Service	PRIME Coverage
Hospital Network Access	Band A
GP Consultation	Covered
GP Review	Covered
Specialist Consultation	Covered
Specialist Review	Covered
Supply of Prescribed Medicines	Covered
Admissions	General Ward
Admissions per annum	21 days
Feeding	Covered
Nursing Care	Covered
Other Consumables	Covered
Prescribed Medications	Covered
In-patient limit	Up to N300000
Laboratory Investigations	Basic - Covered, Comprehensive - Not Covered
Radiological Investigations	Basic - Covered, Comprehensive - Not Covered
Advanced and Complex Investigations	Not Covered (E.g., Echocardiogram, CT scan, MRI)
Dental Services	Up to N15000, Amalgam Filling, Simple Extraction, Surgical Extraction, Scaling & Polishing (Once/year)
Optical Services	Eye testing & Examinations, Medications, Lenses & Frames (Up to N7500)
Neonatal Services	Ear Piercing, Circumcision, Phototherapy
Obstetrics & Gynecology Services	Normal Delivery, Caesarean Section, Post-natal care
Family Planning Services	IUCD, Pills, Injectable
Emergency Medical Services	Stabilization, ICU (Up to 24 hours)
Physiotherapy Services	Up to 5 sessions
Surgical Services	Up to N150000, Minor/Intermediate/Major Surgeries, Anesthesia
Chronic Condition Management	Covered, Prescribed Chronic Medicines (Up to N40000)
HIV/AIDS Treatment	Covered at free specialist centers
Renal Dialysis	Not Covered
Outpatient Psychiatry Cover	Covered (7 weeks)
Inpatient Psychiatric Care	Not Covered
Annual Medical Screening	For Principal & Spouses, Physical Exam, Blood Sugar, Blood Pressure, BMI
Chest X-ray	Not Covered
ECG	Not Covered
Pap Smear	Not Covered
PSA (Prostate Specific Antigen)	Not Covered
Individual Premium/Annum	₦50,525
Family Premium/Annum	₦303,150 (For a family of 6)

CONDITIONS

1. The Premium computed is payable once annually based on the population.

2. Family premium quoted is for a family of 6 (Principal, Spouse, and 4 Children less than 20 years old).

3. The age limit on the Plans is 60 years.

4. Plans or Benefits are not transferable.

Excluded in all Cover Plans

• Transplant surgery, Speech disorder, Thyroid disorders, neurological and neurosurgical disorders
• Plastic/cosmetic surgeries
• Advanced and complex investigations not stated in the schedule of covered services
• Other investigations and treatment problems relating to infertility (e.g., hydrotubation, hysterosalpingogram, I.V.F, G.I.F.T, and artificial insemination)
• Herbal drugs, non-prescription drugs, food supplements, and experimental drugs and treatment
• Other laboratory investigations not listed in the schedule of covered services
• Dental care not listed in the schedule of covered services
• Home care and domiciliary services
• Joint replacements and prosthetic limbs
• Long-term psychiatric illness (Longer than 6 months)
• Executive and VIP room NOT COVERED
• Comprehensive health screening/well persons check outside the scope of the benefits covered by the health checks
• Pre-School Health examinations
• Treatment for newborns not registered on the plan after 6 weeks of birth
• Neonatal care not listed under neonatal services
• Self-inflicted injuries
• Treatment of obesity
• All Covid-19 and Hepatitis Treatment
• Covid-19 testing except as stated in the schedule of covered services
• Speech disorders
• Room upgrades beyond that specified in the plan benefit
• Management of severe burns (burns covering more than 10% body surface area)
• Learning difficulties, behavioral, and developmental problems
• Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners, or complementary medicines practitioners
• Any other treatment, service, procedure, or investigation not listed in the schedule of covered medical services