Alleanza Health Schemes
SME/Cooperatives Plans
Your members/employees are your greatest investment. And medical coverage is a critical factor in retaining and recruiting members/employees for your business, as well as maintaining productivity and members/employee satisfaction. Our health insurance plans help you save money on health care costs and keep your members/employees informed and healthier. And having healthier members/employees means a healthier bottom line for you.
Plans Benefits Coverage
| BENEFIT | Standard Mini | Standard Medium | Standard Elite |
|---|---|---|---|
| HOSPITAL CATEGORY | Band D | BAND D | BAND D |
| OUTPATIENT LIMITS (N) | Covered up to Overall Limit | Covered up to Overall Limit | Covered up to Overall Limit |
| General Consultations | General Consult Covered to the limit of 12 visits (1 visit per month) /Per Policy Year. | Covered. | Covered |
| Specialist Consultations | Limited to Once in a quarter (3 months) visit. (Specialist care limited to only Physician, Gyneacologist, General Surgeon & Peadiatrician) | Limited to Once in a quarter (3 months) visit. (Specialist care limited to only Physician, Gyneacologist, General Surgeon & Peadiatrician) | Covered. (Specialist care limited to only Physician, Gyneacologist, General Surgeon & Peadiatrician) |
| Telemedicine + Psychologist Consultation (Employee Assistance Program) | Unlimited 24/7 | Unlimited 24/7 | Unlimited 24/7 |
| Medication (Drug Prescription) including Chronic Disease drug refill, Outpatients Prescriptions, Inpatients Medications) | Covered to the limit of N60,000/Per Policy Year | Covered to the limit of N80,000/Per Policy Year | Covered to the limit of N100,000/Per Policy Year |
| Laboratory Investigations (Both Outpatient & Inpatient Care) - Routine Haematology, Microbiology , Serology , Endocrine , Histology and Clinical Chemistry . | Basic Routine Investigations Covered to the limit of N25,000/Per Policy Year | Covered for Basic Routine Investigations only. | Covered |
| Routine Radiology Investigations (Subject To Alleanza Health Approval ) | Basic Routine Investigations only. Limit of N25,000/Per Policy Year | Basic Routine Investigations only. | Covered. (Mammogram not covered ). |
| Advanced & Complex Investigations(limited To ECG, CT Scan, MRI Scan and echocardiograph) | Not Covered | Covered for Life Threatening Emergency (Once) Only. ECHO & MRI not covered. | Covered for Life Threatening Emergency (Once) Only. ECHO & MRI not covered. |
| Inpatients Limit (N) | Covered up to Overall Limit | Covered up to Overall Limit | Covered up to Overall Limit |
| Accidents & Emergencies (resuscitative or lifesaving initial treatment only) | Covered up to Surgical Limit | Covered up to Surgical Limit | Covered up to Surgical Limit |
| Hospitalization (Accommodation & Feeding) | Standard Room (Accomodation Only). Covered to the limit of Cumulative 20days Per Policy Year | Standard Room (Accomodation Only). Covered to the limit of Cumulative 20days Per Policy Year | Standard Room. Cumulative 30days |
| Inpatient Medication | Covered up to Drug Prescription Limit | Covered up to Drug Prescription Limit | Covered up to Drug Prescription Limit |
| Surgical Procedures Including Minor, Intermediate And Major Surgeries . | Covered up to Surgical Limit of N150,000.00 (Limited to Listed Surgeries that are Covered). | Covered up to Surgical Limit of N200,000.00 (Limited to Listed Surgeries that are Covered). | Covered up to Surgical Limit of N300,000.00 (Limited to Listed Surgeries that are Covered). |
| Maternity / ANC/Delivery Antenatal Care + Normal Delivery+ Postnatal Care (6 Weeks)+Neonatal Care Services (Male circumcision, Ear piercing) | Covered up to Surgical Limit. | Covered up to Surgical Limit. | Covered up to Surgical Limit. |
