As an individual, you want to have the kind of healthcare that is well-suited to your stage in life. Whether you are just starting out, mid-career or can afford the finer things in life, you want an affordable health plan that has been created just for you.
We offer a robust individual plans that meet your health care needs and suits your budget.
| ... | BENEFITS | BLUE PLAN | ORANGE PLAN | PURPLE PLAN | GREEN PLAN |
|---|---|---|---|---|---|
| PREMIUM | N34,800.00 - per annum | N74,000.00 - per annum | N114,000.00 - per annum | N198,000.00 - per annum | |
| 1 | PRIMARY OUT-PATIENT CARE | ||||
| Registration | Covered | Covered | Covered | Covered | |
| General consultation | Covered | Covered | Covered | Covered | |
| Specialist consultation (Paediatric, Internal medicine, Obstetrics & Gynaecology, General Surgery, Orthopaedic & ENT) | Covered (all) | Covered (all) | Covered (all) | Covered (all) | |
| Routine laboratory investigation | Covered | Covered | Covered | Covered | |
| Prescription and drugs | Covered | Covered | Covered | Covered | |
| Physiotherapy | Covered (max. 3 sessions per annum) | Covered (max. 5 sessions per annum) | Covered (max. 7 sessions per annum) | Covered (max. 10 sessions per annum) | |
| Orthothics for In & Out patients - For treatments related to injuries such as sprains or strains limited to musculoskeletal orthotics such as splints only. | Not Covered | Not Covered | Covered | Covered | |
| 2 | IN-PATIENT CARE | ||||
| General Physicians review | Covered | Covered | Covered | Covered | |
| Specialist review (As covered under Specialist Consultation) | Covered | Covered | Covered | Covered | |
| Admission | Standard Ward | Double Bedded Semi-Private Ward | Private Ward | Private Ward | |
| Feeding (provided by hospital) | Covered | Covered | Covered | Covered | |
| Nursing care | Covered | Covered | Covered | Covered | |
| Routine laboratory investigations | Covered | Covered | Covered | Covered | |
| Prescription, drugs and consumables | Covered (All primary line drugs covered. Systemic drugs for diabetics and Hypertension Generic drugs only subject to due authorization by LifeWORTH HMO) | Covered (All primary line drugs covered. Systemic drugs for diabetics and Hypertension Generic drugs only subject to due authorization by LifeWORTH HMO) | Covered (All primary line drugs covered. Systemic drugs for diabetics and Hypertension Generic drugs only subject to due authorization by LifeWORTH HMO) | Covered (All primary line drugs covered. Systemic drugs for diabetics and Hypertension Generic drugs only subject to due authorization by LifeWORTH HMO) | |
| Services of a dietician | Not Covered | Not Covered | Covered (2 visits per annum) | Covered (4 visits per annum) | |
| Intensive care unit (24 hours) | Covered (Stabilization Only) | Covered (Stabilization Only - 24hrs) | Maximum of 3 Days | Maximum of 7 Days | |
| 3 | RADIOLOGICAL & SPECIALIZED INVESTIGATIONS | ||||
| Plain x-rays for diagnosis. Upper limb e.g. hand/wrist, forearm, elbow, humerus, shoulder, clavicle. Lower limb e.g. foot/toes, joints, long bones, pelvis & hip. Thorax e.g. chest (AP/PA) - All views. Vertebral Spine e.g. cervical spine, lateral neck (soft tissue), thoracic spine, thoracic lumber spine, lumboscaral spine | Covered | Covered | Covered | Covered | |
| Ultrasound (abdominal & pelvic) | Covered | Covered | Covered | Covered | |
| Electrocardiogram (ECG), Exercise ECG (stress test), Echocardiography | Covered (ECG only) | Covered (ECG & Exercise ECG) | Covered (ECG, Exercise ECG & Echocardiography) | Covered (All) | |
