HyPrime Family Plans: Pricing and Benefits

HyPrime Family Plan

Premium per Family of 4 per Annum: 530,080

indicates services which are covered
indicates services not covered under the specific plan

EXCLUSIONS:

The following are excluded from all plans: –

  1. Overseas treatment and transplant surgery
  2. Plastic/cosmetic surgeries
  3. Advanced and complex investigations not stated in schedule of covered services
  4. Investigations and treatment for problems relating to infertility e.g. hydrotubation, hysterosalpingogram, I.V.F, G.I.F.T and artificial insemination
  5. Virility enhancing drugs
  6. Herbal drugs, non-prescription drugs and experimental drugs and treatment
  7. Other laboratory investigations not listed in the schedule of covered services
  8. Dental care not listed in the schedule of covered services
  9. Home care and domiciliary services
  10. Intensive care treatment
  11. Joint replacements and prosthetic limbs
  12. Interstate travel for services not available in State
  13. Psychiatric Treatment and illness
  14. Comprehensive health screening/well persons’ check
  15. Pre – School Health examinations
  16. Renal Dialysis
  17. Cancer Care
  18. HIV/AIDS Care & Treatment
  19. Treatment for newborns not registered on the plan after 6 weeks of birth.
  20. Neonatal Care Services (Treatment of mild or moderate neonatal sepsis, Phototherapy, Incubator Care and Special Care Baby Unit
  21. Optical Care: Lenses, Frames & Contact, Lenses
  22. Self-inflicted injuries
  23. Treatment of obesity
  24. Covid-19 testing and treatment
  25. Treatment of Congenital Abnormalities
  26. Speech disorders
  27. Room upgrades beyond that specified in the plan benefits
  28. Management of severe burns (Burns covering more than 10% body surface area)
  29. Learning difficulties, behavioral and developmental problems
  30. Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners or complementary medicines practitioners
  31. Any other treatment, service, procedure or investigation not listed in the schedule of covered medical services.

NOTE:

  1. Maximum principal age limit is 60 years and Dependant age limit is 18 years.
  2. Family means Principal, Spouse and 2 Dependants.
  3. There will be a waiting period of 2 weeks after registration. Plan purchased becomes active 2 weeks after purchase date.
  4. All benefits are subject to their respective sectional limits which is described as: Inpatient Limit and Outpatient Limit However, within the respective sectional limit, there are specific benefit limits as well. Consequently, in the event that any specific benefit limit under the sectional limit is exhausted, the remaining limit in that section will only cover other benefits within the section apart from the one that the specific benefit limit has been exhausted.
  5. The following benefits will not be covered or provided in the first year of the commencement of the scheme: Maternity Services, Surgeries, Critical Illness + Death Cover and Psychiatric Care. This period otherwise known as waiting period shall commence on the date of entry to the date of renewal. On renewal, this benefit will be accessible provided the enrollee has been enrolled for one year with the HMO.
  6. The following benefits will not be covered or provided in the first 6 months of the commencement of the scheme: Neonatal Care Services and All Immunisations
  7. The following benefits will not be covered or provided in the first 3 months of the commencement of the scheme: Optical Care, Dental Care and Chronic Disease Medication.