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- Private wards if they cost more that the Society’s tariff rate.
- Cost of food and lodging for guardians.
- Meals if charged separately for patients.
- Admission costs incurred during the first three months from date of registration.
- Private nursing services – no award will be made where this benefit is claimed in hospital.
- Guardian Fees.
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Treatment by General Practitioner |
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- Maternity services rendered to a member who has been on MASM for less than twelve consecutive months.
- Where member has exhausted her maternity limit.
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- Slimming tablets
- Infertility drugs
- Disinfectants and antiseptics
- Food e.g. Isomil, Lucozade, Sanatogen Wines etc.
- Cosmetics
- Drugs costing more than K2,500.00 dispensing prior approval from MASM.
- Drugs prescribed/dispensed to Standard and Econoplan Scheme members at Private Medical Institutions.
- Over the counter drugs e.g. Vitamins.
All medicines listed as non payable in the Society’s drug master file |
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- When member has exhausted his or her annual limit.
- Labour charges and technician fees.
- Dental floss, toothpaste.
- Foreign dental treatments except emergencies.
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- Treatment of cosmetic nature e.g. face lifts, breast reductions etc
- Any expense in respect of medical examinations for employment, insurance, education, immigration or travel purposes and vaccinations.
- Treatment for which cost is recoverable in law from any body, party or an Insurance Policy.
- Treatment arising from any wilful or deliberate self inflicted injury or any attempt threat, negligence, suicide, abuse of alcohol or drugs.
- Participation in any hazardous sport or any sport for monitory gain.
- Services which are available free or at a nominal charge e.g. family planning services, under-five clinic services.
- Treatment or services for which Limit of Benefit in a specified period has been exhausted by beneficiary.
- Treatment or services which have been specifically excluded as a benefit under the scheme.
- Local treatment rendered by a service provider who is not registered with the Society.
- Purchase of spectacles, frames, lenses for Econoplan Scheme members.
- Certified psychiatric treatment.
- Occupational therapy.
- Private nursing services.
- Treatment of infertility.
- Treatment of services given by hypnotic, herbalists, traditional healers, homeopaths, naturopaths, acupuncturists etc.
- Treatment by family member or any auto therapy.
- Treatment related to birth defects and congenital illness including heredity conditions.
- Treatment for pre-existing conditions.
- Accommodation or treatment received at health/slimming or similar clinics.
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- Air fares and reparation charges.
- Hotel accommodation.
- Medical reports unless if requested by MASM.
- Funeral services.
- Birth reports.
- Death reports
- Telephone charges.
- Labour charges and technicians fees.
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