A Comparison of Comprehensive Medical Aid Plans
Comprehensive Medical Aid plans have unlimited hospital cover and comprehensive day-to-day benefits. In new generation plans, initial claims will be funded from a medical savings account. Thereafter when all accumulated day-to-day claims reach a specified threshold, another risk benefit kicks in and continues to pay claims until the end of the year.
Traditional options have generous amounts of day-to-day cover for all the different medical providers except for GP's consultations and conservative dentistry where cover is generally unlimited and no benefits carry forward to the next year.
|
| |
|
|
| |
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% NHRPL rate |
|
| |
No Overall Annual Limit |
|
| |
Co-payments apply for certain |
|
| |
procedures |
|
| |
*30 days Post Hospital Cover |
|
| |
*7 days Take Home Medicine |
|
| |
*Oral Contraceptives |
|
| |
*Emergency Trauma at Out Patients |
|
| |
Annual Sub-limits per person: |
|
| |
Oncology & Organ |
R 265,000 |
|
| |
Transplant |
|
|
| |
Renal Dialysis |
R 265,000 |
|
| |
Psychiatric Treatment |
R 17,250 |
|
| |
Specialised Medication |
R120, 000 |
|
| |
Benefit |
|
|
| |
Internal Prosthesis: |
|
|
| |
See detailed benefits |
|
|
| |
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% Medicine Price |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Annual limit: |
|
| |
Single |
R 3,650 |
|
| |
Per Family |
R 7,300 |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% NHRPL Rate |
|
| |
Limits per annum: |
|
| |
Member |
R 4,858 |
|
| |
Member +Spouse |
R 8,602 |
|
| |
Member +Spouse +Child 1 |
R 9,442 |
|
| |
Member +Spouse +Child 2 |
R 10,282 |
|
| |
Member +Spouse +Child 3 |
R 11,122 |
|
| |
Member +Child 1 |
R 5,698 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 7,720 |
|
| |
Spouse/Adult dependant |
R 5,900 |
|
| |
Per Child (Max 3) |
R 2,050 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Me mber |
R 1,632 |
|
| |
Spouse/Adult dependant |
R 1,388 |
|
| |
Per Child |
R 490 |
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
100% MSR |
|
| |
No Overall Annual Limit |
|
| |
* 3 days Take Home Medicine |
|
| |
* Co-payments apply for certain |
|
| |
procedures |
|
| |
Annual Sub-limits: |
|
| |
Physiotherapy |
R 5,500 |
|
| |
Psychiatric Treatment |
R 16,000 |
|
| |
Dialysis (per treatment) |
R 2,200 |
|
| |
Internal Prosthesis: |
|
| |
See detailed benefit schedule |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
34 PMB Chronic Disease Conditions |
|
| |
Only from Mediscor |
|
| |
Subject to scheme formulary. |
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT |
|
| |
(including savings) |
|
| |
100% MSR |
|
| |
GP's: |
|
| |
Subject to general out of hospital limit |
|
| |
Member |
R 2,000 |
|
| |
Member + 1 |
R 2,900 |
|
| |
Member + 2 |
R 3,500 |
|
| |
Member + 3 |
R 4,300 |
|
| |
Member + 4 + |
R 5,200 |
|
| |
Specialists: |
|
|
| |
Subject to general out of hospital limit |
|
| |
Member |
R 6,400 |
|
| |
Member + 1 |
R 9,000 |
|
| |
Member + 2 |
R 11,000 |
|
| |
Member + 3 |
R 13,500 |
|
| |
Member + 4 + |
R 16,500 |
|
| |
Conservative Dentistry: |
|
|
| |
Member |
R 2,300 |
|
| |
Member + 1 |
R 3,300 |
|
| |
Member + 2 |
R 4,000 |
|
| |
Member + 3 |
R 4,900 |
|
| |
Member + 4 + |
R 5,900 |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Income p/m |
R0 - R11,500 |
|
| |
Principal Member |
R 1,794 |
|
| |
Spouse/Adult dependant |
R 989 |
|
| |
1st Child |
R 540 |
|
| |
2nd Child |
R 288 |
|
| |
3rd Child |
R 181 |
|
| |
|
|
|
| |
Income p/m R11,501-R14,700 |
|
| |
Principal Member |
R 1,884 |
|
| |
Spouse/Adult dependant |
R 1,177 |
