Q: What is the Hygeia Health Plan?
A: For a single annual payment, the Hygeia Health Plan gives you access to quality healthcare services across Nigeria for a fixed amount per person/family per year. This lets you manage your money better by avoiding unexpected health care costs.
Q: What's unique about Hygeia Health Plan?
A: The HHP is the first health plan that offers you a combination of health insurance and protection as well as life and accident disability insurance, in partnership with Guaranty Trust Assurance Limited.
Q: What's in it for me?
A: You can gain access to all levels of health care from our network of highly trained staff, with modern facilities in specialist hospitals, clinics and affiliated providers, which are strategically located all over the nation.
Q: How do I apply?
A: You can apply through our website – www.hygeiahmo.com or visit us at our office Hygeia HMO , 11a Idejo street off Adeola Odeku Victoria Island or through Guaranty Trust Assurance Limited , Heritage Plaza, Plot 928a Bishop Aboyade Cole Street, Victoria Island Lagos, or through an Advantium staff of any Guaranty Trust Bank Branch Nationwide.
Q: How many people does family plan cover?
A: Six people! You, your spouse and four dependants under 18 years of age
Q: Am I covered if I am pregnant?
A: No! There is a waiting period of 9 months before you can access maternity care benefits.
Q: If I take the family plan does the Assur personal life and personal accident benefits cover my whole family?
A: No! The Assur personal life and personal Accidental benefits cover subscribers between the ages of 18 and 60
Q; When does my Assur Package begin?
A: You begin to enjoy cover from the day specified on the evidence of benefit
Q: After payment for the health plan, what next?
A: You will receive a welcome pack which will include your Hygeia ID card, a policy certificate, acknowledgement form and leaflets on preventive health.
Q: Can I continue using my old hospital after my enrolment?
A: Yes! Only if the hospital is registered in our network
Q: What can I do if I want to change my provider?
A: Every six months a window of change is opened and you have the opportunity to change your provider.
Q: What is a defined network plan?
A: A defined network plan is the term used in the Hygeia Network to refer to any health benefit plan that creates opportunities for it's enrolees to use network providers. Some people refer to these plans as managed care plans.
Q:When do I need to make a claim?
A: You need only make a claim when you seek care from an alternative provider i.e from a provider outside our network.
Q: How do I claim?
A: Filing a claim on your Assur is easy. All claims must be notified to GTA or Hygeia with evidence of occurrence. On satisfactory completion of claims form, claims will be settled without any delay.
Q: Will I incur any liability if I fail to follow the preauthorization requirements?
A: Yes! If you fail to follow the required preauthorization procedures, you may not be able to make your claims.
Q: What if I have a complaint?
A: You should contact our 24hr Care Call Centre (7736996, 7762433). You can be sure that your problem will be resolved there. Better still, you can fill a feedback form to file in a written grievance.
Q: My health care provider told me that they are no longer with the HMO, but I want to stay with him. What can I do?
A: The agreement between the managed care plan and your health care provider is a separate agreement that may terminate any time during the year of which you will be well informed. If the provider leaves the plan because he or she no longer practises in the plan's service area or is terminated for misconduct, you will be required to consult another health care provider within our network of providers.
Q: What is NHIS all about?
A: The National Health Insurance Scheme (NHIS) was established by the Federal Government to roll out the public health sector insurance in Nigeria . Hygeia HMO is one of the accredited HMO(s) for the implementation of the scheme. For further enquiries about the scheme, please visit the NHIS website.
Q: When can I call?
A: Any time! Our 24hr Care Call Centre is accessible 24hrs a day, 365 days a year. 01-773 6996, 01-7762433.
Q: Does the plan renew automatically?
A: No. The coverage of the plan is for a period (12 months) and a renewal notice will be sent to you before expiration.
Q: How do I pay for renewal?
A: Same process as enrolment. Just pay by either bank draft or cheque.
Q: Can I upgrade my plan whenever it's suitable for me?
A: No. You can only upgrade or change your plan annually.
Q: What happens in an emergency where I can not reach a provider in the network?
A: Get treated in the nearest hospital and notify Hygeia within 24hrs of occurrence.
Q: If I am hospitalized, can I enrol?
A: Yes! But Hygeia will not be responsible for your pre-existing bills.
Q: If am a traveller can I access care anywhere in the nation apart from my chosen provider?
A: Yes! Call the Care Call Centre and they will pre-authorise you for access.
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