PremiumCare Option

PremiumCare is an option plan for members who want more than assurance in their health coverage. The plan allows members to have peace of mind with 150 million kwacha in-patient limit. The plan is ideal for members who frequently travel or who wish to ensure that come what may, they will be covered for any medical emergency.

Overall Annual Limit 150,000,000
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)  18,750,000
Oncology  Subject to MDB per beneficiary p.a.  7,000,000
Organ Transplants *D Subject to MDB per beneficiary p.a.  6,500,000
Chronic Benefit *R 6,500,000
Motor Vehicle Accident subject to MDB  6,500,000
Physiotherapy *R per beneficiary p.a.  344,500
Medicines to take home (TTO)  32,500
Radiology and Pathology  370,000
Specialised Radiology  2  Additional MRI/CT Scan 
Maxillofacial Surgery  6,500,000
Maternity (Delivery including postpartum & Neonatal Care) 15,000,000
Internal and external prosthesis  4,200,000
Medical Appliances  200,000
Psychiatric hospitalisations  15 DAYS P.A 
Sub-Acute Care  Subject to Overall Annual Limit
Ambulance Services  350,000
Emergency Air/Cross-Border Evacuation & Foreign Referal Subject to Overall Annual Limit
Repatriation of Mortal Remains  1,500,000
Emergency Foreign cover  160,000
   
   
Out Patient Services  
Consultations Limit 200,000
Specialists Consultations on Referral 4 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 390,000
Pathology and Radiology (Subject to Procedures Limit) 350,000
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests Covered according to Malawi HIV Policy
Basic Dentistry 205,700
Specialised Dentistry and Orthodontics *P 341,000
Physiotherapy *R Subject to Auxiliary limit
Auxiliary Services *R 278,000
Acute Medicines 195,500
Optometry (Lens and Frame)- Every 2 years 180,000
Eye Test Subject to Optical Limit 1 Eye Test Every 24 months
Funeral Benefit 500,000
   
   
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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