| Primary Immunizations (Based on NPI Scheme) BCG, Measles, DPT, Oral polio, IPV, Vitamin A | Covered. | Covered. | Covered. |
| Secondary Immunizations Additional Immunizations for 0-5 years | Not Covered | Tetanus Toxoid, Anti-Rabies, Anti- Snake only. | Tetanus Toxoid, Anti-Rabies, Anti- Snake, HIB only. |
| Ambulance and Evacuations Services. (Hospital to Hospital) (Home to Hospital & Road Side to Hospital) | Ambulance (Hospital-to-Hospital transfer) (For Immobile Enrollees Only) | Ambulance (Hospital-to-Hospital transfer) (For Immobile Enrollees Only) | Ambulance (Hospital-to-Hospital transfer )(For Immobile Enrollees Only) |
| Physiotherapy | Covered to the limit of N15,000/Per Policy Year | Covered to the limit of N25,000/Per Policy Year | Covered to the limit of N50,000/Per Policy Year |
| Mental Health - Consultation and out-patients Services. In-patient care not covered | Not Covered | Limited to 4 Visits/Year. | Limited to 6 Visits/Year. |
| Dental Care Including Consultations, Investigations, Prescriptions And Procedures . (See excluded Surgeries/Procedures). Scaling & Polishing (limit of 2 times yearly) | Covered to the limit of N15,000/Per Policy Year. | Covered to the limit of N25,000/Per Policy Year. | Covered to the limit of N50,000/Per Policy Year. |
| Ophthalmology/Optical Care Including Consultations , Investigations, Prescriptions And Procedures . | Covered to the limit of N10,000/Per Policy Year. | Covered to the limit of N25,000/Per Policy Year | Covered to the limit of N50,000/Per Policy Year |
| Lenses /Contact Lenses/Frames (Either Unifocal, Bifocal Or Varifocal Lenses With A Limit Of Once Every 2 Years) | Not Covered | Covered (Principal only with a Limit of N5,000) | Covered (Principal only with a Limit of N5,000) |
| Family Planning Services | Not Covered | IUCD and Oral Contraceptives only | IUCD and Oral Contraceptives only |
| HIV /AIDS Care & Treatment | Managed at Government approved Facilities Only | Managed at Government approved Facilities Only | Managed at Government approved Facilities Only |
| Infertility Services (Microsurgery , Insemination and Embryo transfer procedures not covered). | Not Covered | Not Covered | Not Covered |
| Acute Kidney Failure Including Diagnosis , Treatment And Dialysis | Not Covered | Not Covered | Covered up to surgery limit. Emergency Renal Dialysis for Max 3 sessions . |
| Chronic Kidney Failure Including Diagnosis , Treatment And Dialysis | Not Covered | Not Covered | Not Covered |
| Cancer (Consultation And Diagnosis Only) | Not Covered | Not Covered | Covered up to surgery limit |
| Surgical And Medical, Peadiatric And Gyneacological Services /Procedures | Covered up to Surgical Limit (Limited to Listed Surgeries that are Covered). | Covered up to surgery limit | Covered up to surgery limit |
| ENT Care And Surgeries | Covered up to Surgical Limit (Limited to Listed Surgeries that are Covered). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). |
| Orthopaedics Surgeries | Covered up to Surgical Limit (Limited to Listed Surgeries that are Covered). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). |
| Gyneacological Procedures / Surgeries including Ceaserean Section | Covered up to Surgical Limit (Limited to Listed Surgeries that are Covered). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). | Covered up to surgery limit. (See excluded Surgeries /Procedures ). |
| Health screening at Designated Centres (For principals and Spouses) | Not Covered | Physical examination, BMI, Urinalysis, blood pressure, blood sugar, Genotype. | Physical examination, BMI, Urinalysis, blood pressure, blood sugar, Genotype. |
| Mortuary Services up to N250,000 /Principal | Not Covered | Not Covered | Covered |
You can view the general exclusions for Alleanza Health Plans Here