Premium per Life per Annum: ₦58,900
√ 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 plans: –
- Management of Chronic Diseases including but not limited to consultation, prescription drugs and laboratory tests
- 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.
- Dental care not listed in the covered services
- Home care and domiciliary services
- Joint replacements and prosthetic limbs
- Long term psychiatric illness (Longer than 3 months)
- Health screening/well persons check
- Other advanced immunizations not listed in covered services.
- Other advanced & complex Investigations not listed in covered services.
- Other optical services not listed in covered services
- Overseas treatment and transplant surgery
- Plastic/cosmetic surgeries
- Neonatal Services not listed in covered services.
- 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
- Virility enhancing drugs
- Herbal drugs, non-prescription drugs, food supplements and experimental drugs and treatment
- Congenital abnormalities
- Self-inflicted injuries
- HIV/AIDS Care & Treatment
- Treatment of obesity
- Speech disorders
- Room upgrades beyond that specified in the covered services.
- 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
- Maximum principal age limit is 50 years
- There will be a waiting period of 2 weeks after registration. Plan purchased becomes active 2 weeks after purchase date.
- The following benefits will not be covered or provided in the first year of the commencement of the scheme: Surgeries, Cancer Care 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 6 months of the commencement of the scheme: Neonatal Care Services and all Immunisations
- The following benefits will not be covered or provided in the first 3 months of the commencement of the scheme: Optical Care, Dental Care