| COVERED SERVICES | CLASSIC | SILVER | GOLD | GOLD PLUS |
|---|---|---|---|---|
| MEDICAL EMMERGENCY SERVICES: Acute Heart Failure, Shock | ✔ 24 hrs | ✔ 24 hrs | ✔ 48 hrs | ✔ 72 hrs |
| OUT PATIENT SERVICES | General + Specialist Consultation | General + Specialist Consultation | General + Specialist Consultation | General + Specialist Consultation |
| ALLERGIES | ✔ | ✔ | ✔ | ✔ |
| MEASLES | ✔ | ✔ | ✔ | ✔ |
| CHICKEN POX | ✔ | ✔ | ✔ | ✔ |
| PARASITIC AND ALLERGIC SKIN CONDITIONS | ✔ | ✔ | ✔ | ✔ |
| Scabies, Tinea Infection, Acne, Eczema, Seborrheic, Dermatitis | ✔ | ✔ | ✔ | ✔ |
| URINARY TRACT INFECTION | ✔ | ✔ | ✔ | ✔ |
| Uncomplicated & Complicated Urinary Tract Infection | ✔ | ✔ | ✔ | ✔ |
| PEPTIC ULCER DISEASE | ✔ | ✔ | ✔ | ✔ |
| Acute Axacerbation of Peptic Ulcer Disease, GERD | ✔ | ✔ | ✔ | ✔ |
| Indigestion | ✔ | ✔ | ✔ | ✔ |
| UPPER & LOWER RESPIRATORY TRACT INFECTION | ✔ | ✔ | ✔ | ✔ |
| Pneumonia, Bronchitis, Influenza, Viral Croup, Bronchiolitis, Tonsilitis | ✔ | ✔ | ✔ | ✔ |
| ASTHMA | ✔ | ✔ | ✔ | ✔ |
| CORYZA | ✔ | ✔ | ✔ | ✔ |
| DIARRHEA DISEASES | ✔ | ✔ | ✔ | ✔ |
| CADIO-VASCULAR CONDITIONS | ✔ | ✔ | ✔ | ✔ |
| HIV/AIDS-Investigation for confirmation | ✔ | ✔ | ✔ | ✔ |
| PVC, MP, WIDAL, FBC+DIFF, PREGNANCY TEST | ✔ | ✔ | ✔ | ✔ |
| ESR, RBS/FBS, URINALYSIS, M/C/S | ✔ | ✔ | ✔ | ✔ |
| E/U/CR, BLOOD GROUP AND GENOTYPE, HBSAg. | ✔ | ✔ | ✔ | ✔ |
| Out-patient care for 6 weeks | ✔ | ✔ | ✔ | ✔ |
| INPATIENT MEDICAL SERVICES | ||||
| Hypertension, Myocardial Infarction, Cerebrovascular Accident (stroke), | ✔ | ✔ | ✔ | ✔ |
| Cardiomyopathies, Chronic Heart Failure | ✔ | ✔ | ✔ | ✔ |
| BLOOD TRANSFUSION | ✔ | ✔ | ✔ | ✔ |
| Treatment of opportunistic infections | ✔ | ✔ | ✔ | ✔ |
| INVESTIGATIONS | ||||
| HBV/HCV, H, PYLORI | ✔ | ✔ | ✔ | ✔ |
| COOMB's TEST, BLOOD CULTURE, PERIPHERAL | ✖ | ✔ | ✔ | ✔ |
| BLOOD FILM, CLOTTING PROFILE, BLEEDING TIME, INR | ✖ | ✔ | ✔ | ✔ |
| D-TIMER, FECAL OCCULT BLOOD, FERRITIN LEVELSM HbA1c | ✖ | ✔ | ✔ | ✔ |
| LFT, KFT | ✔ | ✔ | ✔ | ✔ |
| MATERNITY AND CHILD SERVICES | ||||
| Confirmation of Pregnancy | ✔ | ✔ | ✔ | ✔ |
| Antenatal Care (from 12 weeks) | ✔ | ✔ | ✔ | ✔ |
| Management of Labour & Delivery | ✔ | ✔ | ✔ | ✔ |
| Surgical Intervention | ✔ | ✔ | ✔ | ✔ |
| Post-Natal Care | ✔ | ✔ | ✔ | ✔ |
| Febrile Convulsions | ✔ | ✔ | ✔ | ✔ |
| Routine immunization Services | ✔ | ✔ | ✔ | ✔ |
| Additional Immunization under 5yrs | ✖ | ✔ | ✔ | ✔ |
| ICU/SCBU (1st 24hrs and monetary limit 50,000) | ✖ | ✔ | Limit: 70,000 | Limit: 100,000 |
| SURGICAL SERVICES | ||||
| Minor Procedures | ✔ | ✔ | ✔ | ✔ |
