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Zenith Detty December Plan

The perfect health insurance plan for your needs

Zenith Detty December Plan

₦141,050/year

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Local evacuation to hospital ✓ ✓ ✓ ✓ Covered
    Stabilization ✓ ✓ ✓ ✓ Covered
    Emergency drugs and investigations ✓ ✓ ✓ ✓ Covered
    .

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    General consultation ✓ ✓ ✓ ✓ Covered
    Specialist consultation ✓ ✓ ✓ ✓ Internal medicine, Cardiology, etc
    Routine Laboratory tests ✓ ✓ ✓ ✓ Covered
    Non Routine Laboratory Investigations ✓ ✓ ✓ ✓ Covered
    Vitamin D Investigations ✓ ✓ ✓ ✓ D3 25-Hydroxy & 1,25-Dihydroxy
    Hepatitis profile, Kidney & Liver Function Tests ✓ ✓ ✓ ✓ Excludes viral load
    Hormonal Assays ✓ ✓ ✓ ✓ Thyroid, Pituitary, Pancreatic, etc.
    Prescribed Drugs ✓ ✓ ✓ ✓ Covered
    Physiotherapy ✓ ✓ ✓ ✓ 10 Sessions
    Chronic Disease Management - - ✓ ✓ 6-month moratorium
    Medical Dermatology ✓ ✓ ✓ ✓ Covered
    Skin Biopsy ✓ ✓ ✓ ✓ Covered
    ENT Services ✓ ✓ ✓ ✓ Covered
    Cervical Collar ✓ ✓ ✓ ✓ Covered
    Dietician (Consultation Only) ✓ ✓ ✓ ✓ Covered
    Speech Therapy ✓ ✓ ✓ ✓ 10 Sessions
    Outpatient Admission ✓ ✓ ✓ ✓ 24-hour observation

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    General ward ✓ ✓ ✓ ✓ Covered
    Semi private ward ✓ ✓ ✓ ✓ Covered
    Private ward ✓ ✓ ✓ ✓ Covered
    General/specialist doctor review ✓ ✓ ✓ ✓ Covered
    Nursing care ✓ ✓ ✓ ✓ Covered
    Drugs and infusions ✓ ✓ ✓ ✓ Covered
    Routine lab investigations ✓ ✓ ✓ ✓ Covered
    Vitamin D Investigations ✓ ✓ ✓ ✓ Covered
    Hepatitis profile, Kidney & Liver Function Tests ✓ ✓ ✓ ✓ Covered, Excluding viral load
    Hormonal Assays - - ✓ ✓ Covered
    Hospital feeding ✓ ✓ ✓ ✓ Where available
    End Stage Kidney Disease Management - - ✓ ✓ 2 Dialysis Sessions/Year
    Admission days ✓ ✓ ✓ ✓ Max. 21 days/case
    Intensive care unit (ICU) - - - ✓ 10 days, 12-month moratorium

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Routine NPI Immunization – 1 ✓ ✓ ✓ ✓ 0–5 years, Children born on the plan, [Tuberculosis, Poliomyelitis, Measles, Yellow Fever, (Pentavalent vaccine; Diphtheria, Pertussis, Tetanus, Hemophilus Influenza type B, Hepatitis B)]
    Routine NPI Immunization – 2 ✓ ✓ ✓ ✓ 0–5 years, Children born on the plan, [Pneumococcal Conjugate Vaccine (PCV), Rotavirus & Vitamin A.]
    Additional Childhood Immunizations ✓ ✓ ✓ ✓ 0–5 years, Children born on the plan, [IPV, & Hep A.]
    Well Baby Clinic ✓ ✓ ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Minor procedures - ✓ ✓ ✓ Covered
    Intermediate procedures - ✓ ✓ ✓ Covered
    Major procedures - ✓ ✓ ✓ Covered
    Surgical limit - ✓ ✓ ✓ N500,000/year

