Service Description |
Hallmark Beryl |
Hallmark Ruby |
Hallmark Topaz |
Hallmark Emerald |
Hallmark Diamond |
Out-Patient Services |
MANAGEMENT OF CHRONIC CONDITIONS
|
Limited to Diabetes and Hypertension only.
|
 |
 |
 |
 |
OUT-PATIENT CARE, GENERAL AND SPECIALIST CONSULTATION
|
 |
 |
 |
 |
 |
PRESCRIBED MEDICATIONS
|
 |
 |
 |
 |
 |
In-Patient Services |
ADMISSIONS (INCLUDING FEEDING)
|
Standard Ward (15 days)
|
Standard Ward (15 days)
|
Semi-Private Ward (15 days)
|
Private Ward (21 days)
|
Private Ward (21 days)
|
NURSING CARE & CONSUMABLES
|
 |
 |
 |
 |
 |
PRESCRIBED MEDICATIONS
|
 |
 |
 |
 |
 |
Diagnostics Services |
ADVANCED AND COMPLEX INVESTIGATIONS: ECHOCARDIOGRAM, CT SCAN, MRI ONLY
|
Not Covered |
Not Covered |
CT ONLY |
 |
 |
BASIC RADIOLOGICAL STUDIES E.G. PLAIN X-RAY &ULTRASONOGRAPHY (ABDOMINAL AND PELVIC)
|
 |
 |
 |
 |
 |
LABORATORY SERVICES- HISTOPATHOLOGY, HEMATOLOGICAL INVESTIGATIONS, MICROBIOLOGICAL INVESTIGATIONS, SEROLOGY& CLINICAL CHEMISTRY
|
 |
 |
 |
 |
 |
SPIROMETRY, ELECTROCARDIOGRAM (ECG) - REST & EEG-ELECTROENCEPHALOGRAM
|
Not Covered |
 |
 |
 |
 |
Obstetrics Services |
ANTENATAL CARE |
All-inclusive Maternity care N100,000 |
 |
 |
 |
 |
ASSISTED DELIVERY |
Within the maternity care limit |
 |
 |
 |
 |
EMERGENCY OR MEDICALLY INDICATED ELECTIVE CAESAREAN SECTION |
Within Maternity limit stated |
 |
 |
 |
 |
FAMILY PLANNING SERVICES - PILLS, INJECTABLES, IUCD, TUBAL LIGATION AND VASECTOMY (WITHIN SURGICAL LIMITS) |
Pills and IUCD Only |
 |
 |
Including Norplant or Implanon |
Including Norplant or Implanon |
FERTILITY SERVICES (CONFIRMATORY INVESTIGATION ONLY) |
Counseling only |
Counseling, SFA, USS |
Counseling, SFA, USS, HSG |
Counseling, USS, SFA, HSG, Hormonal Assay |
Counseling, USS, SFA, HSG, Hormonal Assay, Hysteroscopy |
INDUCTION OF LABOUR & NORMAL DELIVERY |
Within the maternity care limit |
 |
 |
 |
 |
POST-NATAL CARE |
 |
 |
 |
 |
 |
Physiotherapy Services |
ANTENATAL CARE
|
All-inclusive Maternity care N100,000
|
 |
 |
 |
 |
ASSISTED DELIVERY
|
Within the maternity care limit
|
 |
 |
 |
 |
EMERGENCY OR MEDICALLY INDICATED ELECTIVE CAESAREAN SECTION
|
Within Maternity limit stated
|
 |
 |
 |
 |
FAMILY PLANNING SERVICES - PILLS, INJECTABLES, IUCD, TUBAL LIGATION AND VASECTOMY (WITHIN SURGICAL LIMITS)
|
Pills and IUCD Only
|
 |
 |
Including Norplant or Implanon
|
Including Norplant or Implanon
|
FERTILITY SERVICES (CONFIRMATORY INVESTIGATION ONLY)
|
Counseling only |
Counseling, SFA, USS
|
Counseling, SFA, USS, HSG
|
Counseling, USS, SFA, HSG, Hormonal Assay
|
Counseling, USS, SFA, HSG, Hormonal Assay, Hysteroscopy
|
INDUCTION OF LABOUR & NORMAL DELIVERY
|
Within the maternity care limit
|
 |
 |
 |
 |
PHYSIOTHERAPY SESSIONS (UP TO APPROVED LIMITS)
|
3 Sessions
|
5 Sessions
|
10 Sessions
|
15 Sessions
|
Unlimited |
POST-NATAL CARE
|
 |
 |
 |
 |
 |
PRESCRIBED PHYSIOTHERAPEUTIC APPLIANCES: CERVICAL COLLAR, CRUTCHES ONLY
|
Not Covered |
Covered
|
Covered
|
Covered
|
Covered
|
Accidents and Emergencies Services |
EVACUATION (HOSPITAL TO HOSPITAL & ROAD SIDE TO HOSPITAL)
|
 |
 |
 |
 |
 |
INTENSIVE CARE UNIT (ICU) EXCLUDING LIFE SUPPORT
|
Not Covered
|
2 days
|
3 days
|
5 days
|
7days
|
STABILIZATION, EMERGENCY DRUGS AND INVESTIGATIONS (INCLUDING CT SCAN AND MRI ONLY)
|
Covered without CT and MRI
|
Covered without MRI
|
Covered without MRI
|
 |
 |
Neonatal Services |
