In the TSC scheme, outpatient benefits ensure individuals and families receive comprehensive healthcare without hospitalization. These benefits cover various healthcare services, from routine check-ups to specialized treatments. The cover benefits may include but are not limited to:
Cover for regular visits to healthcare providers for check-ups, consultations, and general medical advice, allowing access to medical guidance without needing hospitalization or day-care procedures.
Cover for prescribed physiotherapy sessions when they are part of your treatment plan. These sessions are intended to improve mobility and function, and it is commonly used during rehabilitation after injuries or surgeries.
Outpatient benefits also encompass coverage for prescribed medications and dressings, facilitating access to necessary medicines and supplies as prescribed by your healthcare provider. This ensures that individuals can receive the medication they need without financial barriers. This benefit ensures comprehensive prenatal and postnatal care coverage for expectant mothers, guaranteeing essential medical attention before and after childbirth. It provides peace of mind to families by supporting a healthy start to parenthood.
Routine immunizations are part of this benefit, including vaccinations such as KEPI and Baby Friendly Vaccines. Additionally, it encompasses immunizations against COVID-19, providing protection for you and your family against infectious diseases. This proactive approach to preventive healthcare helps safeguard individuals and communities from preventable illnesses. This benefit guarantees access to the required vaccines for official travel, including vaccinations for diseases like yellow fever or polio. It also extends coverage to non-travel related vaccines like Hepatitis B, ensuring the health and safety of individuals during travel and in their daily lives.
Recognizing the significance of mental health, this benefit covers psychiatric services and counseling, offering valuable support for individuals with mental health concerns. It promotes mental well-being and helps individuals cope with life’s challenges. This benefit includes coverage for family planning services and fertility tests, aiding family planning decisions, and addressing fertility-related matters, including prescribed impotence drugs. It empowers individuals and couples to make informed choices about their family planning and reproductive health.
Comprehensive coverage for testing and treatment of HIV/AIDS is included, encompassing prescribed antiretroviral (ARV) medications to ensure individuals living with HIV/AIDS receive comprehensive care. It supports the health of those affected and contributes to the broader effort to combat HIV/AIDS. You can access alternative treatments like acupuncture and chiropractic care to address specific health concerns upon referral. This flexibility in healthcare options ensures that individuals can explore various avenues for improving their health and well-being.
Outpatient benefits extend to cover the treatment of pre-existing and chronic conditions, including tuberculosis (TB) and cancer, providing continuous care for those managing these conditions. It offers ongoing support and medical attention to individuals with long-term health needs. The principal member and their spouse are entitled to an annual general check-up, facilitating early detection of health issues and promoting overall well-being. These comprehensive health assessments contribute to proactive healthcare management.
This benefit covers various diagnostic tests, including radiology, X-ray, ultrasound, EEG, ECG, Computerized Tomography (CT-SCAN), and MRI scans, essential for accurate diagnoses. It ensures that individuals can access state-of-the-art diagnostic services for precise healthcare evaluation. Access to medical specialists is also readily available upon referral from your primary healthcare provider, providing specialized care when needed. This accessibility to expertise enhances the quality of healthcare received by individuals.
Specific cancer-related tests are also covered, including the PSA test for male employees and spouses, one pap-smear test, and a mammogram for female employees and spouses annually. These screenings play a vital role in early cancer detection, offering individuals the opportunity for timely intervention and treatment. Convenience meets healthcare needs with access to online health services, encompassing virtual consultations, e-pharmacy, and e-laboratory services. This digital healthcare accessibility enhances comfort and provides prompt access to healthcare services.
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