COVERED SERVICES
The scope of services covered by HyPrestige Plan includes:

A. OUT-PATIENT AND SPECIALIST CONSULTATIONS

1. Registration
2. Consultations with general practice doctors
3. Consultations with specialists on referral by a general practitioner
4. Non-specialist and specialist diagnosis of medical and surgical
5. conditions
6. Accident & emergency room services:
7. Patient is stabilised in the event of life threatening emergencies before definitive care
8. Supply of prescribed drugs and medications
9. Routine Immunisations. All immunisations listed as followed are covered:
10. BCG, Measles, DPT, Oral Polio, Vitamin A supplementation
11. Additional Immunisations for children under 5 years
    1. Hepatitis B
    2. HiB (Haemophilus Influenza B)
    3. MMR (Measles, Mumps & Rubella)
    4. Pneumococcal vaccine

Laboratory Tests, these will include:

1. Hematology
2. Clinical chemistry
3. Serology
4. Microbiology
5. Histopathology

Other Diagnostic Services, these will include:

1. Electrocardiography (ECG) – resting, exercise, pre & post exercise
2. Electroencephalography (EEG)
   1. Echocardiography
   2. Doppler scans

 

B. IN PATIENT CARE (FOR COVERED MEDICAL AND SURGICAL CONDITIONS ONLY)
1.   Admissions and accommodation in a single room
2.   Feeding for enrollees on admission
3.   Skilled nursing and medical services
4.   Supply of prescribed drugs, dressings, medical and surgical consumables
5.   Blood transfusion services

 

C. RADIOLOGICAL, LABORATORY & DIAGNOSTIC SERVICES
These services will be carried out and offered based on the clinician’s judgment.
Radiological Services include:

1. Plain and contrast x-rays of all parts of the body
2. Abdominal and pelvic ultrasound scans
3. Advance & Complex investigations which include CT scans, MRI scans, myelogram

E. PHYSIOTHERAPY AND PHYSICAL REHABILITATION SERVICES
These will include:

1. Basic Physical Therapy including infra red therapy, TENS stimulation
2. Supply of basic physiotherapeutic appliances i.e. cervical collar, umbar corset, crutches

 

F. MINOR SURGERIES & PROCEDURES
These include:

1. Wound dressing
2. Incision & drainage of abscesses
3. Suturing of minor cuts and lacerations

 

G. INTERMEDIATE SURGERIES & PROCEDURE
These include:

1. Excision of various lumps
2. Repair of hernia
3. Appendicectomy
4. Closed reduction and manipulation of simple fractures
5. Ear, nose and throat procedures such as antral washout; antrostomy and tonsillectomy

 

H.  MAJOR & COMPLEX SURGERIES AND PROCEDURES

1. Breast surgery
2. Endocrine surgery
3. Oesophageal surgery
4. Abdominal surgery
5. Anorectal surgery
6. Obstetrics and gynaecological surgery
7. Orthopaedic surgery
8. Urological surgery
9. Thoracic surgery
10. Neurosurgery
11. Eye surgery

 

I.  INTENSIVE CARE SERVICES
For enrollees requiring the following:

1. Stroke management
2. Pain management
3. Management of Diabetic emergencies
4. Intensive Care treatment and ICU care: Patient is placed on life support machines when necessary including artificial respiration
5. Ventilator care
6. Treatment of arrhythmias and cardiac emergencies
7. Medical management of Myocardial Infarction or Heart Attack
8. Stabilisation and maintenance treatment for chronic diseases

 

J. CANCER CARE

1. Cancer chemotherapy
2. Radiotherapy for cancer
3. Adjuvant drug management for cancer
4. Oncology tests

K. EVACUATION
Ambulance transportation services will be available to evacuate a HyPrestige Plan enrollee:

1. Between hospitals and hospitals
2. Between road sides and hospitals

L. ANTENATAL & DELIVERY (Up to N400 000 P.A.)

1. Antenatal services, examinations and supply of drugs
2. Management of complications in pregnancy
3. Delivery room services which include:
   1. Management of labour
   2. Normal & Assisted Delivery (vacuum delivery, forceps delivery etc)
   3. Caesarean section delivery
   4. Cervical Cerclage (Shirodkar operation)
4. Post natal check

M. NEONATAL SERVICES
Care required by a new born in the first month of life. This includes:

1. Male circumcision
2. Ear piercing
3. Treatment of mild or moderate neonatal sepsis
4. Phototherapy

N. EYE GLASSES or CONTACT LENSES (up to N40 000 P.A.)

1. Refraction
2. Supply of frames and lenses (unifocal, bifocal, varifocal) replaceable once every two years
3. Contact lenses (soft lenses replaceable twice a year)
4. Treatment of acute and chronic eye diseases

O. DENTAL CARE

1. Routine dental check
2. Scaling and polishing (Annual)
3. Amalgam or composite filing for dental caries
4. Simple (non-surgical) extraction of teeth
5. Surgical extraction of impacted tooth or of tooth with curved mesial roots

 

P. HIV/AIDS CARE AND TREATMENT

1. HIV screening
2. Confirmatory tests
3. Treatment with anti-retroviral drugs when required
4. Treatment of opportunistic infections

 

Q. SELECTIVE HEALTH SCREENINGS

Annual mammogram for women over 35 years

1. Annual cervical smears
2. Annual PSA (prostate specific antigen) for men

 

EXCLUSIONS
The following are excluded from the HyPrestige Plan:

1. Overseas treatment and transplant surgery
2. Plastic/cosmetic surgeries
3. Investigations and treatment for problems relating to fertility e.g.
4. hormone profiles, laparoscopy, hydrotubation, hysterosalpingogram IVF, GIFT and artificial insemination; and virility enhancing drugs
5. Herbal drugs, non-prescription drugs/food supplements, experimental drugs and treatment
6. Dental care not listed under services
7. Home care, momiciliary care and ambulance services
8. Embalmment & autopsies
9. Joint replacements and prosthetic limbs
10. Long term psychiatric illness (longer than 6 months)
11. Comprehensive health screening/well persons check
12. Treatment for newborns not registered on the plan within 4 weeks of birth
13. Self-inflicted injuries
14. Congenital abnormalities
15. Incubator care
16. Special baby unit care
17. Neonatal care not listed under neonatal services