|
| |
1st Child |
R 612 |
|
| |
2nd Child |
R 425 |
|
| |
3rd Child |
R 285 |
|
| |
|
|
|
| |
Income p/m |
R14,701 + |
|
| |
Principal Member |
R 1,973 |
|
| |
Spouse/Adult dependant |
R 1,382 |
|
| |
1st Child |
R 692 |
|
| |
2nd Child |
R 593 |
|
| |
3rd Child + |
R 593 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
Annual Sub-limits per person: |
|
| |
Mental Health Benefit |
21 days |
|
| |
Terminal Care Benefit |
R 23,400 |
|
| |
Alcohol and Drug |
21 days |
|
| |
Rehabilitation |
|
|
| |
Internal Prostheses: |
|
|
| |
See detailed benefit schedule |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
61 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
Limits per annum: |
|
| |
Member |
R 7,044 |
|
| |
Member+Spouse |
R 13,704 |
|
| |
Member+Spouse+Child1 |
R 15,108 |
|
| |
Member+Spouse+Child2 |
R 16,512 |
|
| |
Member+Spouse+Child3 |
R 17,916 |
|
| |
Member+Child 1 |
R 8,448 |
|
| |
|
|
|
| |
Add. New Insured Network Benefit |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 7,700 |
|
| |
Spouse/Adult independant |
R 7,700 |
|
| |
Per Child (Max 3) |
R 1,450 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 2,348 |
|
| |
Spouse/Adult dependant |
R 2,220 |
|
| |
Per Child (Max 3) |
R 469 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
|
|
| . |
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
300% NHRPL rate |
|
| |
No Overall Annual Limit |
|
| |
Co-payments apply for certain |
|
| |
procedures |
|
| |
*30 days Post Hospital Cover |
|
| |
*7 days Take Home Medicine |
|
| |
*Oral Contraceptives |
|
| |
*Emergency Trauma at Out Patients |
|
| |
Annual Sub-limits per person: |
|
| |
Oncology and Organ |
No Limit |
|
| |
Transplant |
|
|
| |
Renal Dialysis |
No Limit |
|
| |
Psychiatric Treatment |
R 17,250 |
|
| |
Specialised Medication |
R120,000 |
|
| |
Benefit |
|
|
| |
Internal Prosthesis: |
|
|
| |
See detailed benefits |
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% Medicine Price |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Annual limit: |
|
| |
Single |
R 9,775 |
|
| |
Per Family |
R 18,280 |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% NHRPL Rate |
|
| |
Limits per annum: |
|
| |
Member |
R 8,830 |
|
| |
Member +Spouse |
R 15,578 |
|
| |
Member +Spouse +Child 1 |
R 17,772 |
|
| |
Member +Spouse +Child 2 |
R 19,966 |
|
| |
Member +Spouse +Child 3 |
R 22,160 |
|
| |
Member +Child 1 |
R 11,024 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 8,900 |
|
| |
Spouse/Adult dependant |
R 6,750 |
|
| |
Per Child (Max 3) |
R 2,350 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 3,188 |
|
| |
Spouse/Adult dependant |
R 2,710 |
|
| |
Per Child |
R 956 |
|
| |
|
|
| |
|
|
|
|
| RESOLUTION HEALTH |
| PRESTIGE |
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% NHRPL Rate |
|
| |
No overall annual limit |
|
| |
*7 day take home medication |
|
| |
Co-payments for certain procedures |
|
| |
Emergency Ward treatment which |
|
| |
does not result in hospitalisation |
|
| |
R1,050 |
|
| |
|
|
| |
|
|
| |
Annual Sub-limts per person: |
|
| |
Oncology |
R262,000 |
|
| |
Internal Prosthesis |
R42,000 |
|
| |
Post hospitalisation: |
R26,250 |
|
| |
Rehabilitation, Step-down |
|
|
| |
and terminal care |
|
|
| |
International travel 90 |
R5 million |
|
| |
days per trip |
|
|
| |
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 PMB Chronic Disease Conditions |
|
| |
Subject to Prestige formulary |
|
| |
Additional 23 Chronic Conditions |
|
| |
Single R 3,675 |
|
| |
Family R 7,350 |
|
| |
Paid over and above PMB |
|
| |
Chronic Benefit |
|
| |
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% NHRPL Rate |
|
