PREMIUM PER PERSON PER ANNUM

Following are the packages together with the proposed premiums per person per annum:

BENEFIT PACKAGE ENHANCED ENHANCED PLUS ULTIMATE

GH¢ GH¢ GH¢
ADULT 4,943.26 8,760.45 15,070.69
CHILD GH¢ GH¢ GH¢
(18YRS & BELOW) 4,696.09 7,884.40 13,563.62
Please note that individuals with chronic/pre-existing conditions will be individually
underwritten; Medications for such conditions may attract additional fees.

Also note, a medical examination report from a designated center would be a

prerequisite to enrollment onto an individual and family policy.

Kindly note that quotations above are valid for a period of three (3) months

SCHEDULE OF BENEFITS
PACKAGE(PLAN) ENHANCED
ENHANCED ULTIMATE
PLUS
OUT-PATIENT BENEFITS
TOTAL MAXIMUM OUT-
GH¢ GH¢ GH¢
PATIENT BENEFIT PER
3,000.00 5,000.00 7,500.00
PERSON PER ANNUM
Covered within Covered within Covered within
GP Consultation benefit limit benefit limit
benefit limit
Covered within Covered within Covered within
Specialist Consultation benefit limit benefit limit benefit limit

Laboratory Investigation
Pathology
▪ Laboratory tests Covered within Covered within Covered within
requested by a doctor benefit limit benefit limit benefit limit
for investigation &
treatment purposes.
Imaging
▪ Endoscopy,
Colonoscopy
▪ X-ray, Covered within Covered within Covered within
▪ USG Scan (including benefit limit benefit limit benefit limit
Doppler)
▪ CT Scan,
▪ MRI
▪ Out-Patient/Minor
Surgery Covered within Covered within Covered within
Suturing of lacerations, benefit limit benefit limit benefit limit
incisions and Drainage
Prescribed Drugs
▪ Acute Medicines
▪ Chronic Medicines & Covered within Covered within Covered within
Treatment benefit limit benefit limit benefit limit
For pre-existing conditions
(i.e., Diabetes, Hypertension
etc.) disclosed at registration.
Covered within Covered within Covered within
Eye Care benefit limit benefit limit benefit limit

Optical
• Optometry, Frames
and Lenses (every 2
years).
Covered up to Covered up to Covered up to
NB: If there is a change in
GH¢300 GH¢400 GH¢500
prescription within the 2-year
period, the cost of lens would
be covered within the benefit
limit.
Dentistry
▪ Basic Dental
Procedures Covered up to Covered up to Covered up to
Consultation and Examination, GH¢300 GH¢500 GH¢500
X-ray, Extractions, Fillings,
Scaling and Polishing
▪ Specialist Dental Covered up to
Procedures Not Covered Not Covered GH¢500
Root Canal Treatment,
Periodontal Treatment
Auxiliary Services
(Upon referral & at the tertiary
institutions and other
designated centers – Accra
Physiotherapy Centre, 37
Physiotherapy,
Hospital, Korle and Spinal Physiotherapy,
Dietician, (Upon
clinic) Dietician, (Upon
referral at the
referral at the tertiary
Not Covered tertiary
▪ Physiotherapy, institutions and other
institutions and
▪ Dietician designated centers),
other designated
▪ Speech Therapy Ambulance Services
centers)

Ambulance Services (Upon

referral & at the tertiary
institutions and other
designated centers)

IN-PATIENT BENEFITS
ENHANCED
PACKAGE(PLAN) ENHANCED ULTIMATE
PLUS
TOTAL MAXIMUM IN-
GH¢ GH¢ GH¢
PATIENT BENEFIT PER
10,000.00 15,000.00 30,000.00
PERSON PER ANNUM
Hospital Accommodation Side Ward Private Ward VIP Ward
Fees for Doctors, Specialists, Covered within Covered within Covered within
Surgeon, Anesthetists, benefit limit benefit limit benefit limit
Physiotherapist
Other Major and Minor
Surgery
(e.g., Piles, Fibroid, Hernia,
Thyroid, Prostate, Spine, etc.)
▪ Operating Theatre Fees
▪ Ward Medicines Covered within Covered within Covered within
▪ Consumables benefit limit benefit limit benefit limit
▪ (Infusion, Material for
Dressing, Sutures,
Bandages, Syringes,
Catheters, Giving Sets,
Cannulae)
 Covered up to the Covered up to the
Covered up to the
Laparoscopic procedures are cost of same cost of same
cost of same
to be disclosed at the point of traditional traditional
traditional procedure
registration. procedure procedure
/surgery
/surgery /surgery

