| Inpatient Benefits |
Care (MWK) |
| Inpatient (IP) Limit | 1,040,000 |
| Hospitalisation (General medical and surgical wards including Ward and Theatre medicines) | Subject to overall IP Limit |
| High Care and ICU | Subject to overall IP Limit |
| Specialists and General Practitioners | Subject to overall IP Limit |
| Theatre Costs | Subject to overall IP Limit |
| Blood Transfusion | Subject to overall IP Limit |
| Major Disease Benefit (MDB) | 500,000 |
| Oncology Subject to MDB per benefiary p.a. | 250,000 |
| Organ Transplants *D Subject to MDB per beneficiary p.a. | 250,000 |
| Chronic Dialysis Subject to MDB per beneficiary p.a. | 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 | One Additional MRI/CT Scan 30% co-pay |
| Maxillofacial Surgery | 250,000 |
| Maternity (Delivery including postpartum and neonatal care) | 260,000 |
| Internal and external prosthesis | 241,500 |
| Medical Appliances | 35,100 |
| Psychiatric hospitalisations | 7 days p.a. |
| Sub-Acute Care | 100,000 |
| Ambulance Services | 50,000 |
| Emergency Air/Cross-Border Evacuation and Foreign Referral | Not covered |
| Repatriation of Mortal Remains | Not covered |
| Emergency Foreign cover | Not covered |
| Outpatient Benefits |
Care (MWK) |
| Out Patient (OP) Limit | 89, 375 |
| Consultations Limit | 25,000 |
| Specialist Consultations on Referral | 1 Visit |
| Antenatal and Postnatal Benefit *E | Covered |
| Antenatal & postnatal Consultations | 4 Visits |
| Ultrasounds | 2 Scans |
| Pathology | 2 Full Blood Count; VDRL; Urinalysis; HIV-Ag Test |
| Procedures | 41,340 |
| Pathology (Subject to Procedures Limit) | 15,000 |
| Radiology (Subject to Procedures Limit) | 17,000 |
| HIV / AIDS Benefit *E Anti-retroviral therapy Pathology Tests | Covered according to Malawi HIV Policy |
| Basic Dentistry | 17,200 |
| Specialised Dentistry and Orthodontics *P | Not Covered |
| Physiotherapy *R | Not Covered |
| Auxiliary services *R | Not Covered |
| Acute Medicines | 30,000 |
| Chronic Medicines *E | 41,600 |
| 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 |
KEY
*E = Enrolment Required
*P = Pre-Authorisation Required
*R = Referral by GP or Specialist required
*D = Donor not covered
