Personal International Silver

PERSONAL INTERNATIONAL SILVER $ 4OO CHILD $ 4OO ADULT
IAA CLINICS
Outpatient Services may be obtained at the following medical service providers
All Upcountry Clinics affiliated to IAA, with prior consent and arrangement with the contractor.
International Hospital Kampala (IHK), Kisugu-Namuwongo
International Medical Center, KPC Building, Kampala
IAA, Kitgum House, Jinja Road
IAA Utl Clinic, 5th Street, Kampala
International Medical Clinic Jinja
IAA Clinic Kasese

Medical Services – Unlimited General consultations Approved X-rays Ultra-sound scans 12 lead ECGs Standard drugs Laboratory Investigations UNEPI Immunizations Family planning incl. Contraceptive pills, IUDs ,Norplant Treatment of HIV opportunistic infections School Medicals HIV Testing and Voluntary Counseling	Hospitalisation at International Hospital, Kampala The contractor will provide hospitalisation in the 2 -bedded ward at IHK up to the cost of US$ 5000 (FIVE thousand United States Dollars). For the following services General surgery Gynaecology Paediatrics Internal medicine Physiotherapy Room Upgrades may be obtained with cash payment subject to availability.

Upcountry Treatment The contractor will provide medical services in various approved upcountry clinics to the members. (Refer to schedule of contract). These services will include: I.Hospitalisation, in case of an emergency, to any approved upcountry hospital. The contractor must however be notified before such admission and/or within 48 hours of admission Members MAY ONLY VISIT clinics and/or medical centres affiliated to and approved by the IAA under this scheme. Visits to any other clinics will not be covered under this scheme.

Ophthalmology Clinic The contractor will provide treatment of I.Eye infections Simple outer eye surgical procedures e.g. removal of mibomiam cysts

Dental Services I.Cleaning once a year II.Non surgical extractions III.Fillings

Emergency Evacuation The contractor will provide emergency medical evacuation from Uganda to South Africa or Kenya in the event of an emergency, which has been authorized by an MEDEX doctor, up to a limit of US$ 100,000 These services will include I. Companion benefit: A person living with the insured person can accompany the insured person on the trip. Room only and travel expenses will be covered. II. Return transport: A one-way return trip after stabilisation. III. Repatriation of Mortal Remains: Expenses associated with the cremation or preparation and transportation of mortal remains of the insured person

Annual Cost A year under this contract will be twelve (12) months from the time of entering the contract. a) Any member who enters into the contract at the time other than the initial agreement will be charged only until the initial contractual year expires. a)Members can be covered for specified time duration at an accordingly prorated premium. No re-imbursement will be done if a member leaves the company during the contract period and not been replaced.

Terms of Payment Payment will be made in full at the beginning of the contractual year.

Membership and Eligibility The member upon commencement of the contractual year will be required to complete a medical form, and will provide to the contractor recent passport photographs of the members covered under this contract.

Medical Insurance

Personal International Silver