What do I do if I am denied service at an accredited service provider?
- Call 0800 222 222 immediately or inform your relationship manager.
My Doctor has asked that I do an MRI. What do I do?
- You are required to seek for Approval from NMI for all advanced imaging [MRI , CT scan, EEG]
- The health provider requesting for the MRI must send a request to NMI.
- Contact 0800 222 222 for more details
Can I use my card to buy over-the-counter [OTC] drugs at the pharmacy?
- Over the counter treatment and self medication are not allowed.
- You can only have access to prescribed medication or diagnostic investigation after undergoing through medical consultation with a Medical officer/ Health Professional.
If I had an accident and damaged my tooth will the insurance pay for crowns?
- Generally, artificial tooth and crown are exclusions.
Can another person use my card to access healthcare?
- The card covers only the person insured [the person whose details are on the membership card]. Health insurance benefits are not transferrable.
Can I change my benefit package after enrollment?
- Yes, moving from one plan to another is allowed .However upgrade can only be done within the first quarter [3 months] of the policy period /benefit year
- Upgrades are subject to conditions [contact your Relationship Manager for further details]
What happens when I exceed my benefit limit?
- This rarely happens but your medical cover ends immediately.
- NMI notifies member(s) who exceed 70% of their utilization.
- Members are encouraged to restrict medical expenses wherever possible to reasonable limits, so as to accumulate enough reserves for emergencies or sudden life threatening medical conditions.
What happens if I do not get all the drugs prescribed at the hospital or one pharmacy?
- The pharmacist will cross out the drugs supplied on the prescription form
- Run photocopy of the original prescription
- You will be given a copy of the prescription form which would enable you take the remaining drugs on the prescription.
- In case you are given a photocopied prescription, ensure that it is endorsed by the Pharmacist/pharmacy attendant.
What happens to me during an emergency?
- Emergency is an unexpectedly injury to or illness of a Beneficiary, which requires immediate medical intervention to preserve life.
- You are required to pay if your NMI plan specific service provider isn’t available within the locality where the emergency occurred.
- Submit the receipt and request forms to your Company HR or contact Nationwide immediately.
Can I visit a clinic or hospital that is not part of the NMI list of clinics and hospitals?
- No, except in emergency situations or when the required care is not available within the network of NMI accredited service providers.
- You are required to seek for pre-authorization from NMI before accessing care at any unaccredited care provider.