What is a known pre-existing condition?
- NMI defines pre-existing condition as any medical condition for which medical advice, diagnosis, care or treatment was recommended or received, for at least in the last twenty-four (24) months prior to the date on which application for Cover was made.
What do I do if I have a valid card but hospital says my data cannot be found on the electronic system?
- The hospital needs to update their RX system to synchronize any new information on your enrollment.
- Report immediately to NMI on 0800 222 222.
- Do not leave the hospital premises until the issue is resolved
Will I be disqualified for not declaring a known pre-existing condition?
- You will not be disqualified however NMI will not bear the cost/expenses arising from the treatment of that undeclared pre-existing medical condition.
How do I access service with the NMI card?
- Each member is required to visit any NMI accredited service providers [hospital, clinic, pharmacy]
- The plan you choose, determines the hospital you can access.
- You show your card to the health attendant and get the needed care required.
If I visit the clinic and get all the medical assistance I need, how would I know what the clinic sends to NMI as my bill?
- After you have received the medical care, you will receive an SMS notification with the total cost of medical services you received.
- You can also check your medical history from the Nationwide RX application download from Google playstore or contact 0800 222 222 for more details on the app.
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.
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.
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 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.
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]