Care Option

Care option is ideal for members who rarely travel within the country, and are satisfied with their current health status. Members on this option generally want to have basic health insurance and nothing else. These members tend to be satisfied with a personal health assessment and primary health cover for themselves and their families. In addition, they have a preference to visit local health centres over general hospitals.

Overall Annual Limit 1,350,000
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)  600,000
Oncology  Subject to MDB per beneficiary p.a.  262,000
Organ Transplants *D Subject to MDB per beneficiary p.a.  262,000
Chronic Benefit *R 250,000
Motor Vehicle Accident subject to MDB  250,000
Physiotherapy *R per beneficiary p.a.  60,000
Medicines to take home (TTO)  22,750
Radiology and Pathology  61,100
Specialised Radiology  1 Additional MRI/CT Scan 30% co-pay
Maxillofacial Surgery  250,000
Maternity (Delivery including postpartum & Neonatal Care) 260,000
Internal and external prosthesis  241,500
Medical Appliances  35,100
Psychiatric hospitalisations  10 DAYS P.A
Sub-Acute Care  100,000
Ambulance Services  50,000 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                                          25,000
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                                          41,340
Pathology and Radiology (Subject to Procedures Limit)                                          33,700
Basic Dentistry                                          17,200
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests

Covered accordingly to Malawi HIV Policy

Specialised Dentistry and Orthodontics *P  Not Covered 
Physiotherapy *R Not Covered
Auxiliary Services *R Not Covered
Acute Medicines                                          30,000
Optometry (Lens and Frame)- Every 2 years                                          35,000
Eye Test Subject to Optical Limit 1 Eye Test Every 24 months
Funeral Benefit                                          60,000
   
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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