Inpatient Benefits |
Care (MWK) |
Inpatient (IP) Limit | 1,040,000 |
Hospitalisation (General medical and surgical wards including Ward and Theatre medicines) | Subject to overall IP Limit |
High Care and ICU | Subject to overall IP Limit |
Specialists and General Practitioners | Subject to overall IP Limit |
Theatre Costs | Subject to overall IP Limit |
Blood Transfusion | Subject to overall IP Limit |
Major Disease Benefit (MDB) | 500,000 |
Oncology Subject to MDB per benefiary p.a. | 250,000 |
Organ Transplants *D Subject to MDB per beneficiary p.a. | 250,000 |
Chronic Dialysis Subject to MDB per beneficiary p.a. | 250,000 |
Motor Vehicle Accident Subject to MDB | 250,000 |
Physiotherapy *R per beneficiary p.a. | 60,000 |
Medicines to take home (TTO) | 22,750 |
Radiology and Pathology | 61,100 |
Specialised Radiology | One Additional MRI/CT Scan 30% co-pay |
Maxillofacial Surgery | 250,000 |
Maternity (Delivery including postpartum and neonatal care) | 260,000 |
Internal and external prosthesis | 241,500 |
Medical Appliances | 35,100 |
Psychiatric hospitalisations | 7 days p.a. |
Sub-Acute Care | 100,000 |
Ambulance Services | 50,000 |
Emergency Air/Cross-Border Evacuation and Foreign Referral | Not covered |
Repatriation of Mortal Remains | Not covered |
Emergency Foreign cover | Not covered |
Outpatient Benefits |
Care (MWK) |
Out Patient (OP) Limit | 89, 375 |
Consultations Limit | 25,000 |
Specialist Consultations on Referral | 1 Visit |
Antenatal and Postnatal Benefit *E | Covered |
Antenatal & postnatal Consultations | 4 Visits |
Ultrasounds | 2 Scans |
Pathology | 2 Full Blood Count; VDRL; Urinalysis; HIV-Ag Test |
Procedures | 41,340 |
Pathology (Subject to Procedures Limit) | 15,000 |
Radiology (Subject to Procedures Limit) | 17,000 |
HIV / AIDS Benefit *E Anti-retroviral therapy Pathology Tests | Covered according to Malawi HIV Policy |
Basic Dentistry | 17,200 |
Specialised Dentistry and Orthodontics *P | Not Covered |
Physiotherapy *R | Not Covered |
Auxiliary services *R | Not Covered |
Acute Medicines | 30,000 |
Chronic Medicines *E | 41,600 |
Optometry (Lens and Frame) - Every 2 years | 35,000 |
Eye Test Subject to Optical Limit | 1 Eye Test Every 24 months |
Funeral Benefit | 60,000 |
KEY
*E = Enrolment Required
*P = Pre-Authorisation Required
*R = Referral by GP or Specialist required
*D = Donor not covered