HyPrime Plus Plan

HyPrime Plus Plan*

Premium per Life per Annum: ₦ 385,500

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

*Access to Category B Hospitals, Lagoon Hospital and Reddington Hospital
**The visits cannot be cumulated over a period of time
***Applies to HyPrime Plus enrollees in Lagos only

D.     EXCLUSIONS:

The following are excluded from the HyPrime Plans: –

  1. Congenital abnormalities
  2. Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners or complementary medicines practitioners
  3. Dental care not listed in the covered services
  4. Health screening/Well Person’s check
  5. Herbal drugs, non-prescription drugs, food supplements and experimental drugs and treatment
  6. HIV/AIDS Care & Treatment
  7. Home care and domiciliary services
  8. Intensive care treatment
  9. Interstate travel for services not available in State
  10. 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
  11. Joint replacements and prosthetic limbs
  12. Kidney Dialysis
  13. Learning difficulties, behavioral and developmental problems
  14. Long term psychiatric illness (Longer than 3 months)
  15. Neonatal intensive care (incubator care) or special care baby unit services
  16. Other advanced & complex Investigations not listed in covered services.
  17. Other advanced immunizations not listed in covered services.
  18. Other Family Planning Services not listed in covered services
  19. Other Neonatal Services not listed in covered services.
  20. Other Optical services not listed in covered services
  21. Overseas treatment and transplant surgery
  22. Plastic/cosmetic surgeries
  23. Room upgrades beyond that specified in the covered services.
  24. Self-inflicted injuries
  25. Speech disorders
  26. Treatment of obesity
  27. Virility enhancing drugs
  28. Any other treatment, service, procedure or investigation not listed in the schedule of covered medical services

E.     NOTE

  1. Maximum principal age limit is 60 years
  2. There will be a waiting period of 2 weeks after registration. Plan purchased becomes active 2 weeks after purchase date.
  3. 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.
  4. The following benefits will not be covered or provided in the first year of the commencement of the scheme: Maternity Services, 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.
  5. 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
  6. The following benefits will not be covered or provided in the first 3 months of the commencement of the scheme: Optical Care, Dental Care.
  7. The following benefits will not be covered or provided in the first 2 months of the commencement of the scheme: Chronic Disease Medication.