• Ebonyi State Health Insurance Agency (EBSHIA)
  • hello@ebshia.eb.gov.ng
  • +234-901-210-2250

EBSHIA Health Benefit Packages

S/No

A. PRIMARY HEALTH CARE

1

Healthcare Preventive / Promotive Services and Hospitalization

1. Medical Consultations
2. Admission or Hospitalization
3. General Outpatient Care and consultation
4. Stabilization

2

Non-Communicable Diseases

1. Screening/referral for Diabetes Mellitus
2. Screening/referral for Hypertension
3. Cervical cancer screening using VIA/VILI

3

Immunization

1. BCG
2. OPV
3. PENTAVALENT VACCINE
4. MEASLES
5. HEPATITIS B
6. VITAMIN A
7. PNEUMOCOCCAL VACCINE
8. Inactivated polio vaccine
9. TD
10. Meningitis

4

Family Planning

1. Education
2. Oral contraceptives
3. IUCDs
4. Injectable

5

Child Welfare Services

1. Growth monitoring
2. Nutrition education
3. Vitamin supplementation
4. De-worming

6

Maternity Care

1. Routine Maternity Care
2. ANC For Pregnancies Up to Four (4) Live Births
3. Consultation by Skilled Health Care Workers
4. Two [2] Obstetric Scans
5. Urinalysis for Protein
6. Screening for Malaria, HIV, Syphilis, HBsAg
7. PCV
8. Blood Group
9. Hematinics
10. Health Education

7

Delivery

1. Normal Delivery by skilled birth attendant
2. Monitoring of Labour Using A Partograph
3. Provision and Repair Of Episiotomy
4. IV/IM Oxytocic’s +Augmentation of Labour For Emergency Cases Such As Uterine Atony
5. IV/IM Anticonvulsants
6. IV/IM Antibiotics
7. PMTCT Counselling Services and Prophylaxis
8. Manual removal of placenta
9. Repair of simple perineal tears

8

Uncomplicated Medical/Surgical Illnesses In Pregnancy

1. Malaria in Pregnancy
2. Diarrhea Using Drugs Stipulated In The EDL
3. Gastritis/Heartburns
4. Emesis
5. Body Pains

9

Post-natal care for mothers and child up to six(6) weeks after delivery

1. Provision Of Drugs As Stipulated In The Essential Drug List
2. Consultation By Skilled Health Care Provider
3. Basic Laboratory Investigations: FBC Urinalysis
4. Management of Simple Post-Natal Infections e.g. Mastitis
5. Emergency Treatment for Post-Partum Hemorrhage
6. Management of uncomplicated Sepsis
7. Essential Newborn Care (including male child circumcision)
8. Counselling/Education And Initiation Of Breast Feeding
9. Treatment Of Simple Neonatal Infections/Infestation e.g. Conjunctivitis, Malaria, URTI, Acute Coryza, Ophthalmic Neonatorum, Dermatitis With Medications Stipulated In the Essential Medicine List
10. Information On Family Planning

10

Child Health

1. Treatment of common childhood illnesses e.g.
2. Uncomplicated malaria
3. Case management of diarrhoea with (low osmolar ORS + Zinc tabs)
4. Uncomplicated UTI
5. Uncomplicated Pneumonia
6. URTI (acute coryza)
7. Uncomplicated otitis media
8. Helminthiasis
9. Skin diseases (heat rashes, eczema and simple allergies)
10. Insect bite and stings
11. Paediatric circumcision (up to 2 years of age)
12. Simple febrile illness

11

Management of uncomplicated malnutrition

1. With counseling on proper dietary intake and investigations on primary cause.
2. Uncomplicated Malnutrition

12

Emergencies: (These Are Crises Situations That Demand Patient Stabilization)

In All Case

1. Establishing an intravenous line
2. Establishing a patent airway
3. Management of convulsion
4. Cardiopulmonary resuscitation
5. Immobilization of fractures (using splints, neck collars etc)
6. Aspiration of mucus plug to clear airway
7. suturing and dressing
8. Control of bleeding
9. Check the vital signs

13

Gastroenteritis

1. Treatment with FBC, MP, Stool for M/C/S
2. ORS
3. Zinc
4. Ringers Lactate
5. Normal Saline
6. Loperamide
7. Ciprofloxacin
8. Tetracycline
9. Metronidazole

14

Asthmatic Attack

1. Treatment with Aminophylline
2. Hydrocortisone
3. Prednisolone
4. Normal Saline
5. Salbutamol(Nebulization)

15

Accidents/RTA

Simple Fractures

1. Bandages
2. Analgesics (Diclofenac, Paracetamol at the Primary level)

16

Dislocations

1. Bandages
2. Analgesics (Diclofenac, Paracetamol at the Primary level)

17

Lacerations/Bleeding / Wounds

1. Inject with TT/ ATS
2. Suture
3. Cotton Wool
4. Normal Saline
5. Gauze
6. Needle & Syringe
7. Methylated spirit, salvon (swab) and iodine.
8. Burns (First Degree <5%):
9. Sofratulle
10. Dermazin
11. Normal Saline

