Medical insurance
country life, in collaboration with authorities of Khyber Pakhtunkhwa, has taken initiative to launch Social health safety (SHP) to offer and promote social and micro medical insurance scheme for the maximum deserving population of four districts of Khyber Pakhtunkhwa namely Kohat, Mardan, Malakand and Chitral. The scheme will target the most deprived segment of society and provide them access to the fitness centers in a extensive range of public and personal hospitals. The proposed target market will have a tendency to increase to consist of a wide variety of society. The scheme objectives to inspire:utilization of health care centers
Provision of exceptional fitness offerings
Provision of cashless offerings to beneficiaries
attention concerning monetary danger because of health related perils
underneath the scheme, the participants could be protected for hospitalization, day care surgeries and maternity blessings, albeit under a prescribed limit. along with the availability of these facilities, the fine of services can also be monitored for development. capabilities inclusive of transportation coins furnish on maternity will inspire the woman populace to make use of the fitness company facilities and will in the end bring about improving the lady and baby survival fee.
extra than 1 Million beneficiaries will be enrolled under the scheme to get the advantage of hospitalization.
Social fitness safety.
coverage region
SHP is a micro medical insurance scheme which covers the cost of hospitalization for medical & surgical approaches along with day care surgeries and maternity blessings to the enrolled households’ up to Rs. 25,000 per person per annum. Pre and post hospitalization care/treatment of as much as sooner or later prior to hospitalization and up to five days from the date of discharge may be furnished underneath the scheme.
under the scheme, there is no age restriction and exclusion of pre-existing circumstance (besides “general Exclusions”). The scheme will cover health facility services normally furnished at the secondary degree (up to DHQ hospital) but such services may be supplied even at tertiary care hospitals.
under the scheme, there's no age limit and exclusion of pre-existing condition (except “popular Exclusions”). The scheme will cowl health center offerings usually supplied at the secondary stage (as much as DHQ sanatorium) however such offerings may be furnished even at tertiary care hospitals.
under the scheme, there may be no age restriction and exclusion of pre-existing condition (except “fashionable Exclusions”). The scheme will cowl health center offerings typically furnished at the secondary level (as much as DHQ health center) but such offerings may be furnished even at tertiary care hospitals.
Maternity and New Born insurance includes treatment taken in empanelled health facility/nursing houses springing up from toddler birth along with everyday transport / caesarean section and / or miscarriage or abortion induced via accident or different medical emergency situation to exclusion. New Born child can also be taken into consideration as part of household and included below the scheme. For maternity instances, transportation prices of Rs.1,000/- according to hospitalization will also be provided.
Exclusions.
the following treatment, gadgets, conditions, activities and their related or consequential charges are excluded from the settlement and the business enterprise shall no longer be answerable for:
fees on account of self-inflicted injury, tried suicide, abuse of alcohol, drug addiction or sexual disorders and remedy of sexually transmitted diseases.
Psychotic, intellectual or fearful problems (together with any neuroses and their physiological or psychosomatic manifestations) or sensual reassignment (whether or not or now not for mental reasons) .
remedy or investigation of fertility, infertility, sterilization or birth control and any hardship bearing on thereto or hormone treatment and investigations.
Participation in or training for any dangerous or dangerous recreation, activity or opposition or any professional recreation.
injuries as a results of an unlawful act by means of the Insured character.
harm or treatment due to warfare, riots, invasion, act of foreign enemies, hostilities or warlike operations (whether or not warfare be declared or no longer), civil struggle, mutiny, civil commotion assuming the proportions of or amounting to a famous uprising, army rebellion, rebel, rebel, military or usurped energy or any act of any individual performing on or on behalf of or in connection with any employer actively directed in the direction of the overthrow or to the influencing of any authorities or ruling frame by pressure, terrorism or violence.
Ionizing radiation or contamination with the aid of radioactivity from any nuclear gasoline or nuclear waste, from the method of nuclear fission or from any nuclear weapons fabric.
offerings or treatment in any spa, hydro clinic, health facility, nursing home or long term-care facility that is not a health center.
acquired immune deficiency syndrome (AIDS related complex syndrome (ARCS) and all illnesses as a result of and /or related to HIV virus or another Sexually Transmitted sickness (STDs).
Experimental or unproven remedy.
Dental examinations, D-rays, extraction, filling, popular dental care / remedy and orthodontic treatment or oral surgery except because of emergency because of coincidence.
cost of correction of refractive errors of the attention and approaches such as Radial Keratotomy and Excimer Laser.
habitual clinical examinations or take a look at-u.s.including costs springing up out of any clinic confinement or admission typically for diagnostic functions, ordinary eye or ear examinations, vaccinations, clinical certificate, exam for employment or tour, spectacles, contact lenses, hearing aids and any treatment that is not taken into consideration medically necessary.
cosmetic or plastic surgical operation, except it is re-optimistic surgery necessitated by using an harm that came about all through the duration at the same time as the insured man or woman turned into protected under this settlement and difficulty to the limits and sub-limits said within the blessings package.
Any fees in appreciate of the donor for organ transplant claims.
price of limbs or supporting equipment for revival or correction of the characteristic(s) of frame.
non-public consolation items which include, prices for phone, comfort objects, meals or different items now not medically important.