EXCLUSION LIST

The following is a list of the general exclusions in relation to medication and

pharmaceutical products as per the different policy documents:

 Costs arising from a member receiving experimental treatment or being a

subject of medical research.
 Infertility, Impotence, male and female birth control, contraception and
sterilization treatment, reversal or any related expenses.-EXAMPLES INCLUDE
FEMIPLAN, YASMIN, MICROGYNON,
 Treatment for alcoholism, drug or substance abuse or any addictive
condition of any kind and any injury or illness arising directly or indirectly
from such abuse or addiction. Weight management treatments and drugs.-
EXAMPLES INCLUDE: PABRINEX INJ, ZYBAN 150MGS CHEWABLE GUMS,,
NICORETTE
 Any cosmetic related treatment and expenses.-EXAMPLES INCLUDE:
LANOLIN CREAM, EVIT CREAM, SKIN LIGHTENERS example SOAPS,
OILATUM SOAP AND CREAM MELACARE,RETIN
A,ENAT,SENSODYNE,LISTERIN MOUTH GARGLE, V WASH, LACTACYD
 Nutritional supplements unless prescribed as part of medical treatment of
specified conditions. EXAMPLES INCLUDE: PREGNACARE PLUS, TRESORIX,
SEVEN SEAS COLD LIVER OIL,JOINT CARE PLUS, JOINTCARE
GEL,CARTILCARE FORTE,
 Self-referred or self-prescribed treatment.
 Diagnostic equipment (e.g. Glucometers, BP machines etc.) and hearing aids.
EXAMPLES INCLUDE: ACCUCHECK TEST STRIPS, GLUCOMETER
 Self-referred or self-prescribed treatment.
 Expenses incurred in connection with venereal or sexually transmitted diseases.
EXAMPLES INCLUDE: STI TREATMENT THERAPY
 Diagnostic/investigative and prescription expenses exceeding 16,000/- with no
written authorization from Britam.
 Nerve blocks prescribed as treatment in pain management.
 Treatment of obesity or slimming preparation. EXAMPLES INCLUDE:
XENICAL TABS

 Experimental treatment and drugs not scientifically recognized or not proven to

be effective based on established medical practice.
  Costs of treatment for, or related to, Menopause, andropause, ageing, puberty
and pre-menstrual tension syndrome. EXAMPLES INCLUDE:
MENOPACE,HORMONAL SUPPLIMENTS, HORMONAL INJECTIONS
 Vaccinations and/or immunizations and other preventive treatments with the
exemption of KEPI and Baby Friendly. EXAMPLES OF PRIVATE VACCINES:
MMR, VARILIX, EXAMPLES OF BABY FRIENDLY VACCINES:HEXAXIM,
PENTAXIM
 Hormonal replacement therapy.
 Applicators, toiletries, sunglasses and/or lenses for sunglasses and beauty
preparations;
 Patented foods and nutritional supplements including baby foods; EXAMPLES
INCLUDE;LIPTOMIL PLUS,NAN
 Contraceptive preparations, remedies and devices; EXAMPLES INCLUDE:
IUCD INSERTION AND REMOVAL
 Tonics, slimming preparations, appetite suppressants and drugs as advertised to
the public for the specific treatment of obesity;
 Sunscreen and sun tanning lotions, Soaps and shampoos (medicinal or
otherwise); EXAMPLES INCLUDE: OILATUM SOAP, ACNE AID SOAP,
 Household and biochemical remedies which are not promoted by the medical
profession;
 Remedies for body building purposes; EXAMPLE PROTEIN SUPPLIMENT
o Aphrodisiacs and all forms of alternative medicine.
o Household bandages, cotton wool, dressings and similar aids.
o Crutches, splints, and standard wheelchairs, unless under rehabilitation
following an accident.

Exclusions under optical benefits

 Replacement of optical frames in a period of less than 2 years from the date of
issue
 Replacement of lenses unless prescribed by a qualified ophthalmologist as
necessary
 Laser eye surgery
 Plano lenses and photochromatic lenses