1. 1	Additional Access to Lagoon Hospitals, Nisa Premier Hospital and Prime Medical Consultant
   2	Benefit can only be drawn from the limit of a nursing mother for a live birth
   3	This benefit includes all surgical costs relating to day case procedures, minor, intermediate ,major surgeries (incl. Caesarean Section), Endoscopic Procedures (Therapeutic and Diagnostic).
   4	ONLY available on Telemedicine Platform as advised by Hygeia HMO.
   5	Terms and Conditions Apply as stated in the comprehensive benefit document
   6	This includes X-Rays, Ultrasounds and Laboratory tests (WHO list of essential in-vitro diagnostics)
   7	Subject to availability of Hygeia designated test centres and NON-refundable if done outside of the designated test centre. It is not elective and MUST be recommended by a Hygeia Network doctor based on clinical assessment.
   8	Enrollee is covered for a payment up to the stated limit in the event of critical illness (as a result of cancer, kidney failure, heart attack or stroke) or Death (Natural, Accidental or Covid related). The actual amount paid is based on the event while eligibility is subject to compliance with the rules of the plan.
   9	This refers to the amount that will be refunded by Hygeia HMO should the enrollee choose to access this care outside of Nigeria. Specific terms and conditions apply.
   10	Health checks can only be done at any of our designated hospitals/diagnostic centers. Health checks are otherwise non-refundable
   11	Ophthalmic Services includes Eye testing, Treatment of acute and chronic eye diseases
   12	Principal Only. Other terms and conditions apply

1. EXCLUSIONS:

The following are excluded from all plans: –

1. Transplant surgery
2. Plastic/cosmetic surgeries
3. Advanced and complex investigations not stated in the schedule of covered services
4. Other investigations and treatment for problems relating to infertility e.g. hydrotubation, hysterosalpingogram, I.V.F, G.I.F.T and artificial insemination
5. Kidney Dialysis
6. Virility enhancing drugs
7. Herbal drugs, non-prescription drugs, food supplements, and experimental drugs and treatment
8. Other laboratory investigations not listed in the schedule of covered services
9. Dental care is not listed in the schedule of covered services
10. Home care and domiciliary services
11. Joint replacements and prosthetic limbs
12. Long term psychiatric illness (Longer than 6 months)
13. Dermatological care deemed not medically necessary
14. Comprehensive health screening/well persons check outside the scope of the benefits covered by the health checks.
15. Pre-School Health examinations
16. Treatment for newborns not registered on the plan after 6 weeks of birth.
17. Neonatal care not listed under neonatal services
18. Self-inflicted injuries
19. Treatment of obesity
20. All Covid-19 Treatment
21. Covid-19 testing except as stated in the schedule of covered services.
22. Speech disorders
23. Room upgrades beyond that specified in the plan benefits
24. Management of severe burns (Burns covering more than 10% body surface area)
25. Learning difficulties, behavioral and developmental problems
26. Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners or complementary medicines practitioners
27. Any other treatment, service, procedure or investigation not listed in the schedule of covered medical services