Benefit package

PREMIER MEDICAID
INTERNATIONAL(HMO)
BENEFIT PACKAGE
BENEFIT PACKAGE
DIALYSIS HOSPITAL
INPATIENT COVERED SERVICES
Surgical procedures (minor to intermediate) Internal surgical appliances/such as prosthesis and External surgical appliances/such crushes,elastic stockings Blood transfusion (international blood care services) PSYCHIATRIC / BEHAVIOURAL HEALTH SERVICES Evacuation and treatment of conditions that are Medical Services: Covered Outpatient and inpatient medical services Provided by a physician,i.e. individual psychotherapy, groupPsychotherapy, psychological testing, family counseling –with family Members to aid diagnosis Orthotics for treatment related to injurie or strains e.g. cervical & lumber braces Orthotics for medically necessary rehabilitation of LOWER LIMB
VERTEBRAL SPINE
ULTRASOUND
DIAGNOSTIC LABORATORY TESTS
HEMATOLOGY
SEROLOGY
BLOOD CHEMISTRY
URINE CHEMISTRY
MICROBIOLOGY
Stool microscopy,culture and sensitivity Sputum microscopy,culture and sensitivity HORMONE ASSAY
Members” prescriptions will be filled from essential drugs list i.e. a Recommended list of essential brand name and generic drugs,which Have been chosen because they provide maximum quality and value REHABILITATION
SERVICES{outpatient short term
therapy}
Rehabilitation Services include
SURGICAL SERVICES
Surgical supplies normally required for covered surgical procedure Anaesthesia normally required for covered surgical procedures Administration of blood and blood plasma Impatient or Outpatient minor or immediate surgeries MINOR SURGERIES INCLUDING BUT NOT
LIMITED TO THE
FOLLOWING
Sub-periosteal drainage for acute osteomyelitis Tonsil ectomy for children (less than 12yrs) Closed reduction and immobilization of joint dislocation Injection sclerotherapy of varicose veins INTERMEDIATE SURGERIES INCLUDING
BUT NOT LIMITED
TO THE FOLLOWING
Laparotomy and biopsy of disease viscera in abdominal cavity Surgical drainage of hematoma of abdominus Major surgeries
Orthopaedic Procedures requiring implants Scaling and polishing(once every six months) Dental treatment as a result of accidental damage MATERNITY CARE
Physician prescribed bed rest during pregnancy Termination of pregnancy for life-endangering condition Hospitalization and skil ed nursing in connection with childbirth for the Mother or newborn child of a virginal or caesarean delivery TERTIARY RADIOLOGICAL INVESTIGATIONS SUCH AS CT SCAN, MRI, MAMMOGRAM Gynecological investigation-Hormonal profile, Semen analysis, etc OPITICAL SERVICES
Supply of Frames(within limit once a year) Supply of lenses(unifocal,bifocal,varifocal or contact once a year) EXCLUSIONS
Artificial limbs& dentals prostheses Specific treatment for AIDS/HIV positive patients For the EXECUTIVE plan the benefit package includes post operative monitoring, home visits or home care include physiotherapy for two weeks where necessary.

Source: http://www.premiermedicaid.com.ng/formpdf/BENEFIT_PACKAGE.pdf