CarePlus Option

CarePlus is the option for members who are looking for basic health cover. The option caters to the basic health necessities for members which includes, dentistry, optometry, and inpatient and outpatient services. This option plan is ideal for members living in the outskirts of the city frequently travel to Malawi’s major cities and towns. It provides a good network of service providers in the town fringes and gives members the option to visit select few service providers within the cities should the need arise.

Overall Annual Limit 5,300,000
Hospitalisation  (General medical and surgical wards including Ward and Theatre medicines)  Subject to Overall Annual Limit
High Care and ICU  Subject to Overall Annual Limit
Specialists and General Practitioners  Subject to Overall Annual Limit
Theatre Costs  Subject to Overall Annual Limit
Blood Transfusion  Subject to Overall Annual Limit
Major Disease Benefit (MDB)  2,625,000
Oncology  Subject to MDB per beneficiary p.a.  1,460,000
Organ Transplants *D Subject to MDB per beneficiary p.a.  1,312,500
Chronic Benefit *R 1,250,000
Motor Vehicle Accident subject to MDB  1,250,000
Physiotherapy *R per beneficiary p.a.  130,000
Medicines to take home (TTO)  23,400
Radiology and Pathology  123,500
Specialised Radiology  1 ; Additional MRI/CT Scan 30% co-pay
Maxillofacial Surgery  1,245,000
Maternity (Delivery including postpartum & Neonatal Care) 1,245,000
Internal and external prosthesis  291,000
Medical Appliances  40,300
Psychiatric hospitalisations  10 DAYS P.A
Sub-Acute Care  100,000
Ambulance Services  100,000 per event
Emergency Air/Cross-Border Evacuation & Foreign Referal Not covered
Repatriation of Mortal Remains  Not covered
Emergency Foreign cover  Not covered
   
   
Out Patient Services  
Consultations Limit 58,500
Specialists Consultations on Referral 1 Visit
Antenatal and Postnatal Benefit *E Covered
Antenatal and Postnatal Consultations 8 Visits
Antenatal Ultrasounds 2 Scans
Antenatal Pathology Hepatitis B, Blood Group and RH, Blood Sugar, 2 Full Blood Count; VDRL; 4 Urinalysis; HIV-Ag Test
Procedures 110,000
Pathology and Radiology (Subject to Procedures Limit) 109,600
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests Covered accordingly to Malawi HIV Policy
Basic Dentistry 80,000
Specialised Dentistry and Orthodontics *P 160,000
Physiotherapy *R Not Covered
Auxiliary Services *R Not Covered
Acute Medicines 79,300
Optometry (Lens and Frame)- Every 2 years 55,000
Eye Test Subject to Optical Limit 1 Eye Test Every 24 months
Funeral Benefit 60,000
   
PREMIUMS  
MAIN 10,320
ADULT 10,320
CHILD 9,600
   
KEY   
*E Enrolment Required 
*P Pre-Authorization Required 
*R Referral by GP or Specialist Required 
*D Donor not Covered 

 

 

 

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