18

Sprains:

1. Analgesic Spray Or Gel

19

Acute Urinary Retention

1. Relieve Retention With Urethral Catheterization.
2. Urinary Catheter
3. Needle/ Syringe
4. Water For Injection
5. Lubricant
6. Savlon
7. Surgical Gloves
8. Analgesics

20

Convulsions From Any Cause

1. Treatment With anti-convulsants and Antipyretics

21

Allergic Reactions

1. Treatment With steroids and anti histamines (Hydrocortisone, Promethazine, Chlorpheniramine)

22

Hypertensive emergencies / Stroke

Sickle Cell

1. Management Of Vaso-Occlusive Crisis In Sickle Cell Disease With Analgesics, Normal Saline, Dextrose Water.

23

Bites

1. Snake Bites, Dog bites and Scorpion stings

24

Medical, Surgical And Ancillary Services

1. Basic Surgical
2. Incision & Drainage
3. Suturing of Simple Lacerations
4. Circumcision(plastibel)
5. Ear piercing for children
6. Minor Wound Debridement
7. Treatment of minor burns
8. Tongue tie

25

Basic Medical (Adult)

1. Malaria and other uncomplicated febrile illness e.g. typhoid fever
2. Pneumonia
3. Acute upper respiratory tract infection
4. Urinary tract infection
5. Mild anaemia treatable with oral haematinics
6. Worm infestation
7. Simple skin diseases (taenia vesicolor, m. furfur and tenia capitis)
8. Management of uncomplicated Hypertension
9. Management of uncomplicated Diabetes Mellitus
10. First Aid Treatment of Poisonings with activated charcoal.
11. Uncomplicated conjunctivitis
12. Treatment of uncomplicated peptic ulcer
13. Treatment of diarrhea and gastroenteritis
14. Uncomplicated fungal, bacterial and parasitic infections
15. Management of simple arthritis
16. Routine management of sickle cell disease
17. Management of simple ENT infections
18. Treatment of mono arthritis using NSAIDs contained in the EML

26

Ancillary Services

1. Pulse oximetry
2. Vital signs monitoring
3. Urethral catheterization

27

Investigative and Diagnostic Services

1. Laboratory Investigations
2. Malaria Parasite
3. PCV and HB
4. Urinalysis
5. Pregnancy test (urine)
6. Blood grouping
7. Genotype
8. Blood sugar
9. Blood and stool microscopy
10. Widal Test for monitoring
11. HIV screening
B. SECONDARY LEVEL ON PARTIAL EXCLUSIONS

1

Healthcare Preventive / Promotive Services and Hospitalization

1. Medical Consultations
2. Admission or Hospitalization
3. Consultation with Specialists.
4. Hospitalization in the general ward not more than 14 cumulative days per annum.

2

Maternal Health

1. Consultation with a Specialist
2. Delivery of Multiple Gestation And Other High Risk Pregnancies Such As Mal-Positioning And Mal-Presentation.
3. Management of Hypertension In Pregnancy
4. Management of Gestational Diabetes.
5. Management of Preterm Labor.
6. Premature Rupture Of Membrane (PROM)
7. Management of Bleeding In Pregnancy – Abortion And Complications, APH, PPH.
8. Management Of Intrauterine Fetal Death
9. Management For Ectopic Pregnancy (Salpingectomy)
10. Puerperal psychosis (50% co-insurance)
11. Cervical cerclage (50% co-insurance)

3

Delivery

1. Normal Delivery for high risk pregnancies
2. Forceps/Vacuum Delivery
3. Caesarean Section (elective, emergency, single live born, twin etc)
4. Hysterectomy

4

Child Health

1. Consultation with a pediatrician
2. Incubator care (max 10 days)
3. Phototherapy
4. EBT (max 2 sessions)
5. Circumcision for males (2 years to 18 years)

5

Asthmatic Attack

1. Management of Asthmatic Attack
2. Nebulization

6

Accidents/RTA

1. Blood Transfusion
2. Antibiotics
3. Open Fixation
4. Traction
5. POP
6. Stabilize the Patient

7

Acute Urinary Retention

1. Catheterization

8

Convulsions From Any Cause

1. Anticonvulsants Secure, airways, Breathing and Circulation
2. Treat cause

9

Acute Abdomen

1. Treatment With Analgesics And Antibiotics As Contained In the EML.

10

Hypertensive emergencies / Stroke

1. Anti-hypertensives . Treatment With Mannitol, Normal Saline, Frusemide and other specialist care

11

Diabetic Coma Management

1. Insulin therapy
2. Normal saline
3. Treat Cause

12

Medical, Surgical And Ancillary Services

Basic Surgical

1. Consultation with a specialist.
2. Repair of major lacerations
3. Appendectomy
4. Herniorraphy
5. Hydrocelectomy
6. Lumpectomy
7. Ganglion cyst removal
8. Venous cut down

