Health Insurance Cover
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
| BENEFIT | GREEN | SPRING | ZEST |
|---|---|---|---|
| Outpatient consultation | Covered | Covered | Covered |
| 1. Emergency Medical Services | |||
| a. Ambulance transport: | Covered | Covered | Covered |
| i. Roadside to hospital | Covered | Covered | Covered |
| ii. Hospital to hospital | Covered | Covered | Covered |
| b. Emergency room stabilization | Covered | Covered | Covered |
| 2. Intensive care | Covered up to the limit of ₦75,000 | Covered up to the limit of ₦100,000 | Covered up to the limit of ₦150,000 |
| 3. Physician Services | |||
| a. General outpatient/inpatient consultation | Covered | Covered | Covered |
| b. Specialist outpatient/inpatient consultation | Covered | Covered | Covered |
| c. Diagnostic X- rays | |||
| i. Upper Limb | |||
| 1. Hand/Wrist | Covered | Covered | Covered |
| 2. Forearm (Radius/Ulna) | Covered | Covered | Covered |
| 3. Elbow | Covered | Covered | Covered |
| 4. Humerus | Covered | Covered | Covered |
| 5. Shoulder | Covered | Covered | Covered |
| 6. Clavicle | Covered | Covered | Covered |
| ii. Lower Limb | |||
| 1. Foot/Toe | Covered | Covered | Covered |
| 2. Ankle | Covered | Covered | Covered |
| 3. Leg (Tibia/Fibula) | Covered | Covered | Covered |
| 4. Knee | Covered | Covered | Covered |
| 5. Femur or Thigh | Covered | Covered | Covered |
| 6. Hip (Single) | Covered | Covered | Covered |
| 7. Pelvis (AP) | Covered | Covered | Covered |
| 8. Pelvis & Hip | Covered | Covered | Covered |
| iii. Thorax | |||
| 1. Chest (PA/AP) | Covered | Covered | Covered |
| 2. Chest (PA/Lateral) | Covered | Covered | Covered |
| 3. Chest (Oblique) | Covered | Covered | Covered |
| 4. Apical/Lordotic | Covered | Covered | Covered |
| 5. Sternum | Covered | Covered | Covered |
| 6. Thoracic Inlet | Covered | Covered | Covered |
| iv. Vertebral Spine | |||
| 1. Cervical Spine | Covered | Covered | Covered |
| 2. Lateral Neck (Soft Tissue) | Covered | Covered | Covered |
| 3. Thoracic Spine | Covered | Covered | Covered |
| 4. Thoraco-lumbar Spine | Covered | Covered | Covered |
| 5. Lumboscaral Spine | Covered | Covered | Covered |
| v. Abdomen | |||
| 1. Abdomen (Plain) | Covered | Covered | Covered |
| 2. Abdomen (Erect/Supine) | Covered | Covered | Covered |
| d. Diagnostic Laboratory Tests | |||
| i. Hematology | |||
| 1. ESR | Covered | Covered | Covered |
| 2. Full Blood Count (FBC) | Covered | Covered | Covered |
| 3. Hemoglobin | Covered | Covered | Covered |
| 4. Malaria | Covered | Covered | Covered |
| 5. PCV | Covered | Covered | Covered |
| 6. RBC | Covered | Covered | Covered |
| 7. Reticulocyte count | Covered | Covered | Covered |
| 8. WBC | Covered | Covered | Covered |
| 9. Platelets | Covered | Covered | Covered |
| 10. Prothrombin time | Covered | Covered | Covered |
| 11. Microfilaria | Covered | Covered | Covered |
| 12. Bleeding Time | Covered | Covered | Covered |
| 13. Clotting time | Covered | Covered | Covered |
| ii. Serology | |||
| 1. ASO Titer | Covered | Covered | Covered |
| 2. Coombs test | Covered | Covered | Covered |
| 3. Heaf test | Covered | Covered | Covered |
| 4. Other Hepatitis Strains | Covered | Covered | Covered |
| 5. Pregnancy (blood) | Covered | Covered | Covered |
| 6. Pregnancy (urine) | Covered | Covered | Covered |
| 7. Rheumatoid factor | Covered | Covered | Covered |
| 8. VDRL | Covered | Covered | Covered |
| iii. Blood Chemistry | |||
| 1. Glucose | Covered | Covered | Covered |
| 2. Calcium | Covered | Covered | Covered |
| 3. Phosphorus | Covered | Covered | Covered |
| 4. Urea | Covered | Covered | Covered |
| 5. Creatinine | Covered | Covered | Covered |
| 6. Uric acid | Covered | Covered | Covered |
| 7. Albumin | Covered | Covered | Covered |
| 8. Cholesterol | Covered | Covered | Covered |
| 9. Triglyceride | Covered | Covered | Covered |
| 10. HDL | Covered | Covered | Covered |
| 11. LDL | Covered | Covered | Covered |
| 12. SGOT | Covered | Covered | Covered |
| 13. SGPT | Covered | Covered | Covered |
| 14. Alkaline Phosphate | Covered | Covered | Covered |
