PremiumCare Option

Inpatient Benefits PremiumCare (MWK)
Inpatient (IP) Limit 150,000,000
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) 18,750,000
Oncology Subject to MDB per benefiary p.a. 7,000,000
Organ Transplants *D Subject to MDB per beneficiary p.a. 6,500,000
Chronic Dialysis Subject to MDB per beneficiary p.a. 6,500,000
Motor Vehicle Accident Subject to MDB 6,500,000
Physiotherapy *R per beneficiary p.a. 344,500
Medicines to take home (TTO) 32,500
Radiology and Pathology 370,000
Specialised Radiology Two Additional MRI/CT Scan 20% co-pay
Maxillofacial Surgery 6 ,500 ,000
Maternity (Delivery including postpartum and neonatal care) 20,000,000
Internal and external prosthesis 1,100,000
Medical Appliances 100,000
Psychiatric hospitalisations 7 days p.a.
Sub-Acute Care Subject to overall IP Limit
Ambulance Services 300,000
Emergency Air/Cross-Border Evacuation and Foreign Referral Subject to IP limit
Repatriation of Mortal Remains 1,500,000
Emergency Foreign cover 160,000

 

Outpatient Benefits PremiumCare (MWK)
Outpatient (OP) Limit 700,960
Consultations Limit 199,550
Specialist Consultations on Referral 3 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 390,000
Pathology (Subject to Procedures Limit) 178,750
Radiology (Subject to Procedures Limit) 149,500
HIV / AIDS Benefit *E Anti-retroviral therapy Pathology Tests Covered according to Malawi HIV Policy
Basic Dentistry 195,000
Specialised Dentistry and Orthodontics *P 255,000
Physiotherapy *R Subject to Auxiliary limit
Auxiliary services *R 220,000
Acute Medicines 195,500
Chronic Medicines *E 208,000
Optometry (Lens and Frame) - Every 2 years 169,000
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

 

 

 

 

 

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