q Benefits List- Zuma Health Trust

Zuma HMO

Zuma Health Trust Limited is a leading Health Maitenance Organization (HMO) offering Social Health Insurance Coverage for all Nigerians.

Contact Info

No 856, Olu Awotesu St.
Jabi, Abuja
info@zumahealthtrust.ng
(234) 0814000 0653
(234) 0814000 0657

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Benefit List for Individual Health Insurance Plans

Cardinal, Cardinal Bronze, Cardinal Silver, Cardinal Gold, Cardinal Diamond & Cardinal Ruby benefit list.

INDIVIDUAL PLAN SERVICES

Cardinal Plan
₦74,844.00 /Person/Yr
Cardinal Bronze
₦96,855.00 /Person/Yr
Cardinal
silver
₦119,827.00 /Person/Yr
Cardinal Gold
₦189,827.00 /Person/Yr
Cardinal Diamond
₦302,784.00 /Person/Yr
Cardinal Ruby
₦488,608.00 /Person/Yr
LIMITS ON PLANS ₦75,000 ₦100,000 ₦150,000 ₦200,000 ₦250,000 ₦300,000

HOSPITAL BANDS

E D C BC B A
Registration
General Consultation
Special Consultation 3 Per Annum 3 Per Annum 4 Per Annum 6 Per Annum 6 Per Annum 8 Per Annum
Routine Laboratory Investigation
Provision of prescribed drugs
SURGICAL CONSUMABLES
NON-INVASIVE CARE AND SIMPLE CONDITIONS:Skilled Nursing Care
NON-INVASIVE CARE AND SIMPLE CONDITIONS:Wound dressing
ENT SERVICES (EAR, NOSE & THROAT SERVICES)
RADIOLOGY INVESTIGATIONS (X-RAYS & ULTRASOUNDS)
CT SCAN X X
Emergency
Emergency
Emergency
Emergency
MR X X
Emergency
Emergency
Emergency
Emergency
Health education
Gymnasium services (At select fitness centres & for principals only) Eligible after first policy year & Number of sessions per Annum 2 3 3 4 5 8
Pills
IUCD (Copper T)
Injectables
Norplants X X X

NEONATAL & POSTNATAL CARE

(Eligibility applies after 18 months)
1st dose of Immunization (0-4 weeks)
Circumcision
Ear piercings

IMMUNIZATION

Oral Polio
Oral Polio
Yellow Fever
Pentavalent
Pneumococcal conjugate X X X
MMR, Rota Virus X X X
Chicken Pox X X X

IN-PATIENT CARE

HOSPITALIZATION GENERAL WARD SEMI-PRIVATE WARD SEMI-PRIVATE WARD SEMI-PRIVATE WARD SEMI-PRIVATE WARD PRIVATE WARD
IN-PATIENT CARE, GENERAL & SPECIALIST CONSULTATION {Refer to Out-patient Section}
PRESCRIBED DRUGS
DRUG SUPPLY
DRUG CONSUMABLES
LABORATORY INVESTIGATION/ DIAGNOSTICS TEST RADIOLOGICAL INVESTIGATIONS (X-RAYS & ULTRASOUND)
SPECIAL INVESTIGATIONS (CT SCAN, MRI) X X X
PHYSIOTHERAPY (SESSIONS per ANNUM) X X 4 6 8 10
IN-PATIENT LIMITS 100,000.00 120,000.00 150,000.00 175,000.00 200,000.00 225,000.00

OBSTETRICS & GYNAECOLOGY

Eligibility for Spontaneous Vaginal Delivery and Caesarian Section Delivery is once every two (2) years. Enrollee is eligible to maximum of three(3) Obstetrics scans throughout pregnancy, each scan is authorized in each trimester.
Antenatal + Delivery + Post Delivery Care (BLOCK LIMIT) 55,000.00 75,000.00 100,000.00 125,000.00 150,000.00 200,000.00
Antenatal Care Services
Consultation
Ultrasound, Obstetrics Scan
Laboratory Investigations
Management of Pregnancy Complications
Management of Labor
Labor Ward Services
Spontaneous Vagina delivery (Normal delivery)
Caesarian Section Delivery

SURGERIES

SURGERIES (MINOR/INTERMEDIATE/MAJOR) (BLOCK LIMIT) 100,000.00 Limit 125,000.00 Limit 150,000.00 Limit 175,000.00 Limit 200,000.00 Limit 250,000.00 Limit
Minor surgeries
Intermediate Surgeries
Major Surgeries

DENTAL CARE

Dental Care Limit 10,000.00 15,000.00 20,000.00 25,000.00 28,000.00 30,000.00
Scaling & Polishing (once in 18 Months)
Simple Extraction
Composite Filling
Amalgam Filling
Root Canal Therapy X X X
Periapical X-Ray
Surgical Extraction X X

EYE CARE

EYE CARE LIMIT 10,000.00 15,000.00 20,000.00 25,000.00 28,000.00 30,000.00
Foreign Body Removal X X X
Eye Examination
Eye Surgeries (refer to annual surgery limit) X X X
Allergies & Conjunctivitis
Frames, Lenses (Once in every two years)
Frames & Lenses Limit(refer to annual eye care limit) 7,500.00 10,000.00 12,500.00 15,000.00 20,000.00 25,000.00

ENT

(Ear, Nose and Throat) Services
ENT LIMIT 10,000.00 15,000.00 20,000.00 25,000.00 28,000.00 30,000.00

ENT

(Ear, Nose and Throat) Services
ENT CONSULTATION
Removal of Foreign Body
Ear Syringing
Removal of Foreign Body
ENT SURGERIES NB: refer to annual surgery limit

INDIVIDUAL PLAN PRICE

Cardinal
Plan
74,844.00 /Person/yr
Cardinal Bronze
96,855.00 /Person/yr
Cardinal
silver
119,827.00 /Person/yr
Cardinal
Gold
189,827.00 /Person/yr
Cardinal Diamond
302,784.00 /Person/yr
Cardinal
Ruby
488,608.00 /Person/yr

NB: The exclusions and services not covered under the plans are here

Things to Note:

  • Occupational/industrial injuries to the extent covered under the Workmen Compensation Act.
  • Injuries resulting from: natural disasters, e.g. earthquakes, landslides. Conflicts eg, social unrest, riots, wars. s
  • Injuries arising from extreme sports, e.g. car racing, horse racing, polo, mountaineering, boxing, wrestling, etc
  • Epidemics
  • Drug abuse/addiction.
  • Domiciliary visit.
  • Surgery eg mammoplasty.
  • Ophthalmology eg provision of contact lens.
  • Anti-tuberculosis drugs.
  • Pre-existing conditions are defined as pregnancy, major diseases, chronic illness and complications arising from diabetes or hypertension
  • These are services not covered under the plans.

Get In Touch

Got any questions? Don't hesitate to get in touch.

Address
No 856, Olu Awotesu St.
Jabi, Abuja
Phone

(234) 08140000653