HyBasic Premium Plan*
Premium per Life per Annum: ₦121,780
√ indicates services which are covered
x indicates services not covered under the specific plan
*Access to Category B Hospitals
**The visits cannot be cumulated over a period of time
***Applies to HyPrime Plus enrollees in Lagos only
The following are excluded from all HyBasic Plans: –
- Advanced & Complex Investigations including but not limited to CT Scan, MRI Scan and Echocardiograph
- Ante-Natal Care & Delivery services including but not limited to Antenatal examinations and supply of drugs, Management of complications in pregnancy, Delivery room services, Management of Labour, Normal & assisted delivery, Caesarean section delivery, Shirodkar operation, Post-natal Check.
- Congenital abnormalities
- Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners or complementary medicines practitioners
- Dental care not listed in the covered services
- Family Planning Services
- Renal Dialysis
- Health screening/Well Person’s check
- Herbal drugs, non-prescription drugs, food supplements and experimental drugs and treatment
- HIV/AIDS Care & Treatment
- Home care and domiciliary services
- Intensive care treatment
- Interstate travel for services not available in State
- Investigations and treatment for problems relating to infertility e.g hormone profiles, laparoscopy, hydrotubation, hysterosalpingogram, I.V.F, G.I.F.T and artificial insemination
- Joint replacements and prosthetic limbs
- Learning difficulties, behavioral and developmental problems
- Long term psychiatric illness (Longer than 3 months)
- Management of Chronic Diseases including but not limited to consultation, prescription drugs and laboratory tests
- Neonatal Services including but not limited to male circumcision, ear piercing, treatment of mild or moderate neonatal sepsis, phototherapy.
- Neonatal intensive care (incubator care) or special care baby unit services
- Other advanced immunizations not specified in the plan benefits.
- Other optical services not listed in covered services
- Overseas treatment and transplant surgery
- Plastic/cosmetic surgeries
- Room upgrades beyond that specified in the plan benefits
- Self-inflicted injuries
- Speech disorders
- Treatment of obesity
- Virility enhancing drugs
- Any other treatment, service, procedure or investigation not listed in the schedule of covered medical services
- Maximum principal age limit is 60 years and Dependant age limit is 18 years.
- Family means Principal, Spouse and 2 Dependants.
- There will be a waiting period of 2 weeks after registration. Plans purchased becomes active 2 weeks after purchase date.
- All benefits are subject to their respective sectional limits which is described as: Inpatient Limit, Outpatient Limit and Pharmacy Benefit 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.
- The following benefits will not be covered or provided in the first year of the commencement of the scheme: Surgeries, Cancer Care, 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.
- The following benefits will not be covered or provided in the first 3 months of the commencement of the scheme: Optical Care, Dental Care