Standard Option

Hospitalisation

Subject to Overall Annual Benefit - M1,000,000.00 per beneficiary

Hospital Alternatives

M23,500.00 per family

Paramedical Services

100% of scheme rates

Blood Transfusion

M35,552.00 per beneficiary

Maternity

Subject to Overall Annual Benefit

Maxillofacial Surgery

Subject to Overall Annual Benefit

Mental Health
(In Hospital)

M31,740.00 per beneficiary, 3 days maximum if admitted by GP

Mental Health
(Out Of Hospital)

M2,116.00 per beneficiary

Oncology

M158,700.00 per beneficiary

Organ Transplant

M158,700.00 per beneficiary for tissue and organ transplant, M21,160.00 for specialized radiology (MRI & CAT scans)

Immune Deficiency

M10,445.00 per beneficiary

Renal Dialysis

M158,700.00 per beneficiary

Prosthetic Appliances

M47,610.00 per beneficiary for internal devices surgically implanted.

M10,580.00 per beneficiary for external devices

Chronic Benefit

M5,896.00 per beneficiary

Dentistry

M2,192.00 per beneficiary

Optometry (Biannual benefit)

M3,043.00 per beneficiary, 100% of optometry benefit for prescribed lenses, M1,465.00 for frames

Pathology, Physical Therapy & Radiology

M5,290.00 per beneficiary

Consultation

8 GP Consultation Visits. Unlimited Specialist Visits. M3,200.00 Prescribed Meds. M1,000.00 Over the Counter OTC. M800.00 Supplents. 150 per script pbpd. OTC.