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