| CT scan | Not Covered | Covered (only in life-threatening emergencies) | Covered | Covered | |
| MRI scan | Not Covered | Not Covered | Covered (only in life-threatening emergencies) | Covered | |
| Diagnostic procedures (endoscopy, colonoscopy et al) | Not Covered | Not Covered | Covered (only in life-threatening emergencies) | Covered | |
| EEG | Not Covered | Not Covered | Covered | Covered | |
| Marrow biopsy | Not Covered | Not covered | Covered | Covered | |
| Myelogram | Not Covered | Not Covered | Not Covered | Covered | |
| Laparoscopy investigation | Not Covered | Not Covered | Covered (only in life-threatening emergencies) | Covered | |
| Diagnostic x-ray (In & Out patient) | Covered | Covered | Covered | Covered | |
| Upper limb e.g. hand/wrist, forearm, elbow, humerus, shoulder, clavicle | Covered | Covered | Covered | Covered | |
| Lower limb e.g. foot/toes, joints, long bones, pelvis & hip | Covered | Covered | Covered | Covered | |
| Thorax e.g. chest (AP/PA) - All views | Covered | Covered | Covered | Covered | |
| Vertebral Spine e.g. cervical spine, lateral neck (soft tissue), thoracic spine, thoracic lumber spine, lumboscaral spine | Covered | Covered | Covered | Covered | |
| Hematology e.g. haemoglobin, PCV, platelets, FBC, Prothrombin time, reticulocyte count, ESR, RBC, WBC, DIFF, bleeding count, clotting time, malaria, microfilaria, HB genotype, Blood grouping, Pregnancy test (urine & Blood) | Covered | Covered | Covered | Covered | |
| Serology limited to preliminary HIV screening only | Covered | Covered | Covered | Covered | |
| Urine chemistry e.g. urinalysis, creatinine clearance | Covered (Urinalysis Only) | Covered (Urinalysis Only) | Covered | Covered | |
| Blood chemistry e.g. Glucose, Electrolytes, Urea, Creatinine, Uric acid, Albumin, Cholesterol, Triglyceride, HDL, LDL | Covered (all) | Covered (all) | Covered (all) | Covered (all) | |
| Hormone Assay e.g. Thyroid hormones | Not Covered | Not Covered | Covered | Covered | |
| Microbiology e.g. Urine microscopy, culture & sensitivity, Stool microscopy, culture & sensitivity, Stool occult blood, swab microscopy, culture & sensitivity, sputum microscopy, culture & sensitivity, sputum ZN Stain. | Covered | Covered | Covered | Covered | |
| 4 | MATERNITY SERVICES | ||||
| Antenatal care | Covered | Covered | Covered | Covered | |
| Normal delivery | Covered | Covered | Covered | Covered | |
| Induction of labor | Covered | Covered | Covered | Covered | |
| Assisted delivery | Covered | Covered | Covered | Covered | |
| Emergency/Clinically Indicated CS and treatment | Covered (Limit of N100,000.00 subject to recovery from client) | Covered (Limit of N200,000.00 subject to recovery from client) | Covered (Limit of N250,000.00 subject to recovery from client) | Covered (Limit of N350,000.00 subject to recovery from client) | |
| Elective C/S on Request | Not Covered | Not Covered | Not Covered | Covered (within covered limit) | |
| Post natal care for mums (Up to 6 weeks) | Covered | Covered | Covered | Covered | |
| Preterm delivery | Covered | Covered | Covered | Covered | |
| Elective C/S on Request | Not Covered | Not Covered | Not Covered | Covered | |
| Family Planning (IUCDs, Injectibles, Oral Contraceptives, Norplant) | Covered (Oral Contraceptives only) | Covered (IUCD & Oral Contraceptives) | Covered (All) | Covered (All) | |
| 5 | CHILD CARE AND PEDIATRIC SERVICES | ||||
