√ indicates services which are covered
x indicates services not covered under the specific plan

A.   EXCLUSIONS:

The following are excluded from the HyBasic Plan:

1. Overseas treatment and transplant surgery
2. Plastic/cosmetic surgeries
3. Management of Chronic Diseases including but not limited to consultation, prescription drugs and laboratory tests
4. Advanced and complex investigations including but not limited to CT Scan, MRI Scan and Echocardiograph
5. Maternity services including but not limited to antenatal care, delivery services, postnatal care services
6. Investigations and treatment for problems relating to infertility e.g.  hydrogenation, hysterosalpingogram, I.V.F, G.I.F.T, and artificial insemination
7. Virility enhancing drugs
8. Herbal drugs, non-prescription drugs, and experimental drugs and treatment
9. Other laboratory investigations not listed in the schedule of covered services
10. Dental care not listed in the schedule of covered services
11. Home care and domiciliary services
12. Intensive care treatment
13. Interstate travel for services not available in State
14. Joint replacements and prosthetic limbs
15. Family Planning Services
16. Renal Dialysis
17. Cancer Care
18. HIV/AIDS Care & Treatment
19. Long term psychiatric illness (Longer than 3 months)
20. Comprehensive health screening/well persons’ check
21. Pre – School Health examinations
22. Neonatal care services including but not limited to male circumcision, ear piercing, treatment of mild or moderate neonatal sepsis, phototherapy, NICU and SBCU
23. Self-inflicted injuries
24. Treatment of congenital abnormalities
25. Treatment of obesity
26. Covid-19 testing and treatment
27. Other advanced immunizations not specified in the plan
28. Other optical services not listed in covered services including but not limited to the treatment of chronic eye diseases, provisions of frames, lenses, and contact
29. Treatment of speech disorders
30. Room upgrades beyond that specified in the plan benefits
31. Management of severe burns (burns covering more than 10% body surface area)
32. Learning difficulties, behavioral and developmental problems
33. Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners, or complementary medicines practitioners
34. Any other treatment, service, procedure, or investigation not listed in the schedule of covered medical services

B. NOTE

1. The maximum principal age limit is 60 years and the Dependant age limit is 18
2. Family means Principal, Spouse and 2
3. There will be a waiting period of 2 weeks after Plans purchased becomes active 2 weeks

after the purchase date.

4. All benefits are subject to their respective sectional limits which is described as: Inpatient Limit and Outpatient Limit. However, within the respective sectional limit, there are specific benefit limits as Consequently, in the event that any specific benefit limit under the sectional limit is exhausted, the remaining limit in that section will only cover other benefits within the section apart from the one that the specific benefit limit has been exhausted.
5. The following benefits will not be covered or provided in the first year of the commencement of the scheme: Surgeries, Critical Illness + Death Cover and Psychiatric Care. This period otherwise known as waiting period shall commence on the date of entry to the date of renewal. On renewal, this benefit will be accessible provided the enrollee has been enrolled for one year with the
6. The following benefits will not be covered or provided in the first 3 months of the commencement of the scheme: Optical Care, Dental Care