SpectraMed

Spectramed is one of the bigger medical aids in South Africa with a total membership of approximately 210,000. It was registered in 1967 and has an excellent Global Credit Rating of A+. All their options have traditional type benefits (specific cover amounts per medical provider) and make no use of savings accounts. Their premiums are based on income so the less you earn the less you pay. All day-to-day and hospital cover is at the NHRPL (National Health Reference Price List) rate.

All benefits are pro-rated depending on when in the year one joins the scheme.

A member has the option of changing their plan without medical underwriting once per year effective from the 1st of January the following year.

SpectraMed Hospital Plan

This plan covers hospitalisation and related bills at 100% NHRPL, with annual limits, which can be topped up and includes emergency transport to a hospital. Chronic medication could pose a problem because it is only obtainable from a state facility. There is an excess payment amount of R2,500 per hospital admission that is not trauma related, but can be removed for an additional premium.

SpectraMed Choice Plan

This is a network option but any practitioner can be used because the medical aid will contact and register your doctor immediately on joining. GP consultations are unlimited and carry a R50 co-payment, payable after the fifth visit. Medication is unlimited from a formulary. Conservative dentistry has no monetary limit but is managed. Hospitalisation and related bills are covered at 100% NHRPL, with annual limits, which can be topped up and includes emergency transport to a hospital. There are twelve in hospital procedures that require a co-payment from the member, but can be removed for an additional premium.

SpectraMed Alliance Plan

This plan has traditional benefits for day-to-day cover, which means that there are specific annual limits per medical provider type that are pro-rated depending on when in the year you join. Nothing gets carried forward and all limits reinstate on the 1st of January every year. Hospitalisation and related bills are covered at 100% NHRPL, with annual limits, which can be topped up and includes chronic medication and emergency transport to a hospital. There are twelve in hospital procedures that require a co-payment from the member, but can be removed for an additional premium.

SpectraMed Elite Plan

This is their flagship plan and has extensive traditional day-to-day cover. Hospitalisation and related bills are covered at 100% NHRPL, with annual limits, which can be topped up and includes chronic medication and emergency transport to a hospital. There are twelve in hospital procedures that require a co-payment from the member, but can be removed for an additional premium.

Optional Additional Benefits

Top-Up Cover

This is an independent product that can be used to increase your hospital cover limits to R2,000,000.

Gap Cover

This independent cover will pay the additional amount charged by the surgeon and anesthetist above the NHRPL rate up to a maximum of three times the NHRPL rate.