Managed Health Plans and Benefits
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Benefits
Basic Health plan
Standard plan
Standard Plus Plan
Advanced Standard plus plan
Comprehensive plan
Super Comprehensive plan
General consultation
Covered up to 3 visits per annum
Covered
Covered
Covered
Covered
Covered
Specialist consultation
Covered (Standard Ward of Cumulative of 15 days in a year)
Covered (Standard Ward – 30 days maximum/annum)
Covered (Semi-Private Room – 30 days /annum)
Covered (Semi-Private Room – 30 days /annum)
Covered (Private Room – 30 days /annum)
Covered (Private Room – 45 days /annum)
Admissions (Including feeding)
Covered (Standard Ward of Cumulative of 15 days in a year)
Covered (Standard Ward – 30 days maximum/annum)
Covered (Semi-Private Room – 30 days /annum)
Covered (Semi-Private Room – 30 days /annum)
Covered (Private Room – 30 days /annum)
Covered (Private Room – 45 days /annum)
Hospital Category
Providers listed under Basic Plan Types
Providers listed under Standard Plan Only
Providers listed under Standard and Standard Plus Plan Only
Providers listed under Standard Plus & Adv. Standard Plan OnlyProviders listed under Standard Plus & Adv. Standard Plan Only
Providers listed under Standard Plus Plan & Comprehensive Plan
Providers listed under Standard Plus Plan, Comprehensive & Super Comprehensive Plan
Accommodation for mothers whose dependants are on admission
Not covered
48 hours in the same ward as above
48 hours in the same ward as above
3 Days in the same ward as above
4 Days in the same ward as above
5 days in the same ward as above
Provision of prescribed Drugs )
Covered
Covered
Covered
Covered
Covered
Covered
Accident and Emergency care
Covered
Covered
Covered
Covered
Covered
Covered
Management of Chronic Diseases
Covered to limit of up to N70K medication
Covered
Covered
Covered
Covered
Covered
Blood transfusion
Covered (2 Pints maximum/annum)
Covered (4 Pints maximum/annum)
Covered (4 Pints maximum/annum)
Covered (4 Pints maximum/annum)
Covered (5 Pints maximum/annum)
Covered (6 Pints maximum/annum)
Basic X-rays
Covered
Covered
Covered
Covered
Covered
Covered
Comprehensive X-rays
Not Covered
Covered
Covered
Covered
Covered
Covered
Basic Laboratory Tests
Covered
Covered
Covered
Covered
Covered
Covered
Comprehensive Laboratory Tests
Not covered
Covered
Covered
Covered
Covered
Covered
Ultrasound Scan Services
Pelvic Scan only
Pelvic & Abdominal Scan only
ECG, EEG Covered (only on emergency/once per annum)
ECG, EEG Covered (only on emergency/once per annum)
ECG, EEG Covered (only on emergency/once per annum)
ECG, EEG Covered (only on emergency/once per annum)
ECG, EEG & EMG
Not Covered
ECG onlycovered once in a year
Covered (Semi-Private Room – 30 days /annum)
Covered (Semi-Private Room – 30 days /annum)
Covered (Private Room – 30 days /annum)
Covered (Private Room – 45 days /annum)
Advanced Radiological Investigation (Including CTScan & MRI)
Not Covered
CT Scan Covered (only on emergency/once per annum)
CT & MRI Covered (only on emergency/once per annum)
CT & MRI Covered (only on emergency/twice per annum)
CT & MRI Covered
CT & MRI Covered
Echocardiogram
Not Covered
Not Covered
Not Covered
Covered (maximum twice per annum)
Covered
Covered
Routine immunizations for 0- 5 years (NPI)
(NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
(NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
