Description

GENERAL EXCLUSIONS ON THE RETAIL PLAN.
• Cosmetic Surgery
• Teeth Whitening
• Dental Prosthetics
• Domiciliary/Hospice Care
• Alternative/Unorthodox medicine
• Neonatal care not listed under Neonatal Services on the benefit schedule
• Self-inflicted/domestic assault injuries
• Congenital abnormalities
• Conditions caused by an act of war, an epidemic or enrollee participating in a riot
• Services primarily for weight reduction or treatment of obesity
• Treatment of substance abuse
• Infertility –All investigations and treatment not listed above
• Orthodontics
• Advanced radiological investigations e.g. CT Scan, Myelogram, EEG not stated on the table etc.
• Advanced and complex investigations e.g. Marrow biopsy, skeletal survey etc.
• Prosthetic device such as cardiac pacemaker, orthopedic implants.
• Management of Chronic Renal Failure (Transplant surgery)
• Induced abortion
• Laser Treatment
• Transplant
• Complex major surgeries e.g. Heart, Brain and Great Blood Vessels
• Neurological surgeries
• Management of Cancer
• Professional sports and willful exposure to danger
• Infectious and contagious diseases in an epidemic
• All procedures, management and investigation not covered by the plans

ELIGIBILITY
• Individuals between age bracket as stated on premium benefit table