| Post natal primary care for new born | Covered (within 6 weeks if covered on family plan) | Covered (within 6 weeks if covered on family plan) | Covered (within 6 weeks if covered on family plan) | Covered (within 6 weeks if covered on family plan) | |
| Emergency care for new born limited to resuscitation | Covered | Covered | Covered | Covered | |
| Routine immunizations (NPI) OPV, DPT, BCG, measles, Vit A, pentavalent, HBV, Yellow fever | Covered | Covered | Covered | Covered | |
| Other immunizations (Non-NPI)-, rotavirus, chicken pox, MMR, Pneumococal | Not Covered | Not Covered | Rotavirus & Peumococcal Only | Covered | |
| General consultation | Covered | Covered | Covered | Covered | |
| Pediatric consultation | Covered | Covered | Covered | Covered | |
| Child care counseling | Covered | Covered | Covered | Covered | |
| Incubator care | Not Covered | Covered for the first 3 days of life only. | Covered for the first 5 days of life only. | Covered for the first 7 days of life only. | |
| Exchange blood transfusion | Not Covered | Covered | Covered | Covered | |
| Phototherapy | Covered as with incubator care limits | Covered as with incubator care limits | Covered as with incubator care limits | Covered as with incubator care limits | |
| Meningococcal meningitis | Not covered | Not covered | Not Covered | Covered | |
| Well child evaluation/child health supervision services (until age 12) | Covered | Covered | Covered | Covered | |
| 6 | DENTAL CARE | ||||
| Routine examination | Covered | Covered | Covered | Covered | |
| Pain relief/therapy | Covered | Covered | Covered | Covered | |
| Amalgam/ Composite fillings | Covered up to Limit of N7,500 | Covered up to Limit of N10,000 | Covered up to Limit of N15,000 | Covered up to Limit of N25,000 | |
| Scaling & polishing (annual) | Covered (1 session only per annum) | Covered (1 session only per annum) | Covered (2 session only per annum) | Covered (2 session only per annum) | |
| Simple extraction | Covered up to Limit of N7,500 | Covered up to Limit of N10,000 | Covered up to Limit of N15,000 | Covered up to Limit of N25,000 | |
| Surgical extraction/ Root canal therapy | Not Covered | Covered up to Limit of N10,000 | Covered up to Limit of N20,000 | Covered up to Limit of N30,000 | |
| Dental preventive care | Covered | Covered | Covered | Covered | |
| 7 | EYE CARE | ||||
| Optical consultation | Covered | Covered | Covered | Covered | |
| Routine examination | Covered | Covered | Covered | Covered | |
| Treatment of simple/primary infection (e.g. conjunctivitis) | Covered | Covered | Covered | Covered | |
| Optical lenses only (per year) | Covered to the limit of N10,000.00 per person per annum. | Covered to the limit of N15,000.00 per person per annum. | Covered to the limit of N25,000.00 per person per annum. | Covered to the limit of N30,000.00 per person per annum. | |
| Foreign body removal | Covered | Covered | Covered | Covered | |
| Eye simple surgeries | Not covered | Covered (Pterygiun excision only) | Covered (Pterygiun excision only) | Covered (Pterygiun excision only) | |
| Contact lens | Not covered | Not covered | Covered (up to lens limits) | Covered (up to lens limits) | |
| Refraction | Covered | Covered | Covered | Covered | |
| Glaucoma treatment and drugs | Not covered | Not covered | Covered | Covered | |
| Glaucoma checking | Not Covered | Not Covered | Covered | Covered | |