ADDITIONAL IMMUNIZATIONS (VARICELLA, ROTARIX, PNEUMOCOCCAL & MMR)
|
Not Covered
|
Not Covered
|
Not Covered
|
Covered
|
Covered
|
NPI IMMUNIZATIONS - BCG, MEASLES, DPT, ORAL POLIO, VITAMIN A SUPPLEMENTATION, PENTAVALENT
|
 |
 |
 |
 |
 |
PRIMARY CARE INCLUDING CIRCUMCISION, EAR PIERCING AND EXCHANGE BLOOD TRANSFUSION |
 |
 |
 |
 |
 |
SPECIAL BABY CARE UNIT (INTENSIVE CARE UNIT-EXCLUDING LIFE SUPPORT, PHOTOTHERAPY & INCUBATOR CARE)
|
24 Hours
|
2 days
|
3 days
|
5 days
|
7days
|
Dental Services |
PRIMARY DENTAL CARE- EXAMINATION, BASIC DENTAL TREATMENT, SIMPLE AMALGAM OR COMPOSITE FILLING, SCALING AND POLISHING, NON-SURGICAL EXTRACTIONS AND PAIN THERAPY/ RELIEF
|
Up to a limit of NGN 10,000
|
Up to a limit of NGN 15,000
|
Up to a limit of NGN 25,000
|
Up to a limit of NGN 50,000
|
Up to a limit of NGN 60,000
|
SECONDARY DENTAL CARE- SURGICAL TOOTH EXTRACTION, ROOT CANAL TREATMENT
|
Up to a limit of NGN 10,000
|
Up to a limit of NGN 15,000
|
Up to a limit of NGN 25,000
|
Up to a limit of NGN 50,000
|
Up to a limit of NGN 60,000
|
Ophthalmological Services |
EYE SURGERIES
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
OPTICAL LENSES ANNUALLY
|
N5,000
|
N7,500
|
N10,000
|
N25,000
|
N40,000
|
PRIMARY EYE CARE- CONSULTATION, EXAMINATION, SIMPLE OR PRIMARY INFECTION OR CONDITIONS AND MEDICATIONS
|
N5,000
|
N7,500
|
N10,000
|
N15,000
|
N20,000
|
Surgical Services |
ANESTHESIA, SURGICAL SUPPLIES/CONSUMABLES, ADMINISTRATION OF BLOOD OR BLOOD PRODUCTS, ETC.
|
Up to a limit of NGN 150,000
|
Up to a limit of NGN 250,000
|
Up to a limit of NGN 300,000
|
Up to a limit of NGN 500,000
|
Up to a limit of NGN 750,000
|
MINOR, INTERMEDIATE, MAJOR SURGERIES AND PROCEDURES
|
Up to a limit of NGN 150,000
|
Up to a limit of NGN 250,000
|
Up to a limit of NGN 300,000
|
Up to a limit of NGN 500,000
|
Up to a limit of NGN 750,000
|
Otolaryngologic (ENT) Services |
ENT SURGERIES |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
TREATMENT OF ENT DISEASES AND REMOVAL OF FOREIGN BODIES |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services |
Other Services |
ANNUAL HEALTH SCREENING AT DESIGNATED CENTERS (PRE-BOOKED) FOR PRINCIPALS ONLY
|
Physical examination, Urinalysis, PCV, blood pressure and FBS
|
Physical examination, Urinalysis, PCV, blood pressure and FBS
|
Physical examination, Urinalysis, PCV, blood pressure and FBS
|
Physical examination, Urinalysis, PCV, blood pressure, blood sugar, EUCR, Chest x-ray, serum cholesterol, cervical smears every 2 years for women 30 years and above, PSA for men above 40 years.
|
Physical examination, Urinalysis, PCV, blood pressure, blood sugar, EUCR, Chest x-ray, ECG, serum cholesterol, annual mammogram, cervical smears every 2 years for women > 30 years and above, PSA for men above 40 years.
|
CANCER CARE: SURGICAL + RADIOTHERAPY & CHEMOTHERAPY
|
As a part of Overall limit on Surgical services |
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
As a part of Overall limit on Surgical services
|
HIV/AIDS- DIAGNOSIS + TREATMENT AT FREE SPECIALIST CENTERS
|
 |
 |
 |
 |
 |
ON-SITE HEALTH CHECKS, HEALTH TALKS/ EDUCATION FORUM OR WELLNESS FAIRS
|
 |
 |
 |
 |
 |
PSYCHIATRY COVER UP TO 6 WEEKS (OUT PATIENT CARE)
|
Covered Upto 3 weeks
|
 |
 |
 |
 |
RENAL DIALYSIS
|
Not Covered
|
1 session
|
2 sessions
|
3 sessions
|
5 sessions
|
STRUCTURED LIFESTYLE MANAGEMENT PROGRAM (PHARMACY BENEFITS)
|
 |
 |
 |
 |
 |