| Intermidiate Procedures | ✔ | ✔ | ✔ | ✔ |
| Major Procedures | ✔ | ✔ | ✔ | ✔ |
| Kindly note that monetary limits apply. | Surgical Limit = 140,000 for individual & 350,000 for family plans | Surgical Limit = 220,000 for individual & 700,000 for family plans | Surgical Limit = 440,000 for individual & 1,000,000 for family plans | Surgical Limit = 550,000 for individual & (to be determined) for family plans |
| EYE SERVICES | ||||
| Basic Eye Examination (only) | ✔ | ✔ | ✔ | ✔ |
| MANAGEMENT OF COMMON EYE AILMENTS | ||||
| stye, Conjuctivities, Ocular Allergies, Keratitis | ✖ | ✔ | ✔ | ✔ |
| Optical Lens Limit (biennial) | 10,000 | 15,000 | 25,000 | To be determined |
| Eye Surgeries (Minor & Intermidiate) | ✔ | ✔ | ✔ | ✔ |
| Major Eye Surgery | ✖ | ✔ | ✔ | ✔ |
| DENTAL CARE | ||||
| TREATMENT OF MINOR AILMENTS | ||||
| Gingivitis, Scurvy, Tooth pain | ✔ | ✔ | ✔ | ✔ |
| Routine pain management | ✔ | ✔ | ✔ | ✔ |
| Surgical Extraction | ✔ | ✔ | ✔ | ✔ |
| Amalgam Filling | ✔ (2) | ✔ (4) | ✔ (6) | ✔ (8) |
| Scaling and Polishing | ✔ (1) | ✔ (1) | ✔ (2) | ✔ (2) |
| Denture and Bridges | ✖ | ✔ | ✔ (1) | ✔ (1) |
| Root Canal Therapy | ✖ | ✔ (1) | ✔ (2) | ✔ (4) |
| Surgical Extraction | ✔ (2) | ✔ (4) | ✔ (6) | ✔ (8) |
| RADIOLOGICAL SERVICES | ||||
| X-rays and Ultrasound | ✔ | ✔ | ✔ | ✔ |
| CT Scan & MRI (50%co-payment) | 50% | 45% | 35% | To be determined |
| Echocardiography | 50% | 45% | 35% | To be determined |
| Electrocardiography | 50% | 45% | 35% | To be determined |
| Doppler Scan | 50% | 45% | 35% | To be determined |
| PHYSIOTHERAPY | 5 sessions | 8 sessions | 10 sessions | 20 sessions |
| CANCER CARE | ||||
| General Outpatient Consultation | ✖ | ✔ | ✔ | ✔ |
| Specialist Consultation | ✖ | ✔ | ✔ | ✔ |
| Cancer Screening only (PSA & Mammography) | ✖ | ✔ (1) | ✔ (2) | ✔ (4) |
| Surgical Treatment of Cancer (subject to global limit) | ✖ | ✖ | ✔ | ✔ |
| MEDICAL CHECKUP | ||||
| Routine Physical | ✔ | ✔ | ✔ | ✔ |
| Annual Medical Examination (co-payments on investigations | ✔ 50% | ✔ 45% | ✔ 35% | ✔ 15% |
| DRUG TYPES COVEwhitesmoke | >Generic | Generic | Branded | Branded |
| ADDED BENEFITS | ||||
| Renal dialysis (subject to policy limit) | ✖ | ✔ (2) | ✔ (6) | ✔ (8) |
| Infertility consultation, investigation & non-hormonal drug management | ✖ | ✔ | ✔ | ✔ |
| CHRONIC DISEASE MANAGEMENT | ✔ | ✔ | ✔ | ✔ |
| INTERNATIONAL HEALTH INSURANCE | ✖ | ✖ | ✖ | ✔ |
| GPA (Group Personal Accident) | ✖ | ✖ | ✖ | ✔ |
| TRAVEL INSURANCE | ✖ | ✖ | ✖ | ✔ |
| HIGH END HOSPITALS | ✖ | ✖ | ✖ | ✔ |
| GYM MEMBERSHIP | ✖ | ✖ | ✖ | ✔ |