| |
GP's: |
Member |
R1,800 |
|
| |
|
Member + 1 |
R2,600 |
|
| |
|
FamilyM+2+ |
R3,400 |
|
| |
Specialists: |
Member |
R1,500 |
|
| |
|
Member + 1 |
R1,750 |
|
| |
|
FamilyM+2+ |
R2,250 |
|
| |
OAL |
Member |
R5,000 |
|
| |
|
Member +1 |
R7,000 |
|
| |
|
FamilyM+2+ |
R9,000 |
|
| |
Medical |
Member |
R9,000 |
|
| |
Appliances |
Member +1 |
R9,900 |
|
| |
|
FamilyM+2+ |
R9,900 |
|
| |
|
|
|
|
| |
Plus: Dentistry, Optometry & |
|
| |
Preventative Care benefits as per |
|
| |
schedule |
|
| |
|
|
| |
Additional benefits paid from risk |
|
| |
Maternity: Out of hospital |
|
| |
10 Gynae Consultations |
|
| |
2 2D Scans |
|
| |
R500 Ante-Natal classes once |
|
| |
registered on ResoBaby |
|
| |
|
|
| |
|
|
| |
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R1,677 |
|
| |
Spouse/Adult dependant |
R1,630 |
|
| |
Per Child (pay to max 3) |
R430 |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
Network Hospitals to be used |
|
| |
Annual Sub-limits per person: |
|
| |
Mental Health Benefit |
21 days |
|
| |
Terminal Care Benefit |
R 23,400 |
|
| |
Alcohol and Drug |
21 days |
|
| |
Rehabilitation |
|
|
| |
Internal Prostheses: |
|
|
| |
See detailed benefit schedule |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
61 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
Limits per annum: |
|
| |
Member |
R 6,336 |
|
| |
Member+Spouse |
R 12,324 |
|
| |
Member+Spouse+Child1 |
R 13,584 |
|
| |
Member+Spouse+Child2 |
R 14,844 |
|
| |
Member+Spouse+Child3 |
R 16,104 |
|
| |
Member+Child 1 |
R 7,596 |
|
| |
|
|
|
| |
Add. New Insured Network Benefit |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 7,700 |
|
| |
Spouse/Adult independant |
R 7,700 |
|
| |
Per Child (Max 3) |
R 1,450 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 2,113 |
|
| |
Spouse/Adult dependant |
R 1,998 |
|
| |
Per Child (Max 3) |
R 442 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
*7 days Take Home Medicine |
|
| |
*Co-payments apply for certain |
|
| |
procedures if not referred |
|
| |
Annual Sub-limits : |
|
| |
Surgical Appliances |
R 3,850 |
|
| |
(eg. support stockings) |
|
|
| |
Mental Health |
R 22,000 |
|
| |
Rehabilitation, Private |
R 30, 300 |
|
| |
nursing, Hospice and |
|
|
| |
step-down facilities |
|
|
| |
Cochlear implants |
R 10, 000 |
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to formulary at State facilities |
|
| |
36 additional conditions limited to |
|
| |
R 6, 000 per family |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
|
|
| |
Member |
R 5,496 |
|
| |
Member+Spouse |
R 9,360 |
|
| |
Member+Spouse+Child1 |
R 11,172 |
|
| |
Member+Spouse+Child2 |
R 12,984 |
|
| |
Member+Spouse+Child3 |
R 14,796 |
|
| |
Member+Child 1 |
R 7,308 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 8,500 |
|
| |
Spouse/Adult dependant |
R 7,100 |
|
| |
Per Child (Max 3) |
R 2,500 |
|
| |
|
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,833 |
|
| |
Spouse/Adult dependant |
R 1,287 |
|
| |
Per Child (Max 3) |
R 605 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
*7 days Take Home Medicine |
|
| |
*Co-payments apply for certain |
|
| |
procedures if not referred |
|
| |
Annual Sub-limits : |
|
| |
Surgical Appliances |
R 3,850 |
|
| |
(eg. support stockings) |
|
|
| |
Mental Health |
R 22,000 |
|
| |
Rehabilitation, Private |
R 30, 300 |
|
| |
nursing, Hospice and |
|
|
| |
step-down facilities |
|
|
| |
Cochlear Implants |
R 10, 000 |
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to reference price list |
|
| |
36 additional conditions limited to |
|
| |
R 6, 000 per family |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
|
|
| |
Member |
