Premium Plan
90% cover, including dental prosthetics.
Consultations, hospitalisation, maternity, dental care and prosthetics: the Premium plan covers 90% of these costs for your whole family, with full optical cover and caps designed for the unexpected.
60 000 F/month, whole family
90%coverage rate
6people covered
10 000 Fone-off enrolment fee
1 500 000 Fcap per illness episode
Benefits details
Premium plan benefits schedule
The exact detail of what's covered and up to what limit.
| Type of benefit | Rate | Cap |
|---|---|---|
| Outpatient and hospital care | ||
| General and specialist consultations | 90% | — |
| Care, medical tests, medical imaging, medical assessment following an illness | 90% | 200 000 FCFA / illness episode, in private facilities |
| Health check-up | Excluded | |
| Surgery and hospitalisation-related costs | 90% | 500 000 FCFA, in private facilities |
| Room costs in case of illness | 90% | 30 000 FCFA / day, maximum 8 days |
| Maternity | ||
| Standard delivery (3 days maximum) | 90% | 250 000 FCFA |
| Twin delivery (3 days maximum) | 90% | 300 000 FCFA |
| Complicated delivery (5 days maximum) | 90% | 500 000 FCFA, in private facilities |
| Dental care | ||
| Dental care | 90% | 100 000 FCFA / year |
| Dental prosthetics | 90% | 50 000 FCFA / year |
| Optical, physiotherapy and pharmacy | ||
| Optical costs | 100% | 100 000 FCFA / 2 years / policyholder (no reimbursement outside the network) |
| Physiotherapy / Rehabilitation | 90% | 100 000 FCFA |
| Pharmacy costs | 80% | Actual costs except excluded medication, 250 000 FCFA / year |
| Outside network and overall caps | ||
| Reimbursement outside the network | 50% | According to our fee schedule |
| Overall cap | — | 1 500 000 FCFA / illness episode |
Monthly premium: 60 000 F per family (720 000 F a year) + one-off enrolment fee of 10 000 F on subscription, i.e. 730 000 F in the first year. Exceeding the caps is possible with prior agreement from our team. An additional annual premium applies for a 7th person covered.
Conditions of cover
Premium plan conditions
Waiting periods
Illness2 months
Switching between plans2 months
Surgery6 months
Optical costs6 months
Dental costs6 months
Prenatal costs6 months
Childbirth9 months
Family composition
Main policyholderIncluded
SpouseIncluded
Biological childrenUp to 4
Children age limit21 years
Students (with proof of enrolment)Up to 25 years
Policyholder age limit59 years
Beyond age 59: pricing is reviewed with our team.
Territorial coverage
Cover applies in:
🇨🇮 Côte d'Ivoire
🇸🇳 Senegal
🇹🇬 Togo
🇬🇲 Gambia
🇧🇯 Benin
🇧🇫 Burkina Faso
🇬🇦 Gabon
Reimbursement outside the network
Rate outside the network50%
Basis of calculationWayvance fee schedule
For care received outside the partner network, reimbursement of 50% is possible according to our fee schedule.
What isn't covered
Details of Premium health cover
Excluded procedures
- Illnesses that occurred before the cover took effect
- Prescription renewals not ordered by a doctor
- Health check-ups, pre-employment, periodic and pre-marital medical examinations
- Products with a preventive purpose that are not therapeutic in nature
- Procedures for cosmetic purposes or addressing a disability or congenital malformation
- Pedicure and manicure care
- Illnesses and accidents resulting from alcohol abuse, drug use, or the policyholder's deliberate act
- Consequences of civil or foreign war
- Thermal spa treatments
- Travel costs, except those covered as transport costs
- Supplements that are not medical in nature
- HIV/AIDS treatment or screening
- Risk of HIV/AIDS transmission during blood transfusions
- Speech therapy sessions
- Physiotherapy and rehabilitation costs without prior approval from the company
- Perineal and uro-gynaecological rehabilitation
- Childbirth preparation classes
Medication not reimbursed (examples)
- Beauty, hygiene and anti-acne products
- Common antiseptics (soap, Cyteal…)
- Anti-obesity medication
- Tonics, vitamins, trace elements
- Appetite stimulants
- Vaccines and serums
- Laxatives
- Contraceptives
- Homeopathy
- Medicinal confectionery and diet products
- Food and dietary products
- Hormonal and fertility treatments
- Treatments for sexual impotence
- Smoking cessation treatment
- Household medical supplies (cotton wool, alcohol, aspirin, mercury…)
- Everyday medical items (thermometer, syringes…)
Subscription
Documents required for the Premium plan
Documents to provide
- ID photo of every family member
- Photocopy of birth certificate (for children)
- Photocopy of ID or equivalent document (husband and wife)
- Proof of school/university enrolment for children aged 21 to 25
Family composition: main policyholder + spouse + up to 4 biological children (age limit: 21, or 25 with proof of enrolment).