Name: Amali Health Plan - Amali Africa
Published: 2022-01-18T09:58:55+00:00

AMALI & AXA MANSARD PLANS

₦7,800/year

or ₦650/month

₦12,000/year

or ₦1,000/month

₦24,000/year

or ₦2,000/month

MICROHEALTH

AMALI PLAN 1

AMALI PLAN 2

EXCLUSION

Plastic/cosmetic surgeries
Investigations and treatment for problems relating to infertility e.g. hormone profiles, laparoscopy, hydrotubation, hysterosalpingogram, I.V.F, G.I.F. Tandartificial insemination
Virility enhancing drugs
Management of Chronic Diseases including but not limited to consultation, prescription drugs and laboratory tests
Family Planning Services
Herbal drugs, non-prescription drugs, food supplements and experimental drugs and treatment
Dental care not listed in the covered services
Home care and domiciliary services
Joint replacements and prosthetic limbs
Long term psychiatric illness (Longer than 6months)
Health screening/well persons check Physiotherapy
Mortuary Services
Immunization

Advanced & Complex Investigations including but not limited to CT, Scan, MRI Scan, and echocardiograph
Optical Services including but not limited to consultations, basic eye care and dispensing of frames, lenses, and contact lenses.
Dental Care
Congenital abnormalities
Other Radiological Investigations not listed in the schedule of covered services.
Neonatal Services including but not limited to male circumcision, ear piercing, treatment of mild or moderate neonatal sepsis, phototherapy.
HIV/AIDS Care & Treatment 22. Treatment of obesity
Speech disorders
Learning difficulties, behavioral and developmental problems
Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners, or complementary medicines practitioners

Registration	Covered – Q1
Consultations	Covered – Q1
General practitioners /medical officers	Covered – Q1
Supply of drugs & medication – drugs recommended in the course of the treatment for covered services	Covered – Q1
Laboratory & diagnostic services (based on the clinician’s judgment)	Covered – Q1
Haematology	Covered – Q1
Clinic chemistry	Covered – Q1
Microbiology	Covered – Q1
Serology	Covered – Q1
Immunology	Covered – Q1
Radiological investigations (x-ray services)	Covered – Q1
Accidents & emergencies	Covered – Q1
Resuscitative or lifesaving initial treatment (up to plan benefit limit)	Covered – Q2
Definitive treatment subject to health cover benefit limit.	Covered – Q2
Surgeries (after 12 months purchase of the product)	25,000 limit – After 12 months
Wound dressings	Covered
Incision of abscesses	Covered
Drainage of abscesses	Covered
Suturing of minor cuts	Covered
Lacerations	Covered
Treatments including but not limited to :	25,000 limit
Malaria and other acute uncomplicated febrile illnesses	Covered – Q1
Diarrheal diseases	Covered – Q1
Acute respiratory tract infections	Covered – Q1
Pneumonia	Covered – Q1
Anaemia (not requiring blood transfusion),	Covered–Q1
Simple skin diseases, e.g tinea vesicolor, m.furfur, tinea capititis	Covered – Q1
Worm infestations	Covered – Q1
Uncomplicated bacteria	Covered – Q1
Fungal parasitic and viral infections/illnesses	Covered – Q1
Arthritis and other minor musculoskeletal diseases	Covered – Q1
Pneumonia	Covered – Q1
Ante-natal care & delivery (after 12 months)	After 12 months

Outpatient limit/ annum	N100,000
For monthly or quarterly payments, access to in-patient or outpatient benefits are limited accordingly	N100,000
Inpatient limit/ annum	N20,000
For monthly or quarterly payments, access to in-patient or outpatient benefits are limited accordingly	N20,000
Malaria & other acute uncomplicated febrile illnesses	Covered
Diarrheal diseases	Covered
Acute respiratory tract infections	Covered
Anaemia (not requiring blood transfusion)	Covered
Simple skin diseases, e.g. tinea vesicolor, m.furfur, tinea capititis	Covered
Worm infestations	Covered
Uncomplicated bacterial infections	Covered
Fungal parasitic and viral infections/illnesses	Covered
Laboratory & diagnostic services (based on the clinician’s judgment)
X-rays, laboratory & diagnostic tests	Covered
Advanced and complex investigations (including ct scan, mri scan)	Not covered
Teleconsultation	Covered
Dr call me back USSD feature	Covered
Accident and emergency	Covered up to 25,000
Evacuation (home/hospital to hospital & road side to hospital)	Covered as above
Intensive care services	Not covered
Minor surgeries and procedures	Covered up to 25,000 (after 9 months of uninterrupted subscription i.e. Moratorium)
Wound dressing Suturing of minor cuts and lacerations Incision and drainage of abscesses Minor ENT (EAR, NOSE, THROAT) procedures like ear syringing
Intermediate, major surgeries and procedures	Not covered
Minor wound debridement Lump excision Hernia repairs Appendectomy Closed reduction and manipulation of simple fractures and dislocations Surgery for haemorrhoids Endoscopy Ent procedures like antral washouts, tonsillectomy Surgery for ectopic pregnancy Myomectomy Elective orthopedic surgery General surgeries like laparotomy Gynecological surgeries like hysterectomy ENT surgeries like adenotonsillectomy Other complex surgeries such as thyroidectomy, open reduction and internal fixation of fractures, brain surgeries, vascular and nerve surgeries	Not covered
INPATIENT TREATMENT (limited to acute ailments) Admissions (including feeding) Prescribed Medicines and Drugs X-Rays, Laboratory & Diagnostic Tests	Covered subject to in-patient limit (after 3 months of uninterrupted subscription)
Mother and childcare
Family Planning Services Pills, Injectables & Copper IUCDs	Not covered
Fertility services (investigation only) Counseling, SFA & USS	Not covered
Antenatal care, delivery and post-natal (Moratorium Applies)	Covered up to N20,000 (after 9 months of uninterrupted subscription i.e. moratorium)
NPI Immunizations (0 – 5yrs)- DPT, Hepatitis B, HiB (Pentavalent), BCG, Measles, Oral Polio, Vitamin A supplementation& yellow fever	Covered at Government Hospitals
Dental Care	Not Covered
Optical Care	Not Covered
Psychiatry Cover up to 8 Weeks	Not covered
Physiotherapy Sessions (3 Sessions)	Not Covered
Management of Chronic Conditions
Out Patient Care, In-Patient care, General and Specialist Consultation	Not Covered
Prescribed treatment	Not Covered

