| Exclusions | Coverage Status |
|---|
| GENERAL CONSULTATION |
| Asthma | COVERED | |
| Hypertension | COVERED UNDER AN ACTIVE PEC EXTENSION | |
| Diabetes | COVERED UNDER AN ACTIVE PEC EXTENSION | |
| Osteoarthritis | COVERED UNDER AN ACTIVE PEC EXTENSION | |
| Peptic Ulcer Disease | COVERED UNDER AN ACTIVE PEC EXTENSION | |
| Rheumatoid arthritis | NOT COVERED | |
| Complications arising from pre-existing conditions e.g hypertensive heart disease, diabetic foot ulcer, Cardiovascular disease, neuropathy, heart failure, Heart attack, stroke, heart failure, Aneurysm, gastric cancer, Rheumatoid arthritis, Osteoporosis etc | NOT COVERED |
| ADVANCED DIAGNOSTIC IMAGING | |||
| CT Scan | NOT COVERED | ||
| MRI | NOT COVERED | ||
| Echocardiography | NOT COVERED | ||
| Endoscopy | NOT COVERED |
| CHEMISTRY INVESTIGATIONS | |||
| Prothrombin time (PT/INR) | NOT COVERED | ||
| Serum Lithium | NOT COVERED | ||
| Serum Lactate Dehydrogenase | NOT COVERED | ||
| Oral Glucose Tolerance Test (OGTT) | COVERED WITH A PEC EXTENSION |
| MICROBIOLOGY AND PARASITOLOGY | |||
| VDRL (Veneral Disease Research Laboratory) Test | NOT COVERED | ||
| Trypanosomes screening | NOT COVERED | ||
| Toxoplasma Screening | NOT COVERED | ||
| Skin Snip for Microfilaria | NOT COVERED | ||
| Skin Scraping for Fungi | NOT COVERED | ||
| Leishmania Screening | NOT COVERED | ||
| Mantoux/Heaf's Test | NOT COVERED | ||
| Blood Culture | NOT COVERED | ||
| Stool Occult Blood | NOT COVERED |
| ADVANCED LABORATORY INVESTIGATIONS/PATHOLOGY | |||
| (HBA1C) | COVERED WITH A PEC EXTENSION | ||
| Prostate Specific Antigen | NOT COVERED | ||
| G-6PD Screening | NOT COVERED | ||
| Thyroid Function Tests | NOT COVERED | ||
| Serum Uric Acid | COVERED WITH A PEC EXTENSION | ||
| Creatinine phosphokinase | NOT COVERED | ||
| Syphilis Screening | NOT COVERED | ||
| Serum immunoglobulins/Antibodies | NOT COVERED | ||
| Immunofluorescence assay | NOT COVERED | ||
| QBC Malaria Concentration And Fluorescent Staining | NOT COVERED | ||
| Pap Smear and Cytology | NOT COVERED | ||
| Protein Electrophoresis | NOT COVERED | ||
| CSF M/C/S (CSF Analysis) | NOT COVERED | ||
| Semen M/C/S | NOT COVERED | ||
| Serum Creatinine Phosphokinase | NOT COVERED | ||
| Serum Iron | NOT COVERED | ||
| 24 Hour Creatinine Clearance | NOT COVERED | ||
| Coomb's Test (Indirect) | NOT COVERED | ||
| Coomb's Test (Direct) | NOT COVERED | ||
| Osmotic Fragility Test | NOT COVERED | ||
| Chlamydia Screening | NOT COVERED | ||
| Seminal Fluid Analysis (SFA) | NOT COVERED | ||
| D-Dimer | NOT COVERED | ||
| Sputum Acid Fast Bacilli (AFB) Test | NOT COVERED |
| INTENSIVE CARE | |||
| ICU, HDU and ICU-related Care | NOT COVERED |
| OBSTETRICS CARE | |||
| Antenatal Care (INCLUDING ALL SPECIALIST CARE AND ANC DRUGS) | NOT COVERED | ||
| Delivery (SVD/NORMAL and COMPLICATED) | NOT COVERED | ||
| Delivery (MULTIPLE) | NOT COVERED | ||
| Assisted Delivery | NOT COVERED | ||
| Therapeutic Abortion (Manual Vacuum Aspiration) | NOT COVERED | ||
| CAESARIAN SECTION | NOT COVERED |
| INFERTILITY CARE | |||
| Fertility Specialist Consultation and Counselling | NOT COVERED | ||
| Fertility Investigations | NOT COVERED |
| CARE FOR THE NEWBORN | |||
| Care for babies NOT actively on the plan | NOT COVERED | ||
| Incubator care | NOT COVERED | ||
| Special baby unit and neonatal intensive unit | NOT COVERED |
| FAMILY PLANNING | |||
| Copper T Intrauterine Device | NOT COVERED | ||
| Injectibles (Depo Provera,Noristerat) | NOT COVERED | ||
| Contraceptive pills | NOT COVERED | ||
| Jadelle implant | NOT COVERED | ||
| Implanon | NOT COVERED | ||
| Norplant | NOT COVERED |
| CANCER CARE | |||
| Oncologist/ Cancer Specialist visits | NOT COVERED | ||
| Oncological investigations | NOT COVERED | ||
| Cancer-related Radiological investigations | NOT COVERED | ||
| Surgical cancer care | NOT COVERED | ||
| Chemotherapy | NOT COVERED |
| RENAL CARE (DIALYSIS) | |||
| Dialysis and all related care | NOT COVERED |
| WELLNESS CHECKS | |||
| Blood Pressure Check (Hypertension Screening) | NOT COVERED | ||
| Blood Sugar Check (Diabetes Screening) | NOT COVERED | ||
| Blood Cholesterol Check | NOT COVERED | ||
| Annual Visual Acuity Check (Using Snellen Chart) | NOT COVERED | ||
| Mammography (For Women ≥ 40 years of age) | NOT COVERED | ||
| Pap Smear | NOT COVERED | ||
| PSA Check (For Men ≥ 40 years of age) | NOT COVERED | ||
| Liver Function Test | NOT COVERED | ||
| Kidney Function Tests (E, U, and Cr) | NOT COVERED | ||
| Chest X-ray | NOT COVERED |
| OTHERS | |||
| Healthcare for pandemics/epidemics/injurires from war or conflict | NOT COVERED | ||
| Autoimmune disorders | NOT COVERED | ||
| Sickle cell anemia and illnesses related to genetic disorders | NOT COVERED | ||
| Plastic/cosmetic surgery and treatments | NOT COVERED | ||
| Birth defects and congential illnesses | NOT COVERED | ||
| Food supplements | NOT COVERED | ||
| Dietary and Nutritional Supplements | NOT COVERED | ||
| Non-prescription drugs | NOT COVERED | ||
| Experimental Drugs and Treatments | NOT COVERED | ||
| Healthcare or costs from alcoholism and substance absuse and intoxication | NOT COVERED | ||
| Health care for organ transplant | NOT COVERED | ||
| Spinal cord injuries/treatment | NOT COVERED | ||
| Glaucoma treatment | NOT COVERED | ||
| Speech disorders and learning disabilities | NOT COVERED | ||
| Hormonal replacement therapy | NOT COVERED | ||
| Health care for attempted suicide/intentional injury/high-risk sports | NOT COVERED | ||
| Embalmment, autopsies and mortuary services | NOT COVERED | ||
| All healthcare arising from, or related to exclusions | NOT COVERED |