CT & MRI (NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
(NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
(NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
(NPI),- including pentavalent vaccines (diphtheria, tetanus, whooping cough)
Additional immunizations for 0-5 years)
Not Covered
Hepatitis B, HiB & Yellow fever only
Hepatitis B, HiB & Yellow fever only
Hepatitis B, HiB & Yellow, MMR & fever only
Hepatitis B, HiB & Yellow fever, MMR, Pneumococcal, Rotavirus, Meningitis only
Hepatitis B, HiB & Yellow fever, MMR, Pneumococcal, Rotavirus, Meningitis only
Minor and Intermediate Surgery
Covered (limit of N100, 000/annum
Covered ( limit of N150,000/annum)
Covered
Covered
Covered
Covered
Major Surgery
Not Covered
Not Covered
Covered ( limit of N250,000/annum)
Covered ( limit of N400,000/annum)
Covered ( limit of N500,000/annum)
Covered ( limit of N750,000/annum)
Surgeries including day case procedure - minor, intermediate and major surgeries – International Refundable limit
Covered (limit of N70, 000/annum for Minor & Intermediate Surgeries only
Covered ( limit of N120,000/annum) annum for Minor & Intermediate Surgeries only
Covered ( limit of N250,000/annum)
Covered ( limit of N300,000/annum)
Covered ( limit of N400,000/annum)
Covered ( limit of N550,000/annum)
Maternity Care
Covered to a limit of N40, 000
Covered to a limit of N60, 000
Covered to a limit of N80, 000
Covered to a limit of N120, 000)
Covered to a limit of N200, 000
Covered to a limit of N400, 000
Caesarian Section Services
Covered to a limit of N100, 000
Covered to a limit of N100, 000
Covered to a limit of N250, 000
Covered to a limit of N350, 000
Covered to a limit of N500, 000
Covered to a limit of N750, 000
Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit)
Not Covered
Covered (24 hours)
Covered (48 hours)
Covered (48 hours)
Covered (3 Days)
Covered (3 Days)
Antenatal Care, Normal Delivery, Caesarian Section - Global Refund on Deliveries
Covered to a limit of N60, 000
Covered to a limit of N90, 000
Covered to a limit of N120, 000
Covered to a limit of N200, 000
Covered to a limit of N300, 000
Covered to a limit of N400, 000
Infertility Treatment
Not Covered
Counselling, Sperm functional Assessment, USS & HSG (N25,000 limit)
Counselling, Sperm functional Assessment, USS & HSG (N35,000 limit)
Counselling, Sperm functional Assessment, USS & HSG (N35,000 limit)
Counselling, Sperm functional Assessment, USS, Hormonal Profile & HSG (N100,000 limit)
Counselling, Sperm functional Assessment, USS, Hormonal Profile & HSG (N100,000 limit)
Family Planning Services
IUCDs, Pills & Injectibles
IUCDs, Pills & Injectibles
IUCDs, Pills & Injectibles
IUCDs, Pills & Injectibles
IUCDs, Pills & Injectibles, Norplants only
IUCDs, Pills & Injectibles, Norplants only
Renal Dialysis
Not Covered
Emergency (1session only)
Covered (2 sessions only)
Covered (2 sessions only)
Covered (3 sessions only)
Covered (4 sessions only)
Health Checks (Principal Only).
Annual Physical Checks only
On-site only - Physical, BP, Blood Sugar, BMI)
On-site only - Physical, BP, Blood Sugar, BMI
On-site only - Physical, BP, Blood Sugar, BMI
To be carried out at IHMS designated Providers’ Outlet & Limited to; Physical, BP, Blood Sugar, FBC, RFT, Lipid Profile and Urinalysis only.
To be carried out at IHMS designated Providers’ Outlet & Limited to; Physical, BP, Blood Sugar, FBC, RFT, Lipid Profile and Urinalysis only.
