Nationwide Medical Insurance Ghana Chronic Care

Nationwide Medical Insurance Ghana Chronic Care

Chronic Care

Area of Cover
Accra
Medical Consultation
GP ConsultationCovered within outpatients limits
Specialist ConsultationCovered within outpatients limits
DieticianNot Covered
Investigations
basic laboratory investigationsCovered within outpatients limits
advanced laboratory investigationCovered within outpatients limits
basic medical imaging [x-ray, ultrasound, ECG, endoscopy]Covered within outpatients limits
advanced medical imaging [MRI, CT, EEG, Echo] requested by specialists onlyNot Covered
Medicines and medical consumables
Prescribed medication for acute conditionsCovered within outpatients limits
Prescribed medication for chronic conditionsCovered up to GHC500 within outpatient limit
MultivitaminsNot covered
Infusions[in hospital use only]Covered within outpatients limits
Materials for dressing, sutures, bandages [in hospital use only]Covered within outpatients limits
Syringes, cathethers, giving sets, cannulae [in hospital use only]Covered within outpatients limits
Admission benefits
AccomodationGeneral ward not exceeding 65.00 per day, not to exceed 15 days per policy year
FeedingNot covered
Nursing care [in-hospital]Covered
Investigations inhospitalCovered within outpatients limits
Prescribed medicines inhopsitalCovered within outpatients limits
Prescribed medicines to take homeCovered within outpatients limits
Emergency benefit
Road ambulanceCovered
StabilizationCovered
Referral to higher level of careCovered
Maternity benefit
Antenatal consultationsCovered within outpatients limits
Obstetric ultrasoundsUp to 2 per pregnancy
Routine pregnancy medication [folic acid, iron, multivitamins, calcium]Covered up to GHC 20 per month within outpatient limit
Normal deliveryCovered up to GHC800
Assisted deliveryCovered up to GHC1,300
Caeserean sectionCovered up to GHC2,000
Postnatal consultationOnce
Complications arising out of childbirthCovered up to GHC500.00; pre-approval required
Newborn benefit
Cover period28 days
Neonatal conditions not congenital in nature for first 28 days of baby’s life, provided mother is a policy holderCovered up to GHC1000
Circumcision for male babies within the first 28 daysCovered up to GHC100
Surgery benefit
Theatre feesUp to GHC4,000 within inpatient limit in a policy year
Surgeons feeUp to GHC4,000 within inpatient limit in a policy year
ConsumablesUp to GHC4,000 within inpatient limit in a policy year
Recovery wardUp to GHC4,000 within inpatient limit in a policy year
Anaesthesia incl anaesthetist feesUp to GHC4,000 within inpatient limit in a policy year
Dental benefit
Basic dentistryCovered up to GHC400 within outpatient limit; preapproval required
Advanced dentistryCovered up to GHC400 within outpatient limit; preapproval required
OrthodonticsNot covered
Cancer benefit
Investigations for diagnosisNot covered
TreatmentNot covered
Eye care benefit
GP eye conditionsCovered within outpatients limits
Ophtalmologist consultationCovered within outpatients limits
Opthalmology conditionsCovered within outpatients limits
Eye surgeryCovered up to 1,000
Lens onlyUp to GHC150 once in 2 year
Frame onlyNot covered
Rehabilitation benefit
PhysiotherapyUp to 10 sessions per policy year with a maximum of GHC60.00 per session
ChiropracticNot covered
Mental health
Therapy sessionsNot covered
Herbal medicine benefit
Herbal consultation
Herbal medicines from CPMR, Mampong and herbal units of GHS facilitiesNot covered
Dialysis
Acute renal dialysisNot covered

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