| 15. Bilirubin | Covered | Covered | Covered |
| 16. Sodium | Covered | Covered | Covered |
| 17. Potassium | Covered | Covered | Covered |
| 18. Bicarbonate | Covered | Covered | Covered |
| 19. Chloride | Covered | Covered | Covered |
| iv. Urine Chemistry | |||
| 1. Creatinine Clearance | Covered | Covered | Covered |
| v. Microbiology | |||
| 1. Stool Microscopy | Covered | Covered | Covered |
| 2. Stool Occult Blood | Covered | Covered | Covered |
| 3. Sputum ZN stain | Covered | Covered | Covered |
| 4. Urine Microscopy, Culture & Sensitivity | Covered | Covered | Covered |
| 5. Stool Microscopy, Culture & Sensitivity | Covered | Covered | Covered |
| 6. Swab Microscopy, Culture & Sensitivity | Covered | Covered | Covered |
| 7. Sputum Microscopy, Culture & Sensitivity | Covered | Covered | Covered |
| 4. SPECIALIST CONSULTATION: | 5 Visits | 5 Visits | 5 Visits |
| (A) Common Specialist | |||
| 1.Cardiologist/Physician | Covered | Covered | Covered |
| 2. O & G | Covered | Covered | Covered |
| (B) Rare Specialist | |||
| 1.Urology | Covered | Covered | Covered |
| 2.Dematology | Covered | Covered | Covered |
| 3.Endocrinology | Covered | Covered | Covered |
| 4.Neorology | Covered | Covered | Covered |
| 5.Neoro-Surgeon | Covered | Covered | Covered |
| 6.ENT | Covered | Covered | Covered |
| 7.Oncologist | Covered | Covered | Covered |
| 8.Cardiotorasic | Covered | Covered | Covered |
| 9.Orthopaedic | Covered | Covered | Covered |
| 5. Rehabilitation Services (Outpatient Short Term Therapy) | |||
| a. Physical | 7 sessions | 7 sessions | 7 sessions |
| 6. Ophthalmic Services | |||
| a. Ophthalmology: | ₦25,000 | ₦40,000 | ₦60,000 |
| i. Pterygium excision | Covered | Covered | Covered |
| ii. Stye incision/drainage | Covered | Covered | Covered |
| iii. Chalazion incision/drainage | Covered | Covered | Covered |
| iv. Pterygium excision | Covered | Covered | Covered |
| v. Trabeculectomy | Covered | Covered | Covered |
| vi. Cataract surgery | Covered | Covered | Covered |
| vii. Consultation | Covered | Covered | Covered |
| viii. Follow-up | Covered | Covered | Covered |
| ix. Foreign body removal | Covered | Covered | Covered |
| x. Refraction | Covered | Covered | Covered |
| xi. CVF/ Glaucoma screening and treatment | Covered | Covered | Covered |
| xii. Intra-Ocular Pressure | Covered | Covered | Covered |
| xiii. Dilated fundoscopy | Covered | Covered | Covered |
| xiv. Diabetic & hypertensive retinopathy | Covered | Covered | Covered |
| b. Optical | |||
| i. Primary care | Covered | Covered | Covered |
| ii. Provision of lenses viz.: unifocal, bifocal, varifocal, contact. | Covered | Covered | Covered |
| 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 extraction | Covered | Covered | Covered |
| b. Surgical extraction | Covered | Covered | Covered |
| c. Amalgam filling | Covered | Covered | Covered |
| d. Composite filling | Covered | Covered | Covered |
| e. Scaling & polishing (Therapeutic) (Preventive:1 per 6 months) | Covered | Covered | Covered |
| f. Pain therapy | Covered | Covered | Covered |
| Dental financial limits | ₦ 20,000 | ₦ 30,000 | ₦ 40,000 |
| 8. Ear, Nose and Throat Care: | |||
| Primary ENT | |||
| i. Consultation | Covered | Covered | Covered |
| Secondary ENT | |||
| i. Foreign Body Removal | Covered | Covered | Covered |
| ii. Otitis | Covered | Covered | Covered |
| iii. Ear Syringing | Covered | Covered | Covered |
| 9. SURGERY (Limits) | ₦ 100,000 | ₦ 150,000 | ₦ 200,000 |
| Surgical drainage of breast abscesses | Covered | Covered | Covered |
| Surgical drainage of galactocele | Covered | Covered | Covered |
| Sub-periosteal drainage for acute osteomyelitis | Covered | Covered | Covered |
| Drainage for septic arthritis | Covered | Covered | Covered |
| Intercostal drainage insertion | Covered | Covered | Covered |
| Aspiration of joints | Covered | Covered | Covered |
| Debridement of wounds | Covered | Covered | Covered |
| Surgical repair of simple wounds | Covered | Covered | Covered |
| Biopsy of breast lump | Covered | Covered | Covered |
| Tracheostomy | Covered | Covered | Covered |
