MediCare is the option for members who want to be on the safe side both in finances and coverage, these members have access to cashless foreign referral, foreign cover, repatriation of remains and even a personal health assessment without having to dig dip into their pockets. Members under this option have access to a large service provider network.
Overall Annual Limit | 14,400,000 |
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) | 6,150,000 |
Oncology Subject to MDB per beneficiary p.a. | 3,200,000 |
Organ Transplants *D Subject to MDB per beneficiary p.a. | 2,750,000 |
Chronic Benefit *R | 2,750,000 |
Motor Vehicle Accident subject to MDB | 2,750,000 |
Physiotherapy *R per beneficiary p.a. | 250,000 |
Medicines to take home (TTO) | 25,000 |
Radiology and Pathology | 335,000 |
Specialised Radiology | 1 ; Additional MRI/CT Scan 30% co-pay |
Maxillofacial Surgery | 2,550,000 |
Maternity (Delivery including postpartum & Neonatal Care) | 7,150,000 |
Internal and external prosthesis | 1,570,000 |
Medical Appliances | 150,000 |
Psychiatric hospitalisations | 10 DAYS P.A |
Sub-Acute Care | Subject to Overall Annual Limit |
Ambulance Services | 250,000 |
Emergency Air/Cross-Border Evacuation & Foreign Referal | Subject to Overall Annual Limit |
Repatriation of Mortal Remains | 1,000,000 |
Emergency Foreign cover | 100,000 |
Out Patient Services | |
Consultations Limit | 120,000 |
Specialists Consultations on Referral | 2 Visits |
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 | 163,410 |
Pathology and Radiology (Subject to Procedures Limit) | 145,000 |
HIV/AIDS Benefit *E Anti-Retroviral Therapy and Pathology Tests | Covered according to Malawi HIV Policy |
Basic Dentistry | 195,000 |
Specialised Dentistry and Orthodontics *P | 250,000 |
Physiotherapy *R | Subject to Auxiliary limit |
Auxiliary Services *R | 250,000 |
Acute Medicines | 121,750 |
Optometry (Lens and Frame)- Every 2 years | 120,000 |
Eye Test Subject to Optical Limit | 1 Eye Test Every 24 months |
Funeral Benefit | 150,000 |
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 |