OUTPATIENT Limit/ Annum For monthly or quarterly payments, access to In-patient or outpatient benefits are limited accordingly	N100,000
INPATIENT LIMIT/ Annum For monthly or quarterly payments, access to In-patient or outpatient benefits are limited accordingly	N200,000
Malaria & other acute uncomplicated febrile illnesses	Covered
Diarrheal diseases	Covered
Acute respiratory tract infections	Covered
Anaemia (not requiring blood transfusion)	Covered
Simple skin diseases, e.g tinea vesicolor, M.furfur, Tinea Capititis	Covered
Worm infestations	Covered
Uncomplicated bacterial infections	Covered
Fungal parasitic and viral infections/illnesses	Covered
Laboratory & diagnostic services (based on the clinician’s judgment)
X-rays, laboratory & diagnostic tests	Covered
Advanced and Complex Investigations (Including CT Scan, MRI Scan)	Emergency only (after 6 months of uninterrupted subscription)
Teleconsultation	Covered
Dr call me back USSD feature	Covered
Accident and Emergency	Covered
Evacuation (home/hospital to hospital & road side to hospital)	Covered
Intensive care services	Emergency only – 24 hours (Subject to In-patient limit) – Q1
Minor surgeries and procedures	Covered
Wound dressing Suturing of minor cuts and lacerations Incision and drainage of abscesses Minor ENT (EAR, NOSE, THROAT) procedures like ear syringing	Covered
Intermediate, major surgeries and procedures	Covered up to a total of N100,000 (after 9 months of uninterrupted subscription i.e. moratorium)
Minor wound debridement Lump excision Hernia repairs Appendectomy Closed reduction and manipulation of simple fractures and dislocations Surgery for hemorrhoids Endoscopy Ent procedures like antral washouts, tonsillectomy Surgery for ectopic pregnancy Myomectomy Elective orthopedic surgery General surgeries like laparotomy Gynecological surgeries like hysterectomy ENT surgeries like adenotonsillectomy Other complex surgeries such as thyroidectomy, open reduction and internal fixation of fractures, brain surgeries, vascular and nerve surgeries
INPATIENT TREATMENT (limited to acute ailments) Admissions (including feeding) Prescribed Medicines and Drugs X-Rays, Laboratory & Diagnostic Tests	Covered subject to in-patient limit (after 3 months of uninterrupted subscription)
Mother and childcare
Family Planning Services Pills, Injectables & Copper IUCDs	Covered subject to in-patient limit (after 3 months of uninterrupted subscription)
Fertility services (investigation only counseling, SFA & USS	Covered subject to in-patient limit (after 6 months of uninterrupted subscription i.e. moratorium)
Antenatal care, delivery and post-natal (Moratorium Applies)	Covered subject to in-patient limit (after 9 months of uninterrupted subscription i.e. moratorium)
NPI Immunizations (0 – 5yrs)- DPT, Hepatitis B, HiB (Pentavalent), BCG,	Covered
Measles, Oral Polio, Vitamin A supplementation& yellow fever	Subject to Outpatient limit
Dental Care	Covered up to N5000/annum after 3 months of uninterrupted access
Optical Care	Covered. Glasses covered up to N5000/ every 2 years, after 3 months of uninterrupted access
Psychiatry Cover up to 8 Weeks	Covered Subject to In-patient limit after 3 months of uninterrupted access
Physiotherapy Sessions (3 Sessions)	Covered after 6 months of uninterrupted access
Management of Chronic Conditions
Out Patient Care, In-Patient care, General and Specialist Consultation	Covered after 12 months
Prescribed treatment	Covered after 12 months