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Eduhealth Brochure
Eduhealth Brochure
Health Plan
for education
professionals in
Mauritius and
Rodrigues.
MEDIBROKER lTD
Medibroker is the only specialist broker in Mauritius which helps individuals
and companies find the right medical insurance solution for them.
Every year, thousands of Mauritians are Preferential rates for the educational
rushed to medical facilities across the island community
for treatment.
1.2 Clinic room fees Standard Room Standard Room Standard Room
1.4 Internal Implants and Prosthesis (Incl. cost of surgery) 50,000 100,000 250,000
2.1 Normal Delivery and Caesarian MUR 35,000 MUR 50,000 MUR 75,000
4.2 Prescribed Blood Tests, X Rays, ECGs and Procedures 2,500 3,500 6,000
4.3 Pre Natal and Post Natal Routine Appointments 5,000 6,000 8,000
Adult Dependant
6.5 Excess Per Illness aligned to Inpatient Benefit 50,000 100,000 500,000
Exclusive
benefits
In addition to the standard covers offered,
Eduhealth provides you with a number of
exclusive benefits which include the following:
• Infertility Treatment
• Full Health Screening
• Overseas Treatment
• Funeral Grants
• Chronic Illnesses
• Hormonal Benefit Therapy
Step by step
Guide
Also, all questions need to be answered clearly
and accurately. Non-disclosure of relevant
information may cause unnecessary hassle like
repudiation of claims and even suspension of
cover.
Step 5
Step 1
Supporting documents
Visit our website
Once your application is approved, you will be
Visit our website at www.eduhealth.mu. Read required to submit the following documents to
the product brochure to understand the activate your cover:
benefits proposed and the relevant terms and 1. ID (or Passport for foreigners) of Main Member
conditions. The website offers a live chat service
for any assistance you may need. You can also 2. ID (or Passport for foreigners) of Spouse
call at our office for more information. (where applicable)
3. Marriage Certificate (where applicable)
4. Birth Certificate for Child Dependant/s
(where applicable)
Step 2 5. Proof of Residential Address- Utility Bill (Not
Choose your preferred option older than 3 months)
6. Bank Account Details
7. Standing Order Form
EDUHEALTH offers 3 different options to cater
for different needs and budget. Choose the
most appropriate option for you and your family.
Remember, all members of a family should be
on the same option. You may also upgrade your Step 6
inpatient limit with an optional catastrophe Payment of premium
cover.
1. Scope of Cover
Eduhealth is a health plan that provides cover for Medical and Surgical Expenses reasonably incurred by the
insured members as a direct result of their sustaining accidental bodily injury and/or illness and/or a disease
within the period of insurance.
2. Eligibility
Eduhealth has been designed exclusively for professionals working in the Education Sector in Mauritius and
Rodrigues. Members may also add their spouse/partners and children in the scheme.
3. Age Limit
Age limit to join Eduhealth is 65 years. Once a member, you and your dependants may stay on the scheme
until you reach the age of 85.
Children below 18 years may be added to the scheme at a special discounted rate. This benefit is extended
to children up to 25 years who are following full time courses.
Member will need to provide certificate of insurance from previous insurer including limit of cover,
remaining balance, terms and conditions of the previous policy and claims history for the past three
years.
SICOM General Insurance Limited reserves the right to accept or reject any application and to impose
waiting periods and exclusions as appropriate.
5. Catastrophe cover
The catastrophe cover, if chosen, will reimburse expenses incurred by a member after limits under the
inpatient cover have been exhausted.
The limit chosen under this section provides for medically necessary and eligible treatment including
hospital bed charges, doctor’s bills, anesthetists’ bills, operating theatre fees, pharmacy, laboratory, and
investigations reasonably incurred by an insured member. Benefits in respect of doctors’ fees will be paid
according to the “scale of costs”.
Treatments not available in Mauritius and its dependencies will be covered but must be authorized by
SICOM General Insurance Limited.
7. KYC Documents
Copies of the following documents need to be submitted, together with the duly completed original
application form:
• ID (or Passport for foreigners) of Main Member.
• ID (or Passport for foreigners) of Spouse (where applicable).
• Marriage Certificate (where applicable).
• Birth Certificate for Child Dependant/s (where applicable).
• Proof of Residential Address - Utility Bill (Not older than 3 months).
• Unmarried children from 18 to the age of 25 years and in full time of education (Proof of full time education
to be submitted).
• Bank Account details.
9. Payment of Premium
The premium is an annual premium covering 12 months insurance period payable monthly in advance.
In which case an economy class ticket for the patient and for an accompanying person shall be provided.
11. Main Exclusions
• Pre-existing medical condition(s)
• Any treatment, detoxification programs, psychological counselling, or psychotherapy/rehabilitation
related to usage/consumption of tobacco, electronic cigarettes (e-cigarette) or vaping of any kind,
alcohol & Illicit drugs or any psychoactive substance use with addictive potential or dependency.
• Any treatment not ordered by a physician.
• Treatment required for medical condition(s) arising as a result of self-harm, self-inflicted injuries including
suicide attempt(s).
• Epidemics and/ or pandemics.
• Loss, breakage, scratching, repairs or replacement of spectacles, frames, and contact lenses.
• Elective abortions/Termination of pregnancy and complications thereof.
• Treatment and medical investigation(s) outside the Territorial Limits of cover unless for emergencies
and/or authorized by us.
• Medical condition(s) arising from an engagement in professional sports.
• Treatment of sleep disorders, including insomnia, obstructive sleep apnea, narcolepsy, snoring and
bruxism.
• Medical Investigation(s) into, and treatment of, loss of hair and any hair replacement.
• Alternative medicine practitioner visits/consultations and treatments, including but not limited to:
Ayurveda, Traditional Chinese Medicine, Homeopathy etc.
12. Non-Disclosure
All pre-existing health conditions and other material facts should be fully and accurately disclosed in the
application form. Non-disclosure may lead to rejection of claims and/or cancellation of the cover. SICOM
General Insurance Limited reserves the right to add or waive waiting periods and/or exclusions as necessary.
13. Cancellation
The insured may terminate the scheme by giving one-month notice to the insurer. However, in case of
termination, the full annual premium remains payable if the benefits provided under the policy have been
fully or partly utilized. In case no benefits have been utilized, the premium shall be payable on prorated basis
calculated on the period of cover provided by the Policy.
Enjoy a
fully digital
service
The Eduhealth Website: Thanks to the Eduhealth website, applying for a healthcare plan has never been easier.
In a few clicks, you can request a quote, submit your application, and chat with an Eduhealth staff member who
will answer any of your questions.
Cashless Service: Forget having to do a bank transfer to clinics or carrying cash on you to visit the optician. All
you have to do is present your National Identity Card, and we’ll handle the payment for you.
Snap and Send: You can submit a claim and receive your refund from the comfort of your house. Take a picture of
your medical bills and send it to us through a digital application. Your claims are processed and refunded directly
in your bank account.
Social Media: Connect with the Eduhealth community and Eduhealth staff via our social media pages.
Your health. Your choice.
If you would like to learn more about Eduhealth, we offer a free and zero obligation consultation with one of our
health insurance specialists.