# Plan Name Gold
# Hospital Category All
# Benefits
1 Out-Patient Services
2 General and Specialist Consultations Covered
3 Supply of Prescribed Drugs Covered
4 Chronic Ailments - Diagnosis Covered
5 Management of Chronic Conditions Covered (N80,000.00 per annum)
6 In-Patient Services
7 Admissions and Feeding General Ward
8 Supply of Prescribed Drugs Covered
9 Nursing Care and Consumables Covered
10 Neonatal and Pediatric Services
11 Primary immunisations(BCG, OPV, DPT, Measles, Yellow Fever, Vit. A, Pentavalent Vaccine, Hep. B, Pneumoccocal) Covered
12 Secondary Immunisations( Tetanus Toxoid, Anti-Rabies, Anti-Snake Venom, HIB, MMR, Rotavirus, Chicken Pox, Meningitis(CMS), Typhoid at designated centres. Covered for Texanus Toxoid and Anti-Snake Venom
13 Primary care including Circumcision, Ear Piercing, Exchange Blood Transfusion, Tongue Tie Release, Nebulisation Covered
14 Booster Dose for children 6 years and above (Meningitis, Yellow Fever & Hepatitis B) at designated centres. Covered
15 Special Baby Care including Incubator Care, Phototherapy 24 hours
16 Diagnostic Services
17 Routine Laboratory Services including Heamatology, Clinical Chemistry, Microbiology, Serology Covered
18 Basic Radiological Investigations icluding Ultrasound scan,Plain X-ray, Pelvimetry,Other routine radiological investigation Covered
19 Advanced Diagnostic Services including Endocrinology, Cytology & Histology. Not Covered
20 Advanced Investigations including ECG Covered (Once per annum)
21 CT-Scan, MRI, Echo & EEG Emergency only
22 Physiotherapy Services
23 Provision of Physiotherapeutic appliances e.g soft and hard cervical collar, Crutches Covered
24 Physiotherapy Sessions 5 Sessions
25 Psychiatric Services
26 Out-Patient Psychiatric Care, Acute Psychosis 12 Weeks
28 Primary & Secondary Dental care services Covered (limit of N15,000 per annum)
29 Optical/Opthalmology Services
30 Optometrist/Opthalmologist Consultation, Basic Eye Examination, Foreign Body Removal, Subconjuctival Infection & Medication Covered
31 Biennial Optical Lenses & Frames Covered (Limit of N10,000 )
32 Optical Surgeries As a part of Annual Surgical Limit
33 Obstetrics and Gynaecological Services
34 ANC/Normal Delivery/Assisted Delivery Covered
35 Reinbursement for Delivery Abroad SVD/CS Not covered
36 Postnatal Care -6 Weeks only Covered
37 Fertility Services (investigation only) Covered (Limit of N20,000 per annum)
38 Family Planning : Counselling, provision of commodities e.g. injectables, pills, IUCD (Copper T) Covered
39 ENT Services
40 Treatment and Removal of Foreign Bodies Covered
41 ENT Surgeries As a part of Annual Surgical Limit
43 Minor, Intermediate, Major Surgeries and Procedures. Covered (limit of N250,000 per annum)
44 Anaesthesia, Surgical Consumables, Oxygen, Administration of Blood Covered (limit of N250,000 per annum)
45 Reinbursement for Surgery/Procedure Abroad Not Covered
46 Accidents and Emergencies
47 Ambulance (Hospital-to-Hospital and Road side to Hospital)(For Immobile members Only) Covered
48 Emergency Stabilization and Resuscitation Management only Covered
49 Intensive Care Services / NICU 24 Hours
50 Other Services/Benefits
52 Renal Dialysis 1 sessions
53 CANCER Care - Cytotoxic Drugs, Chemotherapy, Radiotherapy, Surgery Covered (Limit of N200,000)
54 HIV/AIDS AND TB- Diagnosis & Treatment at Free Govt Centres Covered
55 Health Screening For Principal & Spouse (OHML Designated Centres) once p.a Physical Examination, BMI, PCV, Blood Pressure & Urinalysis
56 Spa / Wellness Not Covered
57 Health Equipment For Chronic Condition Not Covered
58 Second Opinion Service By Experts Covered
59 Network GYM Access Not Covered
60 Premium Per Individual per annum Naira 46,800
61 Premium Per Family per annum 234,000

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