MediCare Option

MediCare is the option for members who want to be on the safe side both in finances and coverage, these members have access to cashless foreign referral, foreign cover, repatriation of remains and even a personal health assessment without having to dig dip into their pockets. Members under this option have access to a large service provider network.

Overall Annual Limit 14,400,000
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)  6,150,000
Oncology  Subject to MDB per beneficiary p.a.  3,200,000
Organ Transplants *D Subject to MDB per beneficiary p.a.  2,750,000
Chronic Benefit *R 2,750,000
Motor Vehicle Accident subject to MDB  2,750,000
Physiotherapy *R per beneficiary p.a.  250,000
Medicines to take home (TTO)  25,000
Radiology and Pathology  335,000
Specialised Radiology  1 ; Additional MRI/CT Scan 30% co-pay
Maxillofacial Surgery  2,550,000
Maternity (Delivery including postpartum & Neonatal Care) 7,150,000
Internal and external prosthesis  1,570,000
Medical Appliances  150,000
Psychiatric hospitalisations  10 DAYS P.A
Sub-Acute Care  Subject to Overall Annual Limit
Ambulance Services  250,000
Emergency Air/Cross-Border Evacuation & Foreign Referal Subject to Overall Annual Limit
Repatriation of Mortal Remains                                    1,000,000
Emergency Foreign cover  100,000
   
   
Out Patient Services  
Consultations Limit                                      120,000
Specialists Consultations on Referral 2 Visits
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 163,410
Pathology and Radiology (Subject to Procedures Limit) 145,000
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests Covered according to Malawi HIV Policy
Basic Dentistry 195,000
Specialised Dentistry and Orthodontics *P  250,000
Physiotherapy *R Subject to Auxiliary limit
Auxiliary Services *R 250,000
Acute Medicines 121,750
Optometry (Lens and Frame)- Every 2 years 120,000
Eye Test Subject to Optical Limit 1 Eye Test Every 24 months
Funeral Benefit 150,000
   
PREMIUMS  
MAIN Acturials to come-up with premiums  
ADULT
CHILD
   
KEY   
*E Enrolment Required 
*P Pre-Authorization Required 
*R Referral by GP or Specialist Required 
*D Donor not Covered 
   

 

 

 

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