No | Plans | Gold2 | Gold3 | Gold4 | HMO 15% Basic Earnings |
---|---|---|---|---|---|
1 | BASIC SERVICES | ||||
A. | Health Education | ✔ | ✔ | ✔ | |
B. | Health Profiling | ✔ | ✔ | ✔ | |
C. | Immunization (NPI) | ✔ | ✔ | ✔ | |
D. | Family Planning Program | ✔ | ✔ | ✔ | |
2 | BASIC CLINIC CARE | ||||
A. | Outpatient | ✔ | ✔ | ✔ | |
B. | Provision of prescribed drugs | ✔ | ✔ | ✔ | 10% Co Payment |
C. | Wound Dressing | ✔ | ✔ | ✔ | |
D. | Specialist Consultation | ✔ | ✔ | ✔ | |
D. | Emergency Treatment | ✔ | ✔ | ✔ | |
D. | Accident and injuries | ✔ | ✔ | ✔ | |
3 | ADMISSIONS | ||||
A. | General Ward | ✔ | ✔ | ✔ | |
B. | Semi-Private Ward | ✔ | ✔ | ✔ | |
C. | Private Ward | ✕ | ✔ | ✔ | |
D. | Meals | ✕ | ✔ | ✔ | |
4 | SURGERIES | ||||
A. | Minor | ✔ | ✔ | ✔ | |
B. | Major | | | | |
C. | Blood Transfusion | | | | |
5 | DENTAL CARE | ||||
A. | Amalgam filling | ✕ | ✕ | ✕ | |
B. | Simple Extraction | ✕ | ✕ | ✕ | |
C. | Scaling and Polishing | ✔ | ✔ | ✔ | |
6 | OPTICAL CARE | ||||
A. | Eye test/Recommendation | ✔ | ✔ | ✔ | |
B. | Provision of eye Glasses | ✕ | ✕ | ✕ | |
C. | Eye Surgeries | ✔ | ✔ | ✔ | 50% Co- Payment |
7 | PARENTAL CARE | ||||
A. | Antenatal | ✔ | ✔ | ✔ | |
B. | Delivery(Normal) | ✔ | ✔ | ✔ | |
C. | Delivery(Assisted) | ✔ | ✔ | ✔ | |
D. | Caesarian Section | ✔ | ✔ | ✔ | 30% Co- Payment |
E. | Circumcision | ✔ | ✔ | ✔ | |
8 | INVESTIGATION | ||||
A. | Basic Diagnostic Lab test | ✔ | ✔ | ✔ | |
B. | Routine X-rays of the Chest/Limbs | ✔ | ✔ | ✔ | |
C. | Contrast Radiological Procedures | ✔ | ✔ | ✔ | |
D. | CT Scan ( Partial Coverage) | ✔ | ✔ | ✔ | |
E. | MRI Scan (Partial Coverage) | ✔ | ✔ | ✔ | |
9 | ADVANCED IMMUNIZATION | ||||
A. | Hepatitis B | ✔ | ✔ | ✔ | |
B. | TB | ✔ | ✔ | ✔ | |
C. | MMR | ✔ | ✔ | ✔ | |
D. | Pneumococcal | ✔ | ✔ | ✔ | |
E. | Cerebrospinal Meningitis | ✔ | ✔ | ✔ | |
10 | INTENSIVE CARE | ✔ | ✔ | ✔ | |
11 | REHABILITATION | ✔ | ✔ | ✔ | |
12 | DAILYSIS | ✕ | ✔ | ✔ | 3 Times Yearly |
13 | ECG | ✔ | ✔ | ✔ | |
14 | Ear Nose and Throat( ENT) | ✕ | ✔ | ✔ | |
15 | ANNUAL MEDICAL CHECK UP | ✕ | ✔ | ✔ | Unrelated to illness. |
16 | CANCER CARE | ||||
A. | Diagnosis | ✕ | ✕ | ✔ | |
B. | Breast Cervical and Prostate | ✕ | ✕ | ✔ | |
17 | HIV/AIDS MANAGEMENT | ||||
A. | Voluntary Counseling /Testing | ✕ | ✔ | ✔ | |
B. | Treatment of Opportunistic Infections | ✕ | ✔ | ✔ | |
C. | Anti- retroviral treatment | ✕ | ✕ | ✔ | |
✕- Non Coverage
✔- Coverage