Staff Medical Insurance Cover Tender in Somalia - 94773216

Procurement Summary

Country: Somalia

Summary: Staff Medical Insurance Cover

Deadline: 13 Jan 2024

Posting Date: 06 Jan 2024

Other Information

Notice Type: Tender

TOT Ref.No.: 94773216

Document Ref. No.:

Competition: ICB

Financier: Other Funding Agencies

Purchaser Ownership: Public

Tender Value: Refer Document

Purchaser's Detail

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Tender Details

Tenders are invited for Staff Medical Insurance Cover
Scope of Work
For this assignment and fair selection, the applicant companies should provide detailed quotations for the Insurance cover for the following categories of benefits at the minimum. Please note the list is not exhaustive.
Outpatient Services
· Routine outpatient consultation,
· Diagnostic Laboratory and Radiology services,
· Prescribed physiotherapy.
· Prescribed drugs and dressings.
· Vaccines: KEPI & Baby Friendly
· Private vaccines up to full outpatient limits.
· Chronic, Pre-existing conditions & and HIV/AIDS including the cost of ARVs covered up to the full out-patient cover limit per family per annum.
· Ambulance Services (for emergency treatment only)
· Congenital conditions up to the full outpatient cover
· Gynaecologic care
· Postnatal care up to six weeks post-delivery. Antenatal and postnatal. Covered within the outpatient up to the full limit
· Annual Check-up Options: up to $200 for the principal member and spouse once per year, for specific conditions
Inpatient Services
· Hospital Accommodation Charges
· Doctor-s (Physician, Surgeon & Anesthetist) fees.
· ICU/HDU and Theatre charges.
· Drugs/Medicines, Dressings and Internal Surgical appliances.
· Pathology, X-ray, Ultrasound, ECG and Computerized Tomography, MRI Scans.
· Radiotherapy and Chemotherapy.
· In-patient Physiotherapy.
· Emergency Road and Air Evacuation that is subject to the overall cover limit.
· Day care surgery
· Home nursing care
· Internal prosthesis
Bed Limit: Standard private room
Dental Benefits (Anaesthetist-s fees, hospital and operating theatre costs, fillings, extraction, root canal)
Optical Benefits - Eye Test, Frames, Contact & Optical Lenses
Maternity
· Caesarian Section to be covered on an emergency and not elective basis.
· Routine antenatal check-ups
· Postnatal care up to six weeks post-delivery
Psychiatric hospitalization Family per annum
Psychosocial support/Counselling (Employment Assistance Program)
Pre-existing chronic ailments and HIV/AIDS hospitalization covered up to per Family per annum
Congenital and neonatal conditions
Post-hospitalization Rehabilitation, Private Nursing & Hospice Services
Premature Deliveries
External Appliances and Internal Surgical Appliances and Prosthesis (wheelchair, crutches, lumbar corset etc.). per family limit
Non-motorized wheelchairs and cress covered for accidents on hire within Inpatient
Non-accidental inpatient ophthalmology cover
Non-accidental inpatient dental cover.
Accidental inpatient dental and optical will be covered up to the full Inpatient limit
Scheme members are covered for emergency air and road evacuation within East Africa/ Horn of Africa.
Days covered outside Somalia in any one visit.
Overseas referral for treatment not available in Somalia/ East Africa/ Horn of Africa
Lodger fees; Lodging facilities for parents accompanying a child below 6 years being admitted
Oncology, Organ Transplant, Acute Renal and Peritoneal Dialysis
Free Health Education webinars/workshops
Political Violence and terrorism cover up to full inpatient limit and outpatient limit.
Note to Quote
Please quote the rate applicable for:
· Short term Cover or pro-rata premium calculation
· Refund of premium when staff leave
· Refund policy of medical expenses incurred when staff use other medical providers
· Please quote any free rider on the cover
· A description of how the service will be administrated and the provider's responsiveness should also be included in the offer.
1. The areas that shouldn-t be covered are:
· Family planning and fertility treatment i.e. costs of treatment related to infertility and impotence.
· Accidents caused by own intoxication or drunkenness or extreme sports
· Nutritional Supplements unless prescribed as part of treatment
· Cosmetic surgery unless caused by accident.
· Chiropractors, Acupuncturist, Herbalist
· Massage or beauty treatment
How to apply
Applications should be sent to this email: [email protected] with the subject line of your email indicated as “STAFF MEDICAL INSURANCE COVER” The deadline for application submission is 13th January 2024

Documents

 Tender Notice