MODUS OPERANDI OF MB&O SERVICES
(RETAIL, INDIVIDUALS AND SME)
A plan must be selected per person or family within a group, either by the company or by the individuals depending on your platform, i.e., Corporate or Retail and SME.
Immediately there is a conclusion on chosen Plans and Hospitals for your workforce or yourself, you are advised to enroll via our platform and await your electronic ID card within a maximum of 2 – 5 working days depending on your staff volume.
Hospital access would then commence with an agreed start date and by presenting your electronic identity card via your Phone to the Hospital staff for clearance to consult with a doctor.
Your electronic Identity card would have a policy validity period which would only be changed upon renewal of the policy.
ELIGIBILITY
Our Corporate policies cover up to age 65 for staff and Spouse, then up to age 21 for a maximum of up to 4 biological children.
Our Retail and SME Policies cover up to age 59 for staff and spouses, then up to age 18 for a maximum of 4 biological children.
REPLACEMENT WINDOW
Upon exit of any staff, a replacement is allowed provided it occurs within the initial three months of commencing the policy. At month four, a prorated premium would be paid on behalf of all new entrants, and exited staff can no longer be replaced.
POLICY PERIOD
All MB &O policies run for twelve months being one full year.
PAYMENT TERMS
Payment terms are different from policy periods and could vary based on specific businesses and terms of agreement per time.
Our Retail and SME Policies cover up to age 59 for staff and spouses, then up to age 18 for a maximum of 4 biological children.
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
- Back to School wellness check
- Embalmment and Autopsies
- Joint replacements and Prosthetic limbs
- Hormonal Replacement Therapy
- Virility-enhancing drugs
- 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.