Chosen Plan
VIP – Family
Value Insurance Plan (VIP)
₦493,062.50/yr
Please read through our General Exclusions & Service Caveats then fill the enrollee form below to get started.
General Exclusions and Service Caveats
Treatment of persons not registered in the scheme.
Treatment including delivery outside network of participating facilities.
Occupational Industrial injuries
Injuries resulting from: Natural disasters e.g. earthquakes, landslides, etc. Conflicts, social unrest, riots, wars, etc.
Epidemics
Drug/substance abuse and addiction
Other Terminal illnesses not stated in the plan
Domiciliary/Hospice care
Periodic Medical check-ups unrelated to illness
Transplant and cosmetic surgeries
Open heart surgery
Neurosurgery
Provision of Hearing aids and associated appliances
Treatment of leprosy
Auto Immune
Congenital abnormalities involving major/extensive surgical repairs e.g. Separation of Siamese twins
Chronic congenital defects e.g. Hirchsprung disease
In-Vitro Fertilization & Fertility Treatment
Dentures, Crowns, bridges, Implants
Maxillo-facial surgeries
Alternative/Un-orthodox treatment
Dental prosthesis
Self-inflicted injuries
Gender reassignment
Hormone replacement therapy
Stem cell or bone marrow transplant
Adult Immunization
All treatment not covered under the scope of the health services
wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | Covered service | Plan maximum |
---|---|---|---|---|---|---|
1 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Area of cover | We will pay up to the maximum limit shown for benefits with limit per policy year. |
3 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Surgeries | 1. Pre – planned surgeries are not covered |
4 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | 2. There is the possibility of antenatal cover during the first year of enrollment in the VIP plan | |
5 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Waiting Period | Pre-defined waiting period of 1 month between registration and activation of health care coverage. |
6 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Change of provider | Change can be effected not more than two (2) times per annum |
7 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Specialist consultation | The number of times a member can meet with a specialist during the period of cover is 6 for SIP & DIP plans, while 12 for VIP. But for rare specialists, it must be based on referrals across all plans (Within above same limits). |
8 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Secondary care | This is subject to pre - authorization. We require you to contact us before receiving any planned admission and some major out-patient treatment. |
9 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Emergency | Covered for stabilization only but we need to be informed under 24hrs |
10 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Pre-existing conditions (including preexisting chronic conditions) | NHA reserves the right to refuse to pay benefit for any such condition which was not declared on a beneficiaries verification form. It is covered across all plans within network only but with a 50% co-payment for both SIP & DIP Plans only. |
11 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Drugs and medications for acute illness | Covered across all plans but with a 20% co payment for both SIP & DIP Plans only. |
12 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Ambulance transport | For a road ambulance for emergency treatment to or between hospitals, or when the medical practitioner says it is medically essential |
13 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Extra Radiological | We cover for CT Scan, MRI only with a 50 % co payment on SIP & DIP Plan per annum. With 1 full payment per annum for VIP Plan. Other high-tech investigations e.g. Cardiac are not Covered |
14 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Travel care | Within network only |
15 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | Adult wellness Check | Physicals only. ( weight, BP, Height, BMI) |
16 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | All dental and optical visits require appointment authorization | This is subject to dental & optical limits across plan DIP & VIP Plans. |
17 | nhaadmin | 14/06/2024 04:37 PM | nhaadmin | 14/06/2024 04:37 PM | International Benefit | Covered for the VIP Plan only. Treatment in India involves: 1. Free Admin services. E.g. Helping beneficiary to find a hospital |