R 6,552 |
|
| |
Member+Spouse |
R 11,532 |
|
| |
Member+Spouse+Child1 |
R 13,692 |
|
| |
Member+Spouse+Child2 |
R 15,852 |
|
| |
Member+Spouse+Child3 |
R18,012 |
|
| |
Member+Child 1 |
R 8,712 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 8,500 |
|
| |
Spouse/Adult dependant |
R 7,100 |
|
| |
Per Child (Max 3) |
R 2,500 |
|
| |
|
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 2,183 |
|
| |
Spouse/Adult dependant |
R 1,659 |
|
| |
Per Child (Max 3) |
R 720 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| MEDSHIELD |
MEDIBONUS OPTION
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
100% of negotiated tarif |
|
| |
No Overall Annual Limit |
|
| |
No co-payments |
|
| |
Annual Sub-limits per family: |
|
| |
Oncology - R450,000 - MS tarif |
|
| |
Organ transplants - unlimited-MS tarif |
|
| |
Dialysis (Chronic) - unlimited-MS tarif |
|
| |
Specialised Medication - R 180,000 |
|
| |
from the oncology limit |
|
|
| |
Psychiatric treatment - R 35,000 per |
|
|
| |
family - MS tarif |
|
|
| |
Prosthesis (internal & external) - |
|
|
| |
R 38,000 per family - MS tarif |
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% cost |
|
| |
All chronic conditions |
|
| |
(below chronic limit) |
|
| |
Annual limit: |
|
| |
Single |
R 10,500 |
|
| |
Family |
R 21, 000 |
|
| |
Above limit: Prescribed Minimum |
|
| |
Benefits only according to algorithms |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT (including savings) |
|
| |
|
|
| |
Member |
R 5 300 |
|
| |
Member + 1 |
R 7 500 |
|
| |
Member + 2 |
R 8 300 |
|
| |
Member + 3 |
R 9 100 |
|
| |
Member + 4 |
R 9 900 |
|
| |
|
|
|
| |
Number of GP visits at MS tarif in |
|
| |
addition to the above |
|
| |
|
|
|
| |
Member |
13 |
|
| |
Member + 1 |
15 |
|
| |
Member + 2 |
17 |
|
| |
Member + 3 |
19 |
|
| |
Member + 4 |
21 |
|
| |
Member + 5 |
23 |
|
| |
|
|
|
| |
Basic Dentistry - unlimited |
|
| |
- MS tarif |
|
|
| |
|
|
|
| |
Maternity benefits in addition to |
|
| |
above - all at MS tarif |
|
| |
GPs, specialists, midwife |
|
| |
- 12 x consultations |
|
| |
Radiology - 2 x 2D scans |
|
|
| |
Amniocentesis - 1 per pregnancy |
|
| |
|
|
|
| |
Optical benefits -1 eye examination |
|
| |
per beneficiary per year |
|
| |
Spectacles/Contact lenses/Multifocals, |
|
| |
readers and frames |
|
|
| |
MS tarif |
|
|
| |
Member |
R 2,100 |
|
| |
Family |
R 3,200 |
|
| |
Sub limits for frames |
R 1, 200 |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
|
|
|
| |
does not apply |
|
| |
|
|
| |
|
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Member |
R 2,004 |
|
| |
Spouse/Adult dependant |
R 1,321 |
|
| |
Per Child |
R 386 |
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
| |
|
|
|
|
|
|
| |
|
As additional Comprehensive Medical Aid Plans are made available we will continue to update this page in our effort to provide our clients with the most up to date information and advice on the medical aid industry in South Africa. If you are still deciding which plan type is best suited to your situation, why not take a look at the Medical Aid Plans page to see the full range of plans.
For more detailed information on any of the above plans, just click on the name of the relevant hospital plan in the tables above. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 021 712 6626. Alternatively, if you would like us to confirm some of the finer details and pricing just fill in our Medical Aid Quote Request form and we will get back to you promptly.
Finally, we invite you to contact us on +27 21 712-6686 at any point in your decision making process for further information on these Comprhensive Medical Aid Plans.
|
|
|
|
