Do You Know Your Pro Health Plan?

Private Health Insurance

The design of the ProHealth Plan is centred on tangible cards as against intangible categorizations of covered services as other HMOs are currently doing. This is a unique product differentiation by ProHealth HMO when compared with what currently obtains in the Nigerian HMO market. Health insurance is generally an intangible product, but we have linked it to a physical, tangible card to achieve a positive impact since the individual is able to feel the product at the time of purchase.
ProHealth HMO currently has 4 Private health insurance cards as shown below;
ProHealth Diamond [silvery-grey in colour]
ProHealth Ruby [bright red in colour]
ProHealth Emerald [bright green in colour]
ProHealth Sapphire [ice blue in colour]

ProHealth Diamond Card entitles the holder to the highest number of benefits(covered services) under the ProHealth private health insurance scheme while ProHealth Sapphire Card carries the least benefits.

Private Health Insurance PlansCOVERED SERVICESSAPPHIREEMERALDRUBY DIAMOND  Outpatient Services     General Consultation ✔✔✔✔ Specialist Consultation/Care 
Routine RoutineTertiary Routine Lab tests✔
✔✔✔ Prescribed Drugs✔
✔✔✔ Physiotherapy (maximum sessions per annum)✔✔✔✔ Management of Chronic Conditions   ✔ Inpatient Services     General ward (15 Days)✔✔✔✔ Semi Private Ward (30 Days)  ✔✔ Private Ward (45 Days)   ✔ Routine Lab Investigations✔✔✔✔ Drugs and Infusions✔✔✔✔ Maternity Services (Family Plan only)     Antenatal Care (from 12 weeks)✔✔✔✔ Normal Delivery✔✔✔✔ Induction of Labour and Assisted Delivery,forceps delivery ✔✔✔ S (Emergency & Medically Indicated Electives) ✔✔✔ Post Natal Care up to 6 weeks ✔✔✔ Family Planning Services     Counseling only
 ✔✔✔ IUCDs, Injectables, Oral contraception & Norplant ✔✔✔ Child Health Services     Routine Immunization (Childhood polio, BCG, DPT, HBV)✔✔✔✔ Additional Childhood Immunization – Under 5 Years (Hib & Rotavirum) ✔✔✔ Non-NPI Immunization     MMR, Hepatitis B, Hib, Varicella, Rotavirum, Pneumococcal  ✔✔ Emergency Services     Local Evacuation to Hospital✔✔✔✔ Accident & Emergency. (Cover the immediate life saving /resuscitative). Secondary care in this care is subject to Plan covered✔✔✔✔ Surgical Services     Minor Surgeries Procedures✔✔✔✔ Intermediate  ✔✔ Major Surgeries Procedures   ✔ Radiological Services     Plain X-Ray (Chest, Limb. & Joint)✔✔✔✔ Ultrasound Scans✔✔✔✔ Mammogram  ✔✔ CT Scan   ✔ MRI   ✔ Eye Care     Consultation & Refraction, visual acquity, Routine Examination✔✔✔✔ Treatment of Simple Infection✔✔✔✔ Intraocular pressure test  ✔✔ Eye Care & Surgeries ( pterygium excision, cataract extraction & Claucoma Treatment)  ✔✔ Provision of lenses :plain, bifocal& varifocal lenses subject to limit of coverge ✔✔✔ Dental Services     Consultation & Treatment of simple infection ✔✔✔ Dental X-Ray, Prescribed Drugs, pain therapy & simple extraction ✔✔✔ Surgical Extraction & Amalgam filling  ✔✔ Gingival debridement   ✔ Scaling & Polishing (Once per annum)   ✔ Root Canal (once per annum)   ✔ HIV/AIDS Support Services     Education & VCT✔✔✔✔ ARV treatment referral to diagnostic centres in Nigeria     Annual Basic medical examination✔✔✔✔ Additional Services     Cancer care -screening, investigation & Radiotherapy   ✔ Fertility Treatment: basic investigation, non-hormonal drug treatment, therapeutic surgeries e.g. uterine adhesiolysis   ✔ INDIVIDUAL PREMIUM Call in Call in Call inCall in FAMILY PREMIUM Call inCall in  Call inCall in

 

GENERAL EXCLUSIONS    Dialysis    Specific Treatment for HIV/AIDS    Cosmetic / Plastic surgeries    Prosthesis and other fitting    Treatment of infertility    Denture and special dental procedures    Cytotoxic treatment    Pre-existing medical conditions    Chronic Conditions end stage diseases including renal failure, kidney failure, liver failure    Certain injuries,- old sport injuries, self inflicted injuries    Overseas treatment and transplant surgery    Investigations and treatment for problems relating to fertility e.g: hormone profiles, hydrotubation, laparoscopy    Epidemics.

The design of the ProHealth Plan is centred on tangible cards as against intangible categorizations of covered services as other HMOs are currently doing. This is a unique product differentiation by ProHealth HMO when compared with what currently obtains in the Nigerian HMO market. Health insurance is generally an intangible product, but we have linked it to a physical, tangible card to achieve a positive impact since the individual is able to feel the product at the time of purchase.
ProHealth HMO currently has 4 Private health insurance cards as shown below;
ProHealth Diamond [silvery-grey in colour]
ProHealth Ruby [bright red in colour]
ProHealth Emerald [bright green in colour]
ProHealth Sapphire [ice blue in colour]

ProHealth Diamond Card entitles the holder to the highest number of benefits(covered services) under the ProHealth private health insurance scheme while ProHealth Sapphire Card carries the least benefits.

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