Family Health Plans

GORAH FAMILY PLAN FAMILY BASIC FAMILY LIFE FAMILY PREMIUM FAMILY BEST
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Premium Individual per year

45,000

75,000

145,000

280,000

Premium Family per year

180,000

285,000

570,000

980,000

         
OUTPATIENT SERVICES        
Out-Patient Limit

80,000

100,000

120,000

150,000

Out Patient Care, General Consultation                                                                
Specialist Consultation 2 sessions 3 sessons 4 sessions 5 sessions
Laboratory & Diagnostic Tests                                                                
X-Rays                                                                
Prescribed Medicines And Drugs                                                                
Management of Chronic Ailment                Eligible After 6 month Eligible After 6 month Eligible After 6 month
Out-Patient Emergency                                                                
Advanced & Complex Investigations (incl. CT Scan, MRI Scan) Emergency Emergency Emergency Emergency
         
IN-PATIENT SERVICES        
In-Patient Limit

100,000

120,000

150,000

200,000

X-Rays, Laboratory & Diagnostic Tests                                                                
Prescribed Medicines And Drugs                                                                
Intensive Care Services                               48 Hours 72 Hours
In- Patient Admission days 15 days /annum 20 days /annum 30 days/annum 30 days/annum
In-Patient Admissions General Ward General Ward Semi-Private ward Private-Ward
In-Patient services (including feeding)                                                                
Physiotherapy Sessions 5 Sessions 5 Sessions 10 Sessions 10 Sessions
Physiotherapy Sessions (Up to approved limits)                                                                
In-Patient Emergency                                                                 
Advanced & Complex Investigations (incl. CT Scan, MRI Scan) Emergency Emergency Emergency Emergency
         
MOTHER AND CHILD SERVICES (APPLY AFTER 12 MONTHS)        
Antenatal Services and Delivery Limit up to       50,000 Limit up to     80,000 Limit up to     100,000 Limit up to       150,000
Post Natal Care up to 6 weeks                                                            
Neonatal Care @Birth                                                                 
Neonatal ICU, Special baby care Unit                         12 hours 24 hours
Family Planning (Counselling,IUCDS, injectables,Implant, and OCP)                                 Plus Implant Plus Implant
Well baby Check                                                                 
         
SURGICAL SERVICES (APPLY AFTER 6 MONTHS)        
Minor, Intermediate, Major Surgeries And Procedures Limit up to     120,000 Limit up to     250,000 Limit up to     350,000 Limit up to     1,000,000
         
DENTAL CARE        
Primary & Secondary Dental Care Covered up to ₦5,000.00 Covered up to ₦10,000.00 Covered up to ₦15,000.00 Covered up to ₦20,000.00
Scaling and Polishing                                                                
Composite /Amalgam Filling                                                               
Non-surgical tooth Extraction                                                                
Pain Relief                                                                 
Dental Emergency                                                                
         
OPTICAL CARE        
Simple Optical Care Limit up to      5,000 Limit up to     10,000 Limit up to     15,000 Limit up to     20,000
Eye testing& Eye Care (Biennial Optical Lenses)(After 6 months) Up to ₦5000.00 Up to ₦7,000.00 Up to ₦10,000.00 Up to ₦15,000.00
Major Eye Surgeries (Subject to surgical limit)                                                                 
         
IMMUNIZATIONS        
Routine Immunization (NPI) for 0 – 5yrs  – DPT, Hepatitis B, HiB (Pentavalent), BCG, Measles, Oral Polio, Vitamin A supplementation& yellow fever (Health Center only)                                                                 
Additional Immunizations -Hepatitis B, HiB, Pneumococcal, Yellow Fever and Meningitis for Adults                                                        
         
EAR,NOSE AND THROAT SERVICES        
ENT Limit            

7,000

10,000

15,000

Treatment of ENT diseases and removal of foreign bodies                                                                
ENT Surgeries ( Subject to surgical limit)                                                                   
         
OTHER BENEFITS        
Accidents & Emergencies                                                        
Evacuation (Home/Hospital to Hospital & Road Side to Hospital)                                                        
Fertility Services (Investigation Only)             BASIC BASIC BASIC
Annual Wellness Check  at Designated Centres (After 9 months) BASIC BASIC BASIC BASIC
HIV/AIDS – to the Extent of Diagnosis + Treatment at Free Specialist Centres                                                        
Outpatient Psychiatry cover up to 4 weeks