INDIVIDUAL HEALTHCARE PLAN
We offer affordable health insurance plans for individuals who
do not have access to employer/sponsored or government run coverage.
This plan is personalised for only you 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: 70,000 | Limit: 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) | ✖ | 10,000 | 15,000 | 25,000 | To 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 sessions | 5 sessions | 8 sessions | 10 sessions | 20 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 | Generic | Generic | Generic | Branded | Branded |
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 |