Medical Insurance

black_mens_health_checkup_original_33114.jpg

Medical Insurance is also called 'Health Insurance'; a type of insurance coverage that pays for medical and surgical expenses following illness or injury that are incurred by the insured member directly to care/medical providers.

Coverage designed to cater for families, small, medium sized and large organisations. Companies with as few as 3 staff can take up an SME or a Corporate cover

Cover is classified into the following two categories:

1. Inpatient:
A condition or procedure that requires the patient to be admitted to hospital overnight for a prescribed or indefinite period

2.  Outpatient:
A patient does not require admission and the treatment and/or procedure may be done at the doctor’s office/clinic

Additional riders:
Dental: Covers routine dentistry including dental consultation, prescription, extractions, fillings and dental x-rays

Optical: Covers routine optical consultations, prescription for frames and other optical prescriptions, prescribed lenses and replacement

Maternity: This benefits caters for in-patient expenses for child delivery and pregrancy relaated complications (including caesarean section and ectopic pregnancy).

NB: Inpatient is the primary benefit

Key determinants for a medical cover:



AGE
  • Determines premium 
  • New applicants over 50 years need to undergo a medical examination. Specific facilities are appointed to do these 
  • Minimum joining age 38 weeks; Upper age limit varies with the underwriter
FAMILY SIZE
  • Members can join as individuals/ family groups/ SME’s/ Corporates 
  • Family includes the principal, spouse and children under 18 years unless they are still dependents/ students
PLAN SELECTED
Plan Minimum limits Maximum limits
Inpatient   10 000 000
Outpatient 30 000 300 000
Dental 10 000 50 000
Optical 10 000 50 000
Maternity 30 000 300 000