PREMIUM PER PERSON PER ANNUM

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

ENHANCED
BENEFIT PACKAGE ENHANCED PLUS ULTIMATE
GH¢ GH¢ GH¢
ADULT 9,117.90 14,143.73 21,672.83
CHILD GH¢ GH¢ GH¢
(18YRS AND BELOW) 8,662.00 12,729.35 19,505.54
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 PLUS ULTIMATE

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

Procedures
Laboratory Investigation
Pathology
Covered within Covered within Covered within
▪ Laboratory tests
requested by a doctor benefit limit benefit limit benefit limit
for investigation &
treatment purposes.
Imaging
Covered within Covered within Covered within
▪ Endoscopy,
Colonoscopy benefit limit benefit limit benefit limit
▪ X-ray,
 ▪ USG Scan (including
Doppler)
▪ CT Scan,
MRI
▪ Out-Patient/Minor
Surgery Covered within Covered within Covered within
Suturing of benefit limit benefit limit benefit limit
lacerations, incisions
and Drainage
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
▪ (Infusion, Material for benefit limit benefit limit benefit limit
Dressing, Sutures,
Bandages, Syringes,
Catheters, Giving Sets,
Cannulae)
Laparoscopic procedures are
to be disclosed at the point of
registration.
Covered within Covered within Covered within
Eye Care benefit limit benefit limit benefit limit

Optical (Lens and Frame

Covered up to Covered up to Covered up to
every 2 years unless
Ghc300 Ghc400 Ghc500
prescription changes)
Dentistry
▪ Basic Dental
Procedures
Covered up to Covered up to Covered up to
Consultation and
GH¢300 GH¢500 GH¢500
Examination, X-ray,
Extractions, Fillings, Scaling
and Polishing
▪ Specialist Dental Covered up to
Procedures Not Covered Not Covered GH¢500
Root Canal Treatment,
Periodontal Treatment
Physiotherapy,
Auxiliary Services Physiotherapy, Dietician,
(Upon referral & at the Dietician, (Upon (Upon referral at
tertiary institutions and other referral at the the tertiary
Not Covered
designated centers – Accra tertiary institutions institutions and
Physiotherapy Centre, 37 and other other designated
Hospital, Korle and Spinal designated centers) centers),
clinic) Ambulance Services
 ▪ Physiotherapy,
▪ Dietician
▪ Speech Therapy

Ambulance Services (Upon

referral & at the tertiary
institutions and other
designated centers)
IN-PATIENT BENEFITS
PACKAGE(PLAN) ENHANCED ENHANCED PLUS ULTIMATE
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
Covered within Covered within Covered within
Fees
▪ Ward Medicines benefit limit benefit limit benefit limit
▪ Consumables
(Infusion, Material for
Dressing, Sutures, Bandages,
Syringes, Catheters, Giving
Sets, Cannulae)
Laboratory Investigation
Pathology
Covered within Covered within Covered within
▪ Laboratory tests
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
 Maternity (Antenatal & Covered up to Covered up to Covered up to
Delivery) Ghc2,000 Ghc3,000 Ghc4,500
Auxiliary Services Covered within Covered within Covered within
Physiotherapy (Upon benefit limit benefit limit benefit limit
referral), Ambulance
Cancer Treatment
Investigations (CT Scan, MRI,
Angiography), Radiotherapy, Covered up 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 hospitalisation Not Covered Not Covered Covered

ADDITIONAL BENEFITS
Glico Healthcare App. About Glico Health Care, Contact numbers, Exclusions, FAQ’s
Download from Google and Service Provider accessibility.
Play Store and App Store
Access to online utilization report
Client Portal
Health Tips, Updates on policy, Goodwill messages from Glico
Quarterly Newsletters:
team, etc.

Access to doctors for consultation by virtual means at the

E-Medicine 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. Toothbrushes 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