General Plan
A. OUT-PATEINT AND SPECIALIST CONSULTATIONS
- Registration
- Consultations with general practice doctors
- Consultations with specialists on referral by a general practitioner
- Non-specialist and specialist diagnosis of medical and surgical conditions
- Accident & emergency room services: The patient is stabilized in the event of life-threatening emergencies before definitive care.
- Supply of prescribed drugs and medications.
(i) Routine Immunizations (immunizations under National Program on Immunization)
All immunizations listed as follows are covered:
- BCG
- Measles,
- DPT
- Hepatitis B
- Oral Polio
- Yellow fever with vitamin A supplementation
(ii) Additional Immunizations
- HiB (Haemophilus Influenza B
MMR 9Measles, Mumps & Rubella) - Pneumococcal vaccine
(iii) Laboratory test: These will include:
- Malaria Parasite; Widal; Full Blood Count and Differentials; Urine Microscopy, Culture and Sensitivity
- Urinalysis; Stool Microscopy, Culture and Sensitivity; Blood Sugar; Electrolyte and Urea, Creatinine,
- Hepatitis Test, Liver Function Test Cholesterol and lipid profile, Prostatic Specific Antigen,
- Hormonal Assay, uric acid assay, Calcium and Phosphate assay, viral culture etc. 9As requested by the Doctor).
(iv) Cardiac Investigations
- Electrocardiography (ECG) – resting, exercise, pre & post exercise: for electrical monitoring of the Heart.
- Echocardiogram: Advanced sonogram investigation of the Heart.
(v) Other Diagnostic Investigations/Procedures
- Electroencephalography (EEG): EEG: Recording of the electrical activity of the brain.
- Endoscopy: Act of viewing the organs with a scope, e.g. Gastroduodenoscopy for Peptic Ulcer Disease, Anoscopy for Rectal Cancer, etc.
- Pap Smear (Screening test used to discover a pre-cancerous state of the female cervix in order to prevent cervical cancer), Barium Meal, Barium Enema etc. (As requested by the Doctor)
B. IN PATIENT CARE (FOR COVERED MEDICAL AND SURGICAL CONDITIONS ONLY)
- Admissions and accommodation
- Feeding for enrollees on admission
- Skilled nursing and medical services
- Supply of prescribed drugs, dressings, medical and surgical consumables
- Blood transfusion services.
C. RADIOLOGICAL, LABORATORY & DIAGNOSTIC SERVICES
These services will be carried out and offered based on the clinician’s judgment. Radiological Services include:
- Plain X-rays of all the parts of the body: Chest X-Rays, Plain Abdominal X-Rays, Limb, Neck, Skull, Back and Joint X-rays etc.
- Abdominal and pelvic ultrasound scans: Abdominal Ultrasound and Pelvic Scan etc.
D. ADVANCED & COMPLEX INVESTIGATIONS
Advanced radiological investigations in which there is a better illumination of the body organs and systems i.e., CT (Computed Tomography) Scan; MR/ (Magnetic Resonance Imaging).
E. PHYSIOTHERAPY AND PHYSICAL REHABILITATIONSERVICES
These will include: Consultation, Basic Physical Therapy including infra-red therapy, TENS stimulation.
F. MINOR SURGERIES & PROCEDURES
These include:
- Wound dressing
- Incision & drainage of abscess
- Suturing of minor cuts and lacerations
- Excision of simple Lipoma (Abnormal collection of fat)
- Excision of Ganglion, Excision Of Sebaceous Cyst
G. INTERMEDIATE SURGERIES & PROCEDURES These include:
- Minor Lumpectomy(Removal of a simple lump)
- Hyrocelectomy (Repair of hydrocele)
- Closed reduction and manipulation of simple fractures
- Ear, nose and throat procedures such as antral washout
- Orchidopexy(Surgical fixing of a “Torsioned Testes”)
- Orchidectomy (Removal of the testis)
H. MAJOR & COMPLEX SURGERIES AND PROCEDURES
- Advanced Lumpectomy (Advanced removal of the breast lump)
- Synovectomy(Surgical operation done on the Synovial cavity)
- Marsupialization (Surgical operation done to repair the female Bertholin’s cyst) etc.
- Laparatomy (Surgical operation done on the abdomen),
- Fixing of fractures(External and Internal Fixation)
- Salpingectomy (Surgical operation done on the female Fallopian tube) etc.
I. MAJOR & COMPLEX SURGERIES AND PROCEDURES
For enrollees requiring the following:
- Stroke management
- Pain management
- Management of Diabetic emergencies
- Intensive Care treatment and /CU care: Patient is placed on life
- support machines when necessary including artificial respiration
- Ventilator care
- Treatment of arrhythmias and cardiac emergencies
- Medical management of Myocardial infarction or Heart Attack
- Stabilization and maintenance treatment for chronic diseases
J. LOCAL EVACUATION
Ambulance transportation services will be available to evacuate enrollee:
- Between hospitals and hospitals
- Between road sides and hospitals
K. ANTENATAL & DELIVERY
- Antenatal services, examinations and supply of drugs
- Management of complications in pregnancy
- Delivery room services which include:
- Management of labor
- Normal & Assisted Delivery (vacuum delivery, forceps delivery etc.)
- Caesarean section delivery
- Post-natal check
L. NEONATAL SERVICES
Care required by a new born in the first month (1st 28 days) of life. This includes:
- Male circumcision
- Ear piercing
- Treatment of mild or moderate neonatal sepsis
- Phototherapy
M. DENTAL CARE
- Routine dental check
- Scaling and polishing (Annual)
- Simple Amalgam filing for dental caries
- Simple (non-surgical) extraction of teeth
O. DENTAL SURGICAL EXTRACTION
- Surgical extraction of impacted tooth or of tooth with curved mesial roots
P. SUPPORTIVE TREATMENT OF HIV/AIDS
- HIV screening
- Voluntary counselling and testing
- Treatment of opportunistic infections
Q. ANNUAL BASIC MEDICAL CHECK UP FOR SAPPHIRE ENROLLEE
- General Physical Examination
- Full Blood Count
- Chest X-ray
- Diabetes Screening
- Screening for High Blood Pressure
- Urine and Stool Tests.
R. ANNUAL COMPREHENSIVE SCREENINGS FOR EMERAID ENROLLEE
- General Physical Examination
- Full Blood Count
- Chest X-ray
- Diabetes Screening
- Screening for High Blood Pressure
- Urine and Stool Tests.
- ECG and Stress Test
- Dental and Eye Check up
- Mammogram for Women
- Pap Smear for Women
- Prostate (PSA) for Men.
SCOPE OF COVERAGE
Spouse and four (4) children. More dependents shall attract extra premium.
