Care option is ideal for members who rarely travel within the country, and are satisfied with their current health status. Members on this option generally want to have basic health insurance and nothing else. These members tend to be satisfied with a personal health assessment and primary health cover for themselves and their families. In addition, they have a preference to visit local health centres over general hospitals.
Overall Annual Limit | 1,350,000 |
Hospitalisation (General medical and surgical wards including Ward and Theatre medicines) | Subject to Overall Annual Limit |
High Care and ICU | Subject to Overall Annual Limit |
Specialists and General Practitioners | Subject to Overall Annual Limit |
Theatre Costs | Subject to Overall Annual Limit |
Blood Transfusion | Subject to Overall Annual Limit |
Major Disease Benefit (MDB) | 600,000 |
Oncology Subject to MDB per beneficiary p.a. | 262,000 |
Organ Transplants *D Subject to MDB per beneficiary p.a. | 262,000 |
Chronic Benefit *R | 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 | 1 Additional MRI/CT Scan 30% co-pay |
Maxillofacial Surgery | 250,000 |
Maternity (Delivery including postpartum & Neonatal Care) | 260,000 |
Internal and external prosthesis | 241,500 |
Medical Appliances | 35,100 |
Psychiatric hospitalisations | 10 DAYS P.A |
Sub-Acute Care | 100,000 |
Ambulance Services | 50,000 per event |
Emergency Air/Cross-Border Evacuation & Foreign Referal | Not covered |
Repatriation of Mortal Remains | Not covered |
Emergency Foreign cover | Not covered |
Out Patient Services | |
Consultations Limit | 25,000 |
Specialists Consultations on Referral | 1 Visit |
Antenatal and Postnatal Benefit *E | Covered |
Antenatal and Postnatal Consultations | 8 Visits |
Antenatal Ultrasounds | 2 Scans |
Antenatal Pathology | Hepatitis B, Blood Group and RH, Blood Sugar, 2 Full Blood Count; VDRL; 4 Urinalysis; HIV-Ag Test |
Procedures | 41,340 |
Pathology and Radiology (Subject to Procedures Limit) | 33,700 |
Basic Dentistry | 17,200 |
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests |
Covered accordingly to Malawi HIV Policy |
Specialised Dentistry and Orthodontics *P | Not Covered |
Physiotherapy *R | Not Covered |
Auxiliary Services *R | Not Covered |
Acute Medicines | 30,000 |
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 |
PREMIUMS | |
MAIN | Acturials to come-up with premiums |
ADULT | |
CHILD | |
KEY | |
*E | Enrolment Required |
*P | Pre-Authorization Required |
*R | Referral by GP or Specialist Required |
*D | Donor not Covered |