A..IN-PATIENT (HOSPITALIZATION)
This caters for expenses where an insured person is confined to a hospital bed, for the purpose of closely monitored medical attention.
The scope of Cover is based on the following: –
- Daily bed charges – net of the amount recoverable under
- the National Hospital Insurance Fund, where applicable.
- Professional doctors’ fees.
- In-Hospital facilities and services.
- Theatre charges.
- Expenses for diagnostic examinations, such as X-rays,
- CT Scans and Laboratory tests.
- Consultants’/Specialists’ fees.
- Drugs & Medicines.
- Surgical appliances.
- Special Exclusions.
- Expenses arising from:-
- Maternity care, child birth, abnormal pregnancy, disorders of the reproductive system, infertility, abortion and miscarriage.
- Except the first ever operation for caesarean section in an insured person’s lifetime.
- Child care in the event of an operation for caesarean section.
- Family planning procedures.
- Cosmetic & Beauty treatment and/or surgery (unless necessitated by injury).
- Nature cure clinics, health hydro, sanitaria or custodial care.
- Procedures of experimental nature and not accepted or approved by the medical profession, such as acupuncture, chiropractic treatment, etc.
- Home nursing or hospital stay, arranged partly or wholly for domestic reasons
B. OUT-PATIENT COVER
This caters for expenses where an insured person receives medical treatment and/or services at a hospital, a doctor’s clinic, or at any other recognized health facility, without being confined to bed
The scope of Cover is based on the following: –
- Professional doctors’ fees.
- Charges for theatre/surgery.
- Expenses for diagnostic examinations, such as X-rays
- CT Scans and Laboratory tests.
- Consultants’/Specialists’ fees.
- Drugs & Medicines.
- Surgical appliances.
Special Exclusions.-Expenses arising from:-
- Maternity care, child birth, abnormal pregnancy, disorders of the reproductive system, infertility, abortion and miscarriage.
- Family planning procedures.
- Cosmetic & Beauty treatment and/or surgery (unless necessitated by injury).
- Nature cure clinics, health hydro, sanitarian or custodial care.
- Procedures of experimental nature and not accepted or approved by the medical profession, such as acupuncture, chiropractic treatment, etc.
Home nursing, arranged partly or wholly for domestic reasons.