MetroHealth HMO plans provide coverage for only the benefit items with a check mark under each plan.

  MetroMini MetroMidi MetroMaxi
Outpatient specialist consultations * * *
Admissions General Ward Semi Private Private Room
Accommodation * * *
Physiotherapy * * *
X rays, Laboratory and diagnostic tests * * *
Accidental emergencies * * *
Prescribed medications/drugs for covered conditions * * *
Routine immunizations * * *
Minor surgeries and procedures * * *
Antenatal Care and delivery * * *
Primary Dental Care (Fillings) * * *
Non surgical extractions * * *
Eye glasses (or contact lenses) Up to N7,000 Up to N22,500 Up to N30,000
HIV/AIDS Care and Treatment * *
Advanced and Complex investigations (including CT Scan and MRI Scan) * *
Additional immunization for 0-5 years (Hepatitis, HiB, MMR, Pneumococcal) * *
Dental surgical extractions * *
Major and complex major surgeries and procedures *
Intensive care services *
Evacuations *
Selective screening *

EXCLUSIONS:

All the benefit plans listed above will not provide coverage for the following:

  1. Pre-existing conditions
  2. Treatment of substance abuse
  3. Conditions caused by an act of war, an epidemic or enrollee participating in a riot
  4. Treatment of mental, emotional or functional nervous disorders or psychological testing
  5. Family planning commodities
  6. Orthodontic services and dental Implants
  7. Hearing aids
  8. An eye surgery solely for the purpose of correcting refractive defects of the eye, such as near-sightedness (myopia), astigmatism and/or farsightedness (presbyopia)
  9. Cosmetic surgery
  10. Non-medical counseling or ancillary services
  11. Services primarily for weight reduction or treatment of obesity
  12. Nutritional counseling or food supplements
  13. Renal Dialysis
  14. Cancer care
  15. Infertility