Our Benefits - Options and Benefits | NMC

Opal

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Key Benefits

Hospital: Major medical expenses

AHB Cover: GPs and specialists in-hospital services payable to a maximum of 150% of the NAMAF tariff

Benefit Cover
Accommodation and Theatre 100%
Physiotherapy and Biokinetics (In-hospital) 100%
Post Rehabilitation
Physiotherapy, Biokinetics and Occupational Therapy
100%
MRI and CT Scans 100%
Internal Appliances and Materials 100% of Cost
Oncology
  • Consultations and Procedures Out-of-Hospital
  • MRI/CT Scans and Other Specialised Radiology Procedures In and Out-of-Hospital
  • Radiation Oncology (Referral from a medical specialist only)
  • Oncology Medication (Chemotherapy, radiotherapy and hormone therapy)
  • Hospitalisation and Related Procedures In-Hospital
100%
Dialysis/Organ Transplant 100%
Maternity - Confinement – Full Procedure
  • Confinement – full procedure
  • 12 Ante-natal consultations per Beneficiary
  • Six sessions, ante-/post-natal classes and education
  • Three sonar scans per Beneficiary per pregnancy
100%

Day-to-Day Benefits


Benefit Cover
General Practitioners and Specialists 100%
Medicine and Injections
  • Acute and Chronic
  • Essential Vaccination/Immunisation (As per WHO guidelines)
  • Self-Medication
100%
Primary Health Care Services 100%
Dentistry 100%
Optical 100%
Auxiliary Services 100%

Contributions


Individuals
Age Band Main Adult Child
0 25 2,068 1,287 573
26 30 2,288 1,447
573
31 35 2,492 1,626
573
36 40 2,793
1,839 585
41 45 3,058
2,016 585
46 50 3,277 2,204
585
51 55 3,566 2,430
585
56 60 3,803 2,608
585
60 65 4,048
2,788
585
66+
4,296
2,990 585
Groups
Income Band
Main Adult Child
0 4,360 1,862 1,205 344
4,361 5,760
2,144
1,368
394
5,761
8,810 2,296 1,419
424
8,811
12,950
2,360 1,522
434
12,951
14,550 2,640 1,691 487
14,551 16,500 2,924
1,861 540