| SPECIAL FEATURES |
ECONO |
EXE |
EXE(O) |
VIP |
VIP(O) |
COMMENTS |
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| CONTRIBUTIONS |
K520 |
K1,300 |
K2,000 |
K3,500 |
K4,200,00 |
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| ANNUAL LIMIT |
K150,000 |
K1,000,000 |
K2,000,000 |
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| AMBULANCE SERVICES |
| MASM EMS-Within 30KM Radius-K2500 |
100% |
100% |
100% |
100% |
100% |
|
| -Outside 30KM Radius |
50% |
80% |
80% |
90% |
90% |
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| BLOOD TRANSFUSION |
| MISSION & PRIVATE INSTITUTIONS |
100% |
100% |
100% |
100% |
100% |
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| DENTAL |
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| DENTAL-ANNUAL LIMIT |
K10,000 |
K50,000 |
|
K100,000 |
|
To Dental spread benefits quarterly |
| DENTURES |
100% SUBJECT TO TARIFF & APPROVAL BY MASM |
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| DRUGS |
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| FOREIGN PRESCRIPTIONS |
| Drugs bought abroad(Old arrangement) |
| Drugs Bought abroad( current arrangement) |
| - Branded |
Nil |
25% |
25% |
60% |
60% |
|
| - Generic |
Nil |
50% |
50% |
70% |
70% |
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| SPECIFIC NAMED DRUGS |
Nil |
50% |
50% |
70% |
70% |
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| OTC'S - Ranges of Antiacids,Pain killers & |
NIL |
50% |
50% |
80% |
80% |
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| Cough Syrups |
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| Drugs supplied by Visiting Specialists |
NIL |
50% |
50% |
60% |
60% |
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| VACCINES- Not covered by Government |
NIL |
? |
? |
? |
? |
Will look at range of vaccines and their |
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prices and then agree on % award. |
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| FOREIGN TREATMENT |
| Specialist foreign treatment |
NIL |
25% |
25% |
60% |
60% |
|
| Travel Emergency |
NIL |
25% |
25% |
60% |
60% |
|
| student foreign cover |
|
25% |
25% |
60% |
60% |
Student cover not applicable now. Students |
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join Platinum & Super |
| MINOR & MAJOR SURGICAL PROCEDURES |
| Elective treatment |
WAIT PERIODS APPLY |
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| Emergency treatment |
NO WAIT PERIODS - PRE AUTHORISATION REQUIRED |
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| MATERNITY |
NO OF VISITS NOT LIMITED |
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NO OF VISITS NOT LIMITED |
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| OPTICAL CARE |
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| Spectacle benefit |
NIL |
K5,000 |
K5,000 |
K10,000 |
K10,000 |
| Years of cover |
NIL |
COVERED ONCE EVERY 2 YEARS |
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| THEATRE FEE |
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| Elective treatment |
WAIT PERIODS APPLY |
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| Emergency treatment |
NO WAIT PERIODS - PRE AUTHORISATION REQUIRED |
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| HOSPITALISATION |
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| Elective treatment |
WAIT PERIODS APPLY |
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| Emergency treatment |
NO WAIT PERIODS - PRE AUTHORISATION REQUIRED |
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| HEARING AIDS |
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| Entitlement |
NIL |
K50000 |
K50000 |
K100000 |
K100000 |
Once every 5 years |
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| EXECUTIVE CHECK |
NIL |
100% |
100% |
100% |
100% |
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Only members who have not claimed in 12 consecutive months are entitled to this benefit |
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Prior approval to be sought from MASM |
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