| 8 | SURGERIES | Global Limits of up to N150,000 per annum for Minor and Intermediate Surgeries | Global Limits of up to N200,000 per annum for Minor, Intermediate and Major Surgeries | Global Limits of up to N250,000 per annum for Minor, Intermediate and Major Surgeries | Global Limits of up to N350,000 per annum for Minor, Intermediate and Major Surgeries |
| MINOR SURGERIES AND PROCEDURES | |||||
| Surgical drainage of simple abscesses | ✔ | ✔ | ✔ | ✔ | |
| Surgical drainage of breast abscesses | ✔ | ✔ | ✔ | ✔ | |
| Surgical drainage of galactocele | ✔ | ✔ | ✔ | ✔ | |
| Sub-periosteal drainage for acute osteomylitis | ✔ | ✔ | ✔ | ✔ | |
| Drainage for septric arthritis | ✔ | ✔ | ✔ | ✔ | |
| Intercostal drainage insertion | ✔ | ✔ | ✔ | ✔ | |
| Aspiration of joints | ✔ | ✔ | ✔ | ✔ | |
| Debridement of wounds | ✔ | ✔ | ✔ | ✔ | |
| Surgical repair of wounds | ✔ | ✔ | ✔ | ✔ | |
| Biopsy of breast lump | ✔ | ✔ | ✔ | ✔ | |
| Biopsy of tumor on abdominal wall | ✔ | ✔ | ✔ | ✔ | |
| Biopsy of bone marrow | ✔ | ✔ | ✔ | ✔ | |
| Excision of tumor on abdominal wall | ✔ | ✔ | ✔ | ✔ | |
| Proctoscopy | ✔ | ✔ | ✔ | ✔ | |
| Evacuation of impacted feaces | ✔ | ✔ | ✔ | ✔ | |
| Closed reduction of fractures | ✔ | ✔ | ✔ | ✔ | |
| Closed reduction and immobilization of joint dislocations | ✔ | ✔ | ✔ | ✔ | |
| Exostectomy | ✔ | ✔ | ✔ | ✔ | |
| Chondromectomy | ✔ | ✔ | ✔ | ✔ | |
| Ganglionectomy | ✔ | ✔ | ✔ | ✔ | |
| Temporary diversion of urine | ✔ | ✔ | ✔ | ✔ | |
| Circumcision | ✔ | ✔ | ✔ | ✔ | |
| Electro fulguration of condylomata acuminata | ✔ | ✔ | ✔ | ✔ | |
| Suprapubic cystostomy | ✔ | ✔ | ✔ | ✔ | |
| Vasectomy | ✔ | ✔ | ✔ | ✔ | |
| Venous obstruction-saphenous by pass | ✔ | ✔ | ✔ | ✔ | |
| 9 | INTERMEDIATE SURGERIES & PROCEDURES | ||||
| Tracheotomy | ✔ | ✔ | ✔ | ✔ | |
| Thoractomy | ✔ | ✔ | ✔ | ✔ | |
| Adenolectomy | ✔ | ✔ | ✔ | ✔ | |
| Tonsillectomy for children (less than 12 years) | ✔ | ✔ | ✔ | ✔ | |
| Injection sclerotherapy of varicose veins | ✔ | ✔ | ✔ | ✔ | |
| Excision-biopsy of breast mass | ✔ | ✔ | ✔ | ✔ | |
| Biopsy of thyriod gland | ✔ | ✔ | ✔ | ✔ | |
| Surgical drainage of hamatoma of rectus abdominus | ✔ | ✔ | ✔ | ✔ | |
| Surgical drainage of peritoneal abscesses | ✔ | ✔ | ✔ | ✔ | |
| Repair of colostomy | ✔ | ✔ | ✔ | ✔ | |
| Anal sphincteroplasty | ✔ | ✔ | ✔ | ✔ | |
| Excision-ligation hemorrhoidectomy | ✔ | ✔ | ✔ | ✔ | |
| Surgical excision of soft tissue tumor | ✔ | ✔ | ✔ | ✔ | |
| Excision-biopsy of soft tissue tumor | ✔ | ✔ | ✔ | ✔ | |
| Surgical drainage of hand abscesses | ✔ | ✔ | ✔ | ✔ | |
| Herniorrhaphy (inguinal, ventral & femoral) | ✔ | ✔ | ✔ | ✔ | |
| Uncomplicated Appendectomy Only | ✔ | ✔ | ✔ | ✔ | |
| 10 | MAJOR SURGERIES & PROCEDURES | ||||
| Hysterectomy | Not Covered | ✔ | ✔ | ✔ | |
| Myomectomy | Not Covered | ✔ | ✔ | ✔ | |
| Prostatectomy | Not Covered | ✔ | ✔ | ✔ | |
| Other Major complex surgeries (requiring implants) | Not Covered | ✔ | ✔ | ✔ | |
| 11 | CHRONIC AILMENT CARE MANAGEMENT SPECIALIST | ||||
| Hypertension | Covered | Covered | Covered | Covered | |
| Diabetes | Covered | Covered | Covered | Covered | |
| Asthma | Covered | Covered | Covered | Covered | |
| Peptic ulcer | Covered | Covered | Covered | Covered | |
| Angina/myocardial infarction | Not Covered | Not Covered | Not Covered | Covered | |
| Sickle cell disease | Covered to a limit of 2 pints of blood per annum where transfusion is required) | Covered to a limit of 3 pints of blood per annum where transfusion is required) | Covered to a limit of 4 pints of blood per annum where transfusion is required) | Covered to a limit of 5 pints of blood per annum where transfusion is required) | |
