Bronze Plan
Covered Services
Outpatient & Specialist Care
- General medical consultations
- Diagnosis and treatment of common illnesses
- Follow-up visits
- Basic nursing services
- Prescription of approved medications
- Basic laboratory investigations
- Minor outpatient procedures
Examples:
- Malaria treatment
- Typhoid treatment
- Respiratory infections
- Minor injuries and wound care
Hospital Admission (General Ward)
- Admission to a general ward for medically necessary treatment
- Bed and accommodation charges within approved limits
- Nursing care during admission
- Doctor’s ward rounds
- Medications administered during admission
- Basic investigations required during hospitalization
Examples:
- Severe malaria requiring admission
- Pneumonia
- Gastroenteritis with dehydration
- Observation after surgery
Basic Surgical Procedures
- Medically necessary minor and selected routine surgeries
- Theatre charges within approved limits
- Anesthesia for covered procedures
- Post-operative care
Examples:
- Appendectomy
- Hernia repair
- Incision and drainage of abscesses
- Minor lump or cyst removal
- Wound suturing
Maternity Support
- Antenatal consultations
- Routine antenatal laboratory tests
- Normal vaginal delivery
- Postnatal care
- Basic pregnancy-related medical care
Examples:
- Antenatal clinic visits
- Delivery by normal labour
- Post-delivery follow-up care
Emergency Services
- Initial emergency stabilization
- Emergency medical consultations
- Treatment of acute medical emergencies
- Emergency medications and procedures
Examples:
- Severe asthma attacks
- Acute allergic reactions
- Severe infections
- Accident-related emergency treatment
Not Covered Services
Private or VIP Hospital Accommodation
Not covered:
- Private rooms
- Executive suites
- VIP wards
Major and Specialized Surgical Procedures
Not covered unless specifically authorized:
- Open-heart surgery
- Organ transplantation
- Neurosurgery
- Complex orthopedic procedures
Advanced Diagnostic Procedures
Not covered:
- MRI scans
- PET scans
- Specialized genetic testing
- Advanced cardiac investigations unless stated otherwise
Intensive Care Unit (ICU) Services
Not covered or subject to separate authorization:
- ICU admission
- Ventilator support
- Critical care management
Cosmetic and Elective Procedures
Not covered:
- Cosmetic surgery
- Non-medically necessary treatments
- Aesthetic procedures
Fertility and Assisted Reproductive Services
Not covered:
- IVF (In Vitro Fertilization)
- Fertility treatments
- Artificial insemination