13

Basic Medical (Adult)

1. Management of complicated Chronic Hypertension
2. Management of complicated Chronic Diabetes Mellitus
3. Palliative Management of TB then referral to donor supported facilities if First Line anti-TB Drugs are unavailable
4. Palliative Management of HIV infection then referral to donor supported facilities, if first Line ARVs are unavailable
5. Treatment of severe musculoskeletal conditions including polyarthritis
6. Liver diseases (Hepatitis, Cirrhosis, Amoebic liver abscess).

14

Ancillary Services

1. Critical care (ICU) max 3 days
2. NG tube
3. Urethral catheterization
4. Nebulization (max 3 days)
5. Oxygen therapy (max 3 days)
6. Dental Caries

15

Dental Services

1. Amalgam filling
2. Scaling and polishing
3. Simple tooth extraction

16

Ophthalmology

1. Provision of low priced spectacles and simple lenses (not exceeding N3,500/Once in 2 years)
2. Refraction

17

Hematology:

1. Grouping & cross matching
2. Blood transfusion (2 pints / year) whole blood and packed cells only
3. White blood cell count
4. Differential white blood cell count (WBC- Diff)
5. Full Blood count (FBC)
6. Red blood cell count (RBC)
7. Reticulocyte count
8. Platelet count
9. Erythrocyte sedimentation rate( ESR)
10. Screening of donor blood
11. Rhesus negative blood (2 PINTS/YEAR) 50% co-payment

18

Microbiology/Parasitology

Blood

1. Culture and sensitivity
2. Malaria parasite (in severe cases)
3. Microfilaria
4. Trypanosomes

19

Urine

1. Culture and sensitivity
2. Microscopy
3. Urinalysis

20

Stool

1. Microscopy, culture and sensitivity.
2. Occult fecal blood test

21

C.S.F

1. Microscopy and count
2. Gram stain
3. Culture and sensitivity

22

SWABS (wound, throat, eye, ear, urethral, aspirates, HVS, endo-cervical

1. Culture and sensitivity
2. Microscopy
3. Gram stain

23

Clinical Chemistry

Full Electrolytes-(1-4))

1. Sodium
2. Potassium
3. Chloride
4. Bicarbonate

24

Urea

25

Creatinine

26

Liver Function Tests-(1-4))

1. Total Bilirubin
2. Direct Bilirubin
3. Alkaline Phosphatase
4. Alanine Aminotransferase (SGPT)
5. Aspartate Aminotransferase (SGOT)
6. Total Protein
7. Cholesterol
8. Triglyceride
9. Fasting Blood Sugar
10. Random Blood Sugar
11. CSF: Chloride
12. CSF: Protein ( Total)
13. CSF: Glucose
14. Urinalysis
15. Urea Clearance

27

Pregnancy Test (a-b)

1. Blood

28

Other serological tests

1. Widal Test
2. VDRL
3. Hepatitis B Surface Antigen (HbsAg)
4. Hepatitis C Antigen (HbcAg)

29

Ultrasound scanning

1. Obstetric Scan
2. Abdominal Scan
3. Pelvic Scan
4. Abdominal-pelvic scan
5. CT Scan and MRI (70% co-insurance) *Patient pays 70% of cost.

30

Radiographic investigations (X-rays)

Upper limb

1. Hand/Finger
2. Wrist
3. Forearm
4. Elbow
5. Humerus
6. Shoulder
7. Clavicle

31

LOWER LIMB

1. Foot/Toe
2. Ankle
3. Leg (Tibia/Fibula)
4. Knee
5. Hip
6. Femur Or Thigh
7. Pelvic

32

THORAX

1. Chest (PA/AP)
2. Chest (PA/Lateral)

33

VERTEBRAE

1. Cervical Spine
2. Lateral Neck (Soft Tissue)
3. Thoracic Spine
4. Thoraco Lumber Spine
5. Lumbar Spine
6. Lumbo Sacral Spine
7. Sacrum
8. Sacro Illiac Joint (S.I.J.)
9. Cervical Spine (Oblique)
10. Sacro-coccxy

34

ABDOMEN

1. Abdomen (Plain)
2. Abdomen (Erect/Supine)
3. Abdomen (Pregnancy)
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