| Tuberculosis (Counselling and primary investigation only) | Covered | Covered | Covered | Covered | |
| Tuberculosis Treatment | Not Covered | Not Covered | Not Covered | Not Covered | |
| Arthritis | Covered | Covered | Covered | Covered | |
| Epilepsy | Not Covered | Not Covered | Not Covered | Covered | |
| Benign prostrate hyperplasia | Not Covered | Covered | Covered | Covered | |
| Hyperlipidemia | Not Covered | Covered | Covered | Covered | |
| Psychosis (depression) | Covered | Covered | Covered | Covered | |
| Acute renal dialysis (emergencies only) | Not Covered | Not Covered | Covered to a limit of 2 sessions per annum | Covered to a limit of 3 sessions per annum | |
| 12 | HIV/AIDS MANAGEMENT (NACA PROGRAMME) | ||||
| Counseling | Covered | Covered | Covered | Covered | |
| Screening | Covered but limited to primary investigations only | Covered but limited to primary investigations only | Covered but limited to primary investigations only | Covered but limited to primary investigations only | |
| Treatment ; Referral ONLY (at designated Governement health Centres) | Covered | Covered | Covered | Covered | |
| 13 | ANNUAL MEDICAL CHECK UP | ||||
| Routine clinic examinations (with no lab investigations), height, weight, BMI, blood pressure, other vitals (Principals only) | Covered | Covered | Covered | Covered | |
| Routine clinic examinations (with lab investigations), urinalysis, blood sugar, HB/PCV, pap smear, PSA (Principals only) | Not Covered | Not Covered | Covered | Covered | |
| 14 | ACCIDENTS AND EMERGENCIES | ||||
| Stabilization | Covered | Covered | Covered | Covered | |
| Emergency drugs and investigation | Covered | Covered | Covered | Covered | |
| Ambulance Evacuation (Locally from Hospital to Hospital and/or site of injury to Hospital only) | Covered | Covered | Covered | Covered | |
| 15 | WELLNESS AND FITNESS | ||||
| Counseling | Covered | Covered | Covered | Covered | |
| Consultation | Covered | Covered | Covered | Covered | |
| Quarterly health education talks and programme with health check | Covered | Covered | Covered | Covered | |
| 16 | ACCESS TO 24 HOUR HELP LINE | Covered | Covered | Covered | Covered |
| 17 | Behavioral Health Services | ||||
| Psychological testing | Covered | Covered | Covered | Covered | |
| Family counseling - counseling with family members to aid diagnosis and treatment | Covered | Covered | Covered | Covered | |
| Outpatient psychiatric care services | Covered (1 week) | Covered (2 weeks) | Covered (3 weeks) | Covered (5 weeks) | |
| Psychiatric care drugs | Covered (1 week) | Covered (2 weeks) | Covered (3 weeks) | Covered (5 weeks) | |
| Psychosis (depression) | Covered (1 week) | Covered (2 weeks) | Covered (3 weeks) | Covered (5 weeks) | |
| 18 | Cancer Treatment (Radiotherapy, Chemotherapy) | ||||
| Counseling/First Consultation | Covered | Covered | Covered | Covered | |
| preliminary diagnosis | Not covered | Not covered | Covered | Covered | |
| Supply of prescription drugs for supportive management and chemotherapy | Not covered | Not covered | Not covered | Not covered | |
| Inpatient hospital services for the following: Inpatient care following a mastectomy, Inpatient care following a lymph node dissection for the treatment of breast cancer | Not covered | Not covered | Not covered | Not covered |
Please note that Individual Policy Holders are not entitled to ANC (Antenatal care) and Maternity care.
