Nationwide Medical Insurance Ghana Family Care
Family Care
| Area of Cover | |
|---|---|
| Accra | |
| Medical Consultation | |
|---|---|
| GP Consultation | Covered within outpatients limits |
| Specialist Consultation | Covered within outpatients limits |
| Dietician | Covered within outpatients limits |
| Investigations | |
|---|---|
| basic laboratory investigations | Covered within outpatients limits |
| advanced laboratory investigation | Covered 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 only | Covered up to 2 images in a policy year; preapproval required |
| Medicines and medical consumables | |
|---|---|
| Prescribed medication for acute conditions | Covered within outpatients limits |
| Prescribed medication for chronic conditions | Covered up to GHC1,200 within outpatient limit |
| Multivitamins | Covered up to GHC15.00 per prescription and not to exceed one prescription per month |
| 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 | |
|---|---|
| Accomodation | General ward not exceeding 65.00 per day, not to exceed 15 days per policy year |
| Feeding | Not covered |
| Nursing care [in-hospital] | Covered |
| Investigations inhospital | Covered within outpatients limits |
| Prescribed medicines inhopsital | Covered within outpatients limits |
| Prescribed medicines to take home | Covered within outpatients limits |
| Emergency benefit | |
|---|---|
| Road ambulance | Covered |
| Stabilization | Covered |
| Referral to higher level of care | Covered |
| Maternity benefit | |
|---|---|
| Antenatal consultations | Covered within outpatients limits |
| Obstetric ultrasounds | Up to 2 per pregnancy |
| Routine pregnancy medication [folic acid, iron, multivitamins, calcium] | Covered up to GHC 20 per month within outpatient limit |
| Normal delivery | Covered up to GHC800 |
| Assisted delivery | Covered up to GHC1,300 |
| Caeserean section | Covered up to GHC2,000 |
| Postnatal consultation | Once |
| Complications arising out of childbirth | Covered up to GHC500.00; pre-approval required |
| Newborn benefit | |
|---|---|
| Cover period | 28 days |
| Neonatal conditions not congenital in nature for first 28 days of baby’s life, provided mother is a policy holder | Covered up to GHC1000 |
| Circumcision for male babies within the first 28 days | Covered up to GHC100 |
| Surgery benefit | |
|---|---|
| Theatre fees | Up to GHC4,000 within inpatient limit in a policy year |
| Surgeons fee | Up to GHC4,000 within inpatient limit in a policy year |
| Consumables | Up to GHC4,000 within inpatient limit in a policy year |
| Recovery ward | Up to GHC4,000 within inpatient limit in a policy year |
| Anaesthesia incl anaesthetist fees | Up to GHC4,000 within inpatient limit in a policy year |
| Dental benefit | |
|---|---|
| Basic dentistry | Covered up to GHC400 within outpatient limit; preapproval required |
| Advanced dentistry | Covered up to GHC400 within outpatient limit; preapproval required |
| Orthodontics | Not covered |
| Cancer benefit | |
|---|---|
| Investigations for diagnosis | Not covered |
| Treatment | Not covered |
| Eye care benefit | |
|---|---|
| GP eye conditions | Covered within outpatients limits |
| Ophtalmologist consultation | Covered within outpatients limits |
| Opthalmology conditions | Covered within outpatients limits |
| Eye surgery | Covered up to 1,000 |
| Lens only | Up to GHC150 once in 2 year |
| Frame only | Not covered |
| Rehabilitation benefit | |
|---|---|
| Physiotherapy | Up to 10 sessions per policy year with a maximum of GHC60.00 per session |
| Chiropractic | Not covered |
| Mental health | |
|---|---|
| Therapy sessions | Not covered |
| Herbal medicine benefit | |
|---|---|
| Herbal consultation | |
| Herbal medicines from CPMR, Mampong and herbal units of GHS facilities | Not covered |
| Dialysis | |
| Acute renal dialysis | Not covered |
See Also
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About Nationwide Medical Insurance Ghana
Nationwide Medical Insurance Ghana Claims
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