Laboratory Investigation
Pathology
▪ Laboratory tests Covered within Covered within Covered within
requested by a doctor benefit limit benefit limit benefit limit
for investigation &
treatment purposes.
Imaging
▪ Endoscopy,
Colonoscopy
▪ X-ray, Covered within Covered within Covered within
▪ USG Scan (including benefit limit benefit limit benefit limit
Doppler)
▪ CT Scan
▪ MRI
Covered within Covered within Covered within
Intensive Care benefit limit benefit limit benefit limit

Auxiliary Services Covered within Covered within Covered within

Physiotherapy (Upon referral), benefit limit benefit limit benefit limit
Ambulance
Cancer Treatment
Investigations (CT scan, MRI,
Angiography), Radiotherapy, Covered up to Covered up to Covered up to
Chemotherapy, Surgery (GH¢5,000) (GH¢10,000) (GH¢20,000)
• Organ Transplant
(Heart, Kidney, Liver)
▪ Kidney Dialysis
Psychiatric hospitalization
▪ Stress
▪ Mania
▪ Depression Not Covered Not Covered Covered
▪ Psychologist
consultation
▪ Psychosis
ADDITIONAL BENEFITS
 Glico Healthcare
About Glico Health Care, Contact numbers, Exclusions, FAQ’s
Beneficiary App.
Download from Google and Service Provider accessibility.
Play Store and App Store
Health Tips, Updates on policy, Goodwill messages from Glico
Quarterly Newsletters:
team, etc.

Access to doctors for consultation by virtual means at the

E-Health Service
comfort of your home when unable to visit the hospital.

Mobile Pharmacy Delivery of prescribed medications at place of convenience

EXCLUSIONS
Like in every other insurance scheme, certain services are not covered. Glico HealthPlan does not
cover the following:

1. Any expenses incurred in connection with injury or illness directly caused or contributed
to by war or invasion or whilst engaged or taking part in Military, Naval or Air Force
Services operations or dangerous sports and recreational activities.
2. Cost incurred as a result of riot or civil commotion, revolution insurrection or Military or
usurped power, nuclear or chemical contamination providing that the patient was just a
victim and not a perpetrator.
3. Any expenses for which the member has been or can be reimbursed from any form of
insurance or any other source except in respect of an excess of expenditure beyond the
amount recovered from such other source or the treatment to which he is entitled without
charges.
4. Treatment not recommended or undertaken by registered medical practitioner, or
undertaken in nature cure clinic, or health hydros, or traditional health clinic or similar
establishment or hypnotist unless previously negotiated.
5. The fitting or provision of hearing aids, wigs, crowns, bridges, inlays, dentures, implants,
orthodontics, and orthopedic appliances unless previously negotiated.
6. Treatment directly or indirectly arising from intentional self injury
7. Injury or illness resulting from alcoholism or illegal drug use or the use of drugs not
medically prescribed.
8. Home nursing, Rehabilitation centers and Spas, charges for any stay in hospital or
registered nursing home which is arranged wholly or partly for domestic reasons.
9. Treatment for any illness or injury that originated before the insured was accepted for this
insurance unless such illness or any related preceding condition was fully disclosed on the
application form and accepted by the Organisation without any restrictions.
10. Claims in respect of invalid tonics and high energy drinks
11. Fertility tests, treatment of infertility e.g., prescribing of fertility drugs like
Clomid, Artificial insemination, Assisted reproduction. Medications for sexual
and erectile dysfunction e.g., Viagra, Cialis, Levitra, Contraception including
sterilization
12. Termination of Pregnancy – Unless on medical grounds. (Incomplete abortions
and in cases deemed detrimental to the mother’s life).
13. Tooth brushes and pastes
14. Medicated soaps, shampoos, and lotions except for the treatment of skin
diseases, toilet preparations and cosmetics of all kinds
15. Dietary Supplements, Vitamins and Vitamin/Mineral preparations except for
conditions stated in the benefit schedule.
16. Any contingency arising whilst any member insured under this policy is outside the
geographical limits of Ghana unless previously negotiated.
17. Periodic or routine medical examinations and screening outside what is provided by the
terms of the policy.
18. Any prophylactic treatment, injections, inoculations or vaccinations unless previously
negotiated.
19. Cosmetic procedures, Surgeries, Aesthetic treatments including but not limited to revision
of scars.
20. Treatment available as free public healthcare services, Immunisations, HIV
infection/AIDS, Treatment of Tuberculosis, Onchocerciasis, Buruli Ulcer, unless previously
negotiated.
21. Any expenses incurred on feeding other than when on admission are not covered.