General Conditions for all HIFIND Policies

(RETAIL, INDIVIDUAL AND SME PACKAGES)

  • Moratorium applies to all new policies as detailed below
  • For all renewals, access to care would be after 15 days for inpatients
  • Outpatient access at renewal would be immediate – only for renewals made on anniversary, defaulted renewals would return to first year policy status, except when they have spent three consecutive years on the scheme.
  • Monthly Payment is open to only Subscribers without Pre-existing ailments
  • Customers with pre-existing ailments would also pay associated fees for managing such conditions*

Modus Operandi and Moratorium for all HIFIND Policies Less Than 10 Individuals

(RETAIL, INDIVIDUALS AND SME)

  • Unlock more benefits as your plan extends
  • Access is open to outpatient only from 16th day of making payment for new Customers
  • Inpatient access is from Month 4 for new Customers.
  • Specialist Consultations starts from Month 4 for HIFIND MAX and not available for HIFINDMID
  • Surgeries not linked with pre-existing conditions gets covered only after month 12
  • In patient access is only available for a maximum of 6 -12, 24, 48 or 72 Hours per case depending on selected plan
  • Optical & Dental access either by GP or Specialist starts from Month 6
  • All Pre - existing conditions are excluded for HIFIND MID
  • Pay N48,000 to include other listed Pre-existing condition for HIFIND MAX same would be based on MBANDO approvals
  • Pay N12, 000 for each additional year for persons over 59 years
  • All Maternity services are excluded from both HIFIND Plans i.e. MAX and MID
  • Only Basic screenings and first line medications would be provided for all Pre-existing ailments on HIFIND MAX.
  • All Medications for chronic Conditions would be delivered via our Pharmacy connect
  • All pre-existing Surgical care are excluded from the Retail arrangement
  • Only Hypertension and Diabetes management are covered under Chronics for HIFIND MAX Plans only after six months on the scheme.
  • Mode of access for more Chronic conditions are described above and to be approved by MBANDO Management

Excluded Services for all MB&O Plans

(RETAIL, INDIVIDUALS AND SME)

  • All procedures, management and investigations that are not covered by the plans
  • Definitive management of BPH, CVA/Stroke and all forms of Hepatitis disease, Sickle Cell Disease , Psychosis, Depression,
  • Services that are beyond the scope of practice of the healthcare practitioner performing the service.
  • Experimental services.
  • Medical or surgical treatment for infertility, including In Vitro Fertilization (IVF), Ovum transplants and Gamete Intro-Fallopian Tube Transfer (GIFT), Zygote Intra Fallopian Transfer (ZIFT), or cryogenic or other preservation techniques used in these or similar procedures;
  • Surgical operations of the cranial cavity, brain, spine, spinal cord, heart and chest cavity,
  • Surgeries relating to malignant conditions (cancers).
  • All kinds of transplants and any surgical procedures requiring implants, Prostheses.
  • Specific treatments for Hepatitis B infection.
  • Medical or surgical treatment for obesity;
  • Medical or surgical treatment or regimen for reducing or controlling weight.
  • Cosmetic treatments and surgeries.
  • Surgery or related services for cosmetic purposes to improve appearance, but not to restore bodily function or correct deformity resulting from disease, trauma etc.
  • Any condition, which in the opinion of the Hospital’s Chief Medical Officer is directly related to the Human Immune Deficiency Virus (HIV) including Acquired Immune Deficiency Syndrome (AIDS) and AIDS Related Complex (ARC).
  • Occupational and industrial injuries and conditions
  • Injuries and conditions arising from natural disasters, civil unrest, riots, domestic violence, epidemics.
  • Herbal drugs, non-prescription drugs/food supplements, experimental drugs and treatment
  • Embalmment and Autopsies
  • Joint replacements and Prosthetic limbs
  • Hormonal Replacement Therapy
  • Drug abuse and addiction, self-inflicted injury
  • Management of renal failure including dialysis
  • Chemotherapy and Radiotherapy
  • Bodily injury sustained from war, riot strike, mutiny, civic commotion or any illegal act such as fighting.
  • Bodily injury sustained while participating in extreme sports like mountaineering, hand gliding, parachuting, horse racing, motor or motorcycle racing etc.