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Antenatal care - - - ✓ Covered
    Normal delivery - - - ✓ Covered
    Assisted delivery - - - ✓ Covered
    Cesarean Section - C/S - - - ✓ Covered, emergency & medically indicated elective
    Epidural Anesthesia - - - ✓ Where medically indicated, N75,000.
    Family Planning - - - ✓ Counseling, OCPs, IUCDs
    Phototherapy, Incubator care - - - ✓ 0–28 days
    Neonatal ICU - - - ✓ 10 days

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Antenatal care - - - ✓ Covered
    Normal delivery - - - ✓ Covered
    Assisted delivery - - - ✓ Covered
    Cesarean Section - C/S - - - ✓ Covered, emergency & medically indicated elective
    Epidural Anesthesia - - - ✓ Where medically indicated, N75,000.
    Family Planning - - - ✓ Counseling, OCPs, IUCDs
    Phototherapy, Incubator care - - - ✓ 0–28 days
    Neonatal ICU - - - ✓ 10 days

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Plain X-rays & Ultrasound - - - ✓ Covered
    ECG & EEG ✓ ✓ ✓ ✓ 6-month moratorium
    Echocardiogram & Doppler - - ✓ ✓ 6-month moratorium
    Radio-opaque studies (Barium, HSG, IVU) - - ✓ ✓ 6-month moratorium
    CT-Scan - ✓ ✓ ✓ 3-month moratorium, 1 session of either CT-Scan or OCT
    OCT - - ✓ ✓ 6-month moratorium, 1 session of either CT-Scan or OCT
    MRI - - ✓ ✓ 1 session, in Emergency only

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Endoscopic procedures - - ✓ ✓ 6-month moratorium
    Audiogram ✓ ✓ ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Consultation & Routine Exam - ✓ ✓ ✓ Covered
    Treatment of infection - ✓ ✓ ✓ Covered
    Optical Lenses - ✓ ✓ ✓ Limit of N40,000, Biennial
    Simple Eye Surgeries - ✓ ✓ ✓ Pterygium, Stye, Chalazion
    Cataract & Glaucoma Surgery - ✓ ✓ ✓ N250,000 combined

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Dental Consultation & Routine Exam - ✓ ✓ ✓ Covered
    Treatment of Dental infection - ✓ ✓ ✓ Covered
    Plain dental X-rays - ✓ ✓ ✓ Covered
    Simple Dental extraction - ✓ ✓ ✓ Covered
    Amalgam Dental fillings - ✓ ✓ ✓ 5 sessions/year
    Composite Dental fillings - ✓ ✓ ✓ 4 sessions/year
    Dental Scaling & polishing - ✓ ✓ ✓ 1 session/year
    Dental Surgical extraction - ✓ ✓ ✓ Covered
    Root canal treatment - ✓ ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Annual Medical Exams with investigations - - ✓ ✓ Age 45+, 6-month moratorium, At designated centers only. [Physical Examination, Electrocardiogram (ECG) – Resting, Urinalysis, Full Blood Count, Cholesterol Check, Random or Fasting Blood Sugar, Liver Function Test, Kidney Function Test, HIV, HBSAg, Hepatitis C (enrollee consent required)].

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Counseling - ✓ ✓ ✓ Covered, 3-month moratorium
    Outpatient consultation & treatment - ✓ ✓ ✓ Up to 8 weeks

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Basic investigations - - - ✓ Covered, Semen analysis, HSG, etc.
    Simple surgical intervention - - - ✓ Covered, Hydrotubation, etc.
    Non-hormonal drug treatment - - - ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Screening (Breast, Cervix, Prostate) - - - ✓ Covered
    Colposcopy - - - ✓ Covered
    Mammogram - - - ✓ Covered
    PSA test - - - ✓ Covered
    Surgical treatment - - - ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Voluntary counseling & testing - - ✓ ✓ Covered
    Treatment of opportunistic infections - - ✓ ✓ Covered
    ART facilitation at designated centers - - ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Anti-TB treatment facilitation - - ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Category 1 Providers only ✓ ✓ ✓ ✓ Covered

    Specific Benefit Immediate (After WP) After 3 Months (Month 4) After 6 Months (Month 7) After 12 Months (After Renewal) Notes on coverage
    Overall Financial Limit ✓ ✓ ✓ ✓ N2,000,000 pppa
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