Emergency ambulance Services
Covered
Covered
Covered
Covered
Covered
Covered
Ophthalmic Care
Primary Eye Care only
Primary & Comprehensive Covered (N 60,000 limit per annum)
Primary & Comprehensive Covered (N 80,000 limit per annum)
Primary & Comprehensive Covered (N 120,000 limit per annum)
Primary & Comprehensive Covered (N 170,000 limit per annum)
Primary & Comprehensive Covered (N 250,000 limit per annum)
Optical ware – Lense and frame or contact lenses
Covered (N5, 000 in 2 years)
Covered (N 7,000 limit in 2 years)
Covered (N 8,500 in 2 years)
Covered (N 10,000 in 2 years)
Covered (N 20,000 limit in 2 years)
Covered (N 30,000 in 2 years)
Primary Dental Care
Covered
Covered
Covered
Covered
Covered
Covered
Comprehensive Dental Care (surgical extraction, root canal therapy and dental prosthesis)
Not Covered
Covered (N 10,000 limit per annum)
Covered (N 20,000 limit per annum)
Covered (N 30,000 limit per annum)
Covered (N 50,000 limit per annum)
Covered (N 75,000 limit per annum)
High Dependency Unit (HDU)
Not Covered
Not Covered
Not Covered
Covered (48 hours)
Covered (3 days)
Covered (5 days)
Intensive Care Services (ICU)
Not Covered
Covered (24 hours)
Covered (48 hours)
Covered (48 hours)
Covered (3 days)
Covered (5 days)
Physiotherapy
4 Sessions
10 Sessions
10 Sessions
10 Sessions
12 sessions
15 sessions
Psychiatric Treatment
Not Covered
Outpatient Care Only (3 months)
Outpatient Care Only (3 months)
Outpatient Care Only (3 months)
Outpatient Care Only (3 months)
Outpatient Care Only (4 months)
Medical Enquiries
Covered
Covered
Covered
Covered
Covered
Covered
Inter-state Referral Services for services not available in State or Out of station Care
Covered
Covered
Covered
Covered
Covered
Covered
HIV/AIDS Care & Treatment (management of opportunistic infection only)
Covered
Covered
Covered
Covered
Covered
Covered
Cancer Care: Oncology Tests, Drugs + Chemotherapy & Radiotherapy (Local or International Management)
Not Covered
Covered ( limit of N200,000/annum)
Covered ( limit of N300,000/annum)
Covered ( limit of N400,000/annum)
Covered ( limit of N500,000.00/annum)
Covered ( limit of N600,000.00/annum)
Mortuary Services (Cleaning, Embalmment, Storage & Autopsy
Not Covered
N 50,000 limit
N 50,000 limit
N 50,000 limit
N 50,000 limitN 50,000 limitN 50,000 limitN 50,000 limitN 50,000 limit
N 50,000 limit
| Standard Plan | Standard Plus | Advanced Standard Plus Plan | Comprehensive Plan | Super Comprehensive Plan | ||
|---|---|---|---|---|---|---|
Standard Benefits |
||||||
| 1 | General Consultation | |||||
| 2 | Specialist consultation | |||||
| 3 | Admissions (including feeding) | |||||
| 4 | Accommodation for mothers whose dependents are on admission | |||||
| 5 | Provision of Prescribed Drugs | |||||
| 6 | Accident and Emergency Care | |||||
| 7 | Management of Chronic Diseases | |||||
| 8 | Blood Transfusion | |||||
| 9 | Basic X-rays | |||||
| 10 | Comprehensive X-rays | |||||
| 11 | Basic Laboratory Test | |||||
| 12 | Comprehensive Laboratory Tests | |||||
| 13 | Ultrasound Scan Services | |||||
| 14 | ECG, EEG & EMG | |||||
| 15 | Advanced Radiological Investigation (Including CT Scan & MRI) | |||||
| 16 | Echocardiogram | |||||
| 17 | Routine immunizations for 0- 5 years (NPI) | |||||
| 18 | Additional Immunizations | |||||
| 19 | Minor Surgeries | |||||
| 20 | Intermediate Surgeries | |||||
| 21 | Major Surgeries | |||||
| 22 | Surgeries including day case procedure - minor, intermediate and major surgeries – International Refundable limit | |||||
| 23 | Maternity Care | |||||
| 24 | Caesarian Section Services | |||||
| 25 | Neonatal Intensive Care Services (Incubator care & Special intensive baby care unit) | |||||
| 26 | Global Refund on Deliveries | |||||
| 27 | Infertility Treatment | |||||
| 28 | Family Planning Services | |||||
| 29 | Renal Dialysis | |||||
| 30 | Health Checks (Principal Only). | |||||
| 31 | Emergency ambulance Services | |||||
| 32 | Ophthalmic Care | |||||
| 33 | Optical ware – Lense and frame or contact lenses | |||||
| 34 | Comprehensive Dental Care | |||||
| 35 | High Dependency Unit (HDU) | |||||
| 36 | Intensive Care Services (ICU) | |||||
| 37 | Physiotherapy | |||||
| 38 | Psychiatric Treatment | |||||
| 39 | Medical Enquiries | |||||
| 40 | Inter-state Referral Services for services not available in State or Out of station Care | |||||
| 41 | HIV Support | |||||
| 42 | Cancer Care: Oncology Tests, Drugs + Chemotherapy & Radiotherapy (Local or International Management) | |||||
| 43 | Mortuary Services (Cleaning, Embalmment, Storage & Autopsy | |||||
| 44 | Comprehensive Ophthalmic Care | |||||
Optional Benefits |
||||||
| 1 | Primary Ophthalmic Care | |||||
| 2 | Primary Dental Care | |||||