MEDIPLAN Healthcare Limited is a Health Maintenance Organization incorporated in May 2000 in Nigeria to carry on the business of providing healthcare services to corporate organizations and members of the public, under a prepaid arrangement, utilizing a network of primary, secondary and specialist healthcare providers nationwide.
A Health Maintenance Organization is a limited liability company that combines the principles of insurance and healthcare management to provide comprehensive, qualitative, affordable, defined and easily accessible healthcare to an enrolled population through an associated network of healthcare providers who are responsible for care delivery.
An individual or institution that provides medical services (e.g. a physician, hospital, laboratory, e.t.c.)
A healthcare professional responsible for providing a wide variety of basic healthcare services. This is usually the entry point into the healthcare system. The PCP has an on-going relationship with the individual and knows the patient’s medical history; and therefore is responsible for the coordination of the care of the enrollee.
A person who is covered by health insurance.
– Guaranteed access to quality healthcare services
– Better and wider choice of primary care services
– User-friendly healthcare provider network
– Efficient referral system through primary to secondary to tertiary levels of care
– Portability for emergency or out-of-station care
– No penalty for cost of usage
– Access to counseling on immunization services
– Guaranteed customer service satisfaction
– Peace of mind
The form will be duly processed, which includes the issuance of a policy number and the medical scheme I.D card. Upon issuance of your I.D card you can go to the Primary Care Provider indicated on your form to receive care when the need arises.
Only providers accredited for this scheme can be used. You are expected to choose from this list of providers. It is possible your current doctor’s hospital facility might be on our network already, in which case you should be able to choose him.
No, you are not allowed to use a provider not registered on the scheme, except in the event of a medical emergency.
A medical emergency is defined as a medical condition, which if not attended to promptly can lead to death or permanent physical or mental disability. Therefore, arrangement has been put in place for the enrollee to attend any hospital within our provider network, located around the place of occurrence. However, where a health facility within our network is not available, any other hospital in the immediate vicinity can be used, but, Mediplan is to be informed within 24 hours of admission. Such examples of emergencies include: Road Traffic Accidents, fractures, severe bleeding from any part of the body, high blood pressure leading to irrational talk, dizziness e.t.c.
Yes, you can change your healthcare provider under the following circumstances:
1) Transfer to another location, city or state
2) Dissatisfaction with quality of care delivered by your chosen provider after due investigation by Mediplan
3) Change of enrollee’s place of residence.
In each of the above mentioned case, a formal letter should be written to that effect giving 30 days notice. The change will become effective at the start of a new month following the expiration of the 30 days.
However, where the reason for change bears on dissatisfaction with services rendered, there shall be intervention by our medical personnel after which if the need still arises, the change shall be effected.
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