Micro Health Form

Addosser Micro Finance

Addosser Micro Health Insurance Form

Individual Basic Plan

The following services shall be covered subject to an overall benefit limit of N250k per enrollee per annum:

- Basic Plan - 12,000
- Admissions & Accommodation (Up to 4 Admissions/Annum)
- This includes accommodation in a four bedded room or general ward
- Treatment: Malaria, Typhoid, Injuries etc.
- Hospital admission including feeding
- Medication/Drugs
- Laboratory Tests: Blood tests, Urine, Hepatitis B, HIV I & II, Diabetes screen, Blood sugar, Pregnancy tests etc.
- Over the phone consultation with a doctor (Telemedicine)

Addosser Micro Finance

Addosser Micro Health Insurance Form

Family Plan

The Family Plan is for a minimum family size of 4 (Principal, Spouse, and 2 Children less than 18 years old) and a maximum family size of 6 (Principal, Spouse, and 4 Children less than 18 years old).

- Overall Health Benefit: N920,000
- Family Plan: N 72,000
- Plan Validity: 12 Months
- Age limit: 60 years (parents), 18 years (children)

General Benefits: ...

- Accidents & Emergencies: Resuscitative or lifesaving initial treatment.
- Accommodation (including feeding).
- Inpatient medication.
- Surgeries.
- Hospital-based consultations with General practice doctors and medical officers.
- Hospital-based Consultations with specialists.
- Outpatient Prescription Medicines.
- Telemedicine
- Antenatal Care + Normal Delivery+ Postnatal care (6 Weeks)+Neonatal Care Services (Male circumcision, Ear Piercing).
- NPI Immunizations for 0-5years & Family Planning Services.
- HIV/AIDS Care & Treatment.
- Optical Care & Physiotherapy.

Kindly choose your preferred plan

Choose your preferred plan

Family Plan (₦ 72,000)

Kindly fill in the information below

First Name *

Surname *

Others

Email address *

Gender*

Marital Status *

Date of Birth *

Mobile Number*

Preferred Hospital *

Residential Address *

Upload Passport * (maximum image size must be 405kb)

Amount *

Spouse

First Name

Surname

Others

Relationship

Gender

Mobile Number

Email Address

Residential Address

Upload Passport (maximum image size must be 405kb)

Beneficiary 1

First Name

Surname

Others

Relationship

Gender

Mobile Number

Email Address

Residential Address

Upload Passport (maximum image size must be 405kb)

Beneficiary 2

First Name

Surname

Others

Relationship

Gender

Mobile Number

Email Address

Residential Address

Upload Passport (maximum image size must be 405kb)

Beneficiary 3

First Name

Surname

Others

Relationship

Gender

Mobile Number

Email Address

Residential Address

Upload Passport (maximum image size must be 405kb)

Beneficiary 4

First Name

Surname

Others

Relationship

Gender

Mobile Number

Email Address

Residential Address

Upload Passport (maximum image size must be 405kb)

Addosser Micro Health Insurance Form

Individual Basic Plan

Addosser Micro Health Insurance Form

Family Plan

Kindly choose your preferred plan

Individual Plan (₦ 12,000)

Family Plan (₦ 72,000)

Spouse

Beneficiary 1

Beneficiary 2

Beneficiary 3

Beneficiary 4