Inpatient Benefits | MediCare (MWK) |
Inpatient (IP) Limit | 12,800,000 |
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) | 6,150,000 |
Oncology Subject to MDB per benefiary p.a. | 3,200,000 |
Organ Transplants *D Subject to MDB per beneficiary p.a. | 2,750,000 |
Chronic Dialysis Subject to MDB per beneficiary p.a. | 2,750,000 |
Motor Vehicle Accident Subject to MDB | 2,750,000 |
Physiotherapy *R per beneficiary p.a. | 234,000 |
Medicines to take home (TTO) | 25,000 |
Radiology and Pathology | 335,000 |
Specialised Radiology | One Additional MRI/CT Scan 30% co-pay |
Maxillofacial Surgery | 2,550,000 |
Maternity (Delivery including postpartum and neonatal care) | 8,000,000 |
Internal and external prosthesis | 570,000 |
Medical Appliances | 94,250 |
Psychiatric hospitalisations | 7 days p.a. |
Sub-Acute Care | Subject to overall IP Limit |
Ambulance Services | 200,000 |
Emergency Air/Cross-Border Evacuation and Foreign Referral | Subject to overall IP Limit |
Repatriation of Mortal Remains | 600,000 |
Emergency Foreign cover | 80,000 |
Outpatient Benefits | MediCare (MWK) |
Outpatient (OP) Limit | 376,220 |
Consultations Limit | 119,860 |
Specialist Consultations on Referral | 2 visits |
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 | 163,410 |
Pathology (Subject to Procedures Limit) | 72,500 |
Radiology (Subject to Procedures Limit) | 65,000 |
HIV / AIDS Benefit *E Anti-retroviral therapy Pathology Tests | Covered according to Malawi HIV Policy |
Basic Dentistry | 195,000 |
Specialised Dentistry and Orthodontics *P | 200,000 |
Physiotherapy *R | Subject to Auxiliary limit |
Auxiliary services *R | 200,000 |
Acute Medicines | 119,860 |
Chronic Medicines *E | 130,000 |
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 |
KEY
*E = Enrolment Required
*P = Pre-Authorisation Required
*R = Referral by GP or Specialist required
*D = Donor not covered