered
4. SPECIALIST CONSULTATION:5 Visits5 Visits5 Visits
(A) Common Specialist
1.Cardiologist/PhysicianCoveredCoveredCovered
2. O & GCoveredCoveredCovered
(B) Rare Specialist
1.UrologyCoveredCoveredCovered
2.DematologyCoveredCoveredCovered
3.EndocrinologyCoveredCoveredCovered
4.NeorologyCoveredCoveredCovered
5.Neoro-SurgeonCoveredCoveredCovered
6.ENTCoveredCoveredCovered
7.OncologistCoveredCoveredCovered
8.CardiotorasicCoveredCoveredCovered
9.OrthopaedicCoveredCoveredCovered
5. Rehabilitation Services (Outpatient Short Term Therapy)
a. Physical7 sessions7 sessions7 sessions
6. Ophthalmic Services
a. Ophthalmology:₦25,000₦40,000₦60,000
i. Pterygium excisionCoveredCoveredCovered
ii. Stye incision/drainageCoveredCoveredCovered
iii. Chalazion incision/drainageCoveredCoveredCovered
iv. Pterygium excisionCoveredCoveredCovered
v. TrabeculectomyCoveredCoveredCovered
vi. Cataract surgeryCoveredCoveredCovered
vii. ConsultationCoveredCoveredCovered
viii. Follow-upCoveredCoveredCovered
ix. Foreign body removalCoveredCoveredCovered
x. RefractionCoveredCoveredCovered
xi. CVF/ Glaucoma screening and treatmentCoveredCoveredCovered
xii. Intra-Ocular PressureCoveredCoveredCovered
xiii. Dilated fundoscopyCoveredCoveredCovered
xiv. Diabetic & hypertensive retinopathyCoveredCoveredCovered
b. Optical
i. Primary careCoveredCoveredCovered
ii. Provision of lenses viz.: unifocal, bifocal, varifocal, contact.CoveredCoveredCovered
iii. Provision of optical frames₦ 20,000₦ 25,000₦ 30,000
Please note that unless otherwise mutually agreed by parties, this benefits shall not be transferred to spouse or dependants
7. Dental Care
Benefit Covered:
a. Simple extractionCoveredCoveredCovered
b. Surgical extractionCoveredCoveredCovered
c. Amalgam fillingCoveredCoveredCovered
d. Composite fillingCoveredCoveredCovered
e. Scaling & polishing (Therapeutic) (Preventive:1 per 6 months)CoveredCoveredCovered
f. Pain therapyCoveredCoveredCovered
Dental financial limits₦ 20,000₦ 30,000₦ 40,000
8. Ear, Nose and Throat Care:
Primary ENT
i. ConsultationCoveredCoveredCovered
Secondary ENT
i. Foreign Body RemovalCoveredCoveredCovered
ii. OtitisCoveredCoveredCovered
iii. Ear SyringingCoveredCoveredCovered
9. SURGERY (Limits)₦ 100,000₦ 150,000₦ 200,000
Surgical drainage of breast abscessesCoveredCoveredCovered
Surgical drainage of galactoceleCoveredCoveredCovered
Sub-periosteal drainage for acute osteomyelitisCoveredCoveredCovered
Drainage for septic arthritisCoveredCoveredCovered
Intercostal drainage insertionCoveredCoveredCovered
Aspiration of jointsCoveredCoveredCovered
Debridement of woundsCoveredCoveredCovered
Surgical repair of simple woundsCoveredCoveredCovered
Biopsy of breast lumpCoveredCoveredCovered
TracheostomyCoveredCoveredCovered
ThoracotomyCoveredCoveredCovered
Drainage of paronychiaCoveredCoveredCovered
ProctoscopyCoveredCoveredCovered
Evacuation of impacted fecesCoveredCoveredCovered
Closed reduction of fracturesCoveredCoveredCovered
Closed reduction and immobilization of joint dislocationsCoveredCoveredCovered
ExostectomyCoveredCoveredCovered
ChondromectomyCoveredCoveredCovered
GanglionectomyCoveredCoveredCovered
Temporary diversion of urineCoveredCoveredCovered
Biopsy of thyroid glandCoveredCoveredCovered
OophorectomyCoveredCoveredCovered
Surgical drainage of hematoma of rectus abdominusCoveredCoveredCovered
Surgical drainage of peritoneal abscessCoveredCoveredCovered
LaparotomyCoveredCoveredCovered
Laparotomy and biopsy of disease viscera in abdominal cavityCoveredCoveredCovered
Repair of colostomyCoveredCoveredCovered
Anal sphincteroplastyCoveredCoveredCovered
Excision-Ligation HemorrhoidectomyCoveredCoveredCovered
Milligan’s procedureCoveredCoveredCovered
Surgical drainage of anal abscessCoveredCoveredCovered
PolypectomyCoveredCoveredCovered
SequesrectomyCoveredCoveredCovered
Saucerization of chronically infected boneCoveredCoveredCovered
Surgical excision of soft tissue tumorCoveredCoveredCovered
Excision-biopsy of soft tissue tumorsCoveredCoveredCovered
Surgical drainage of hand abscessCoveredCoveredCovered
OrchidopexyCoveredCoveredCovered
HydroceleoctomyCoveredCoveredCovered
Excision of Intrascrotal massCoveredCoveredCovered
Surgery for torsion of spermatic cordCoveredCoveredCovered
VaricocelectomyCoveredCoveredCovered
SigmoidoscopyCoveredCoveredCovered
Theirsch’s procedureCoveredCoveredCovered
Lord’s procedureCoveredCoveredCovered
EpigasticherniorraphyCoveredCoveredCovered
Dissection of femoral triangleCoveredCoveredCovered
Dissection of inguinal nodesCoveredCoveredCovered
VenoplastyCoveredCoveredCovered
Division of perforating veinsCoveredCoveredCovered
ProstatectomyCoveredCoveredCovered
MyomectomyCoveredCoveredCovered
HysterectomyCoveredCoveredCovered
ThyroidectomyCoveredCoveredCovered
Surgical Services and related Diagnostic Services for the treatment of Temporomandibular Joint Dysfunction (TMJ) or other deformities of the jaw, including orthognathic surgery, osteotomy, or any surgical repositioning of portions of the upper or lower jaws or the bodily repositioning of entire jawsCoveredCoveredCovered
10. Health Maintenance and preventive services
a. Annual Basic Medical Examination (All plans – accessible when plan has not been used in a year).
i. Physical ExaminationCoveredCoveredCovered
ii. Full blood countCoveredCoveredCovered
iii. UrinalysisCoveredCoveredCovered
iv. Blood sugar testCoveredCoveredCovered
v. Chest X-rayCoveredCoveredCovered
11. Hospital Inpatient Services For Covered Services
Ward Eligibility: (20 days per year)Standard wardStandard wardStandard ward
a. Special dietsCoveredCoveredCovered
b. Services of a dieticianCoveredCoveredCovered
c. Skilled nursingCoveredCoveredCovered
d. Use of operating, delivery, cast, and treatment rooms and equipmentCoveredCoveredCovered
e. Prescribed drugs administered while the Enrollee is an Inpatient.CoveredCoveredCovered
f. Medical and surgical dressings, supplies, casts, and splints that have been ordered by a Physician for Covered ServicesCoveredCoveredCovered
g. Oxygen and administration of oxygenCoveredCoveredCovered
12. Patient Education
a. Patient education classes are covered for all conditions.CoveredCoveredCovered
Class of HospitalBAND CBAND BBAND A
Premium per Head₦250,000₦400,000₦650,000
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