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FAMILY HEALTHCARE PLAN

We are well structured to provide managed healthcare for you and your family members.

Irrespective of your socio-economic status and demographics.

This plan allows you and your family to enjoy a variety of

health benefit packages from Standard to Gold plus categories

COVERED SERVICES STANDARD CLASSIC SILVER GOLD GOLD PLUS
MEDICAL EMMERGENCY SERVICES: Acute Heart Failure, Shock ✔ 24 hrs✔ 24 hrs ✔ 24 hrs✔ 48 hrs✔ 72 hrs
OUT PATIENT SERVICES General Consultation Only General + Specialist Consultation General + Specialist Consultation General + Specialist Consultation General + Specialist Consultation
Out-patient care for 6 weeks
INPATIENT MEDICAL SERVICES
ALLERGIES
MEASLES
CHICKEN POX
PARASITIC AND ALLERGIC SKIN CONDITIONS
Scabies, Tinea Infection, Acne, Eczema, Seborrheic, Dermatitis
URINARY TRACT INFECTION
Uncomplicated & Complicated Urinary Tract Infection
PEPTIC ULCER DISEASE
Acute Axacerbation of Peptic Ulcer Disease, GERD
Indigestion
UPPER & LOWER RESPIRATORY TRACT INFECTION
Pneumonia, Bronchitis, Influenza, Viral Croup, Bronchiolitis, Tonsilitis
ASTHMA
CORYZA
DIARRHEA DISEASES
CADIO-VASCULAR CONDITIONS
Hypertension, Myocardial Infarction, Cerebrovascular Accident (stroke),
Cardiomyopathies, Chronic Heart Failure
BLOOD TRANSFUSION
HIV/AIDS-Investigation for confirmation
Treatment of opportunistic infections
INVESTIGATIONS
PVC, MP, WIDAL, FBC+DIFF, PREGNANCY TEST
ESR, RBS/FBS, URINALYSIS, M/C/S
E/U/CR, BLOOD GROUP AND GENOTYPE, HBSAg.
HBV/HCV, H, PYLORI
COOMB's TEST, BLOOD CULTURE, PERIPHERAL
BLOOD FILM, CLOTTING PROFILE, BLEEDING TIME, INR
D-TIMER, FECAL OCCULT BLOOD, FERRITIN LEVELSM HbA1c
LFT, KFT
MATERNITY AND CHILD SERVICES
Confirmation of Pregnancy
Antenatal Care (from 12 weeks)
Management of Labour & Delivery
Surgical Intervention
Post-Natal Care
Febrile Convulsions
Routine immunization Services
Additional Immunization under 5yrs
ICU/SCBU (1st 24hrs and monetary limit 50,000) Limit: 70,000Limit: 100,000
SURGICAL SERVICES
Minor Procedures
Intermidiate Procedures
Major Procedures
Kindly note that monetary limits apply. Surgical Limit = 50,000 for individual & 150,000 for family plans Surgical Limit = 140,000 for individual & 350,000 for family plans Surgical Limit = 220,000 for individual & 700,000 for family plans Surgical Limit = 440,000 for individual & 1,000,000 for family plans Surgical Limit = 550,000 for individual & (to be determined) for family plans
EYE SERVICES
Basic Eye Examination (only)
MANAGEMENT OF COMMON EYE AILMENTS
stye, Conjuctivities, Ocular Allergies, Keratitis
Optical Lens Limit (biennial) 10,00015,00025,000To be determined
Eye Surgeries (Minor & Intermidiate)
Major Eye Surgery
DENTAL CARE
TREATMENT OF MINOR AILMENTS
Gingivitis, Scurvy, Tooth pain
Routine pain management
Surgical Extraction
Amalgam Filling ✔ (2)✔ (4)✔ (6)✔ (8)
Scaling and Polishing ✔ (1)✔ (1)✔ (2)✔ (2)
Denture and Bridges ✔ (1)✔ (1)
Root Canal Therapy ✔ (1)✔ (2)✔ (4)
Surgical Extraction ✔ (2)✔ (4)✔ (6)✔ (8)
RADIOLOGICAL SERVICES
X-rays and Ultrasound
CT Scan & MRI (50%co-payment) 50%45%35%To be determined
Echocardiography 50%45%35%To be determined
Electrocardiography 50%45%35%To be determined
Doppler Scan 50%45%35%To be determined
PHYSIOTHERAPY 3 sessions5 sessions8 sessions10 sessions20 sessions
CANCER CARE
General Outpatient Consultation
Specialist Consultation
Cancer Screening only (PSA & Mammography) ✔ (1)✔ (2)✔ (4)
Surgical Treatment of Cancer (subject to global limit)
MEDICAL CHECKUP
Routine Physical
Annual Medical Examination (co-payments on investigations ✔ 50%✔ 45%✔ 35%✔ 15%
DRUG TYPES COVERED GenericGenericGenericBrandedBranded
ADDED BENEFITS
Renal dialysis (subject to policy limit) ✔ (2)✔ (6)✔ (8)
Infertility consultation, investigation & non-hormonal drug management
CHRONIC DISEASE MANAGEMENT
INTERNATIONAL HEALTH INSURANCE
GPA (Group Personal Accident)
TRAVEL INSURANCE
HIGH END HOSPITALS
GYM MEMBERSHIP
MENTAL HEALTH SERVICES
EXCLUSIONS: to be hilighted in the policy document