| Thoracotomy | Covered | Covered | Covered |
| Drainage of paronychia | Covered | Covered | Covered |
| Proctoscopy | Covered | Covered | Covered |
| Evacuation of impacted feces | Covered | Covered | Covered |
| Closed reduction of fractures | Covered | Covered | Covered |
| Closed reduction and immobilization of joint dislocations | Covered | Covered | Covered |
| Exostectomy | Covered | Covered | Covered |
| Chondromectomy | Covered | Covered | Covered |
| Ganglionectomy | Covered | Covered | Covered |
| Temporary diversion of urine | Covered | Covered | Covered |
| Biopsy of thyroid gland | Covered | Covered | Covered |
| Oophorectomy | Covered | Covered | Covered |
| Surgical drainage of hematoma of rectus abdominus | Covered | Covered | Covered |
| Surgical drainage of peritoneal abscess | Covered | Covered | Covered |
| Laparotomy | Covered | Covered | Covered |
| Laparotomy and biopsy of disease viscera in abdominal cavity | Covered | Covered | Covered |
| Repair of colostomy | Covered | Covered | Covered |
| Anal sphincteroplasty | Covered | Covered | Covered |
| Excision-Ligation Hemorrhoidectomy | Covered | Covered | Covered |
| Milligan’s procedure | Covered | Covered | Covered |
| Surgical drainage of anal abscess | Covered | Covered | Covered |
| Polypectomy | Covered | Covered | Covered |
| Sequesrectomy | Covered | Covered | Covered |
| Saucerization of chronically infected bone | Covered | Covered | Covered |
| Surgical excision of soft tissue tumor | Covered | Covered | Covered |
| Excision-biopsy of soft tissue tumors | Covered | Covered | Covered |
| Surgical drainage of hand abscess | Covered | Covered | Covered |
| Orchidopexy | Covered | Covered | Covered |
| Hydroceleoctomy | Covered | Covered | Covered |
| Excision of Intrascrotal mass | Covered | Covered | Covered |
| Surgery for torsion of spermatic cord | Covered | Covered | Covered |
| Varicocelectomy | Covered | Covered | Covered |
| Sigmoidoscopy | Covered | Covered | Covered |
| Theirsch’s procedure | Covered | Covered | Covered |
| Lord’s procedure | Covered | Covered | Covered |
| Epigasticherniorraphy | Covered | Covered | Covered |
| Dissection of femoral triangle | Covered | Covered | Covered |
| Dissection of inguinal nodes | Covered | Covered | Covered |
| Venoplasty | Covered | Covered | Covered |
| Division of perforating veins | Covered | Covered | Covered |
| Prostatectomy | Covered | Covered | Covered |
| Myomectomy | Covered | Covered | Covered |
| Hysterectomy | Covered | Covered | Covered |
| Thyroidectomy | Covered | Covered | 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 | Covered | Covered |
| 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 Examination | Covered | Covered | Covered |
| ii. Full blood count | Covered | Covered | Covered |
| iii. Urinalysis | Covered | Covered | Covered |
| iv. Blood sugar test | Covered | Covered | Covered |
| v. Chest X-ray | Covered | Covered | Covered |
| 11. Hospital Inpatient Services For Covered Services | |||
| Ward Eligibility: (20 days per year) | Standard ward | Standard ward | Standard ward |
| a. Special diets | Covered | Covered | Covered |
| b. Services of a dietician | Covered | Covered | Covered |
| c. Skilled nursing | Covered | Covered | Covered |
| d. Use of operating, delivery, cast, and treatment rooms and equipment | Covered | Covered | Covered |
| e. Prescribed drugs administered while the Enrollee is an Inpatient. | Covered | Covered | Covered |
| f. Medical and surgical dressings, supplies, casts, and splints that have been ordered by a Physician for Covered Services | Covered | Covered | Covered |
| g. Oxygen and administration of oxygen | Covered | Covered | Covered |
| 12. Patient Education | |||
| a. Patient education classes are covered for all conditions. | Covered | Covered | Covered |
| Class of Hospital | BAND C | BAND B | BAND A |
| Premium per Head | ₦250,000 | ₦400,000 | ₦650,000 |
Corporate
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Oga Protect
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Family & Personal
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