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IN HOSPITAL BENEFIT |
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150% MSR |
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No Overall Annual Limit |
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Co-payments apply for certain |
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procedures |
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Annual Sub-limits: |
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Oncology |
R 250,000 |
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Physical Rehabilitation |
R 30,000 |
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(per family) |
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Take home medicine |
R 250 |
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(per admission) |
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Internal Prosthesis: |
R 27,000 |
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CHRONIC MEDICATION BENEFIT |
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150% MSR |
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27 PMB Chronic Disease Conditions |
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Subject to scheme formulary, |
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only from Pharmacy Direct |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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150% MSR |
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Limits per annum: |
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Member |
R 2,316 |
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Member +Spouse |
R 4,116 |
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Member +Spouse +Child 1 |
R 4,824 |
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Member +Spouse +Child 2 |
R 5,532 |
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Member +Spouse +Child 3 |
R 6,240 |
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Member +Child 1 |
R 3,024 |
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Plus Basic and Advanced Dental |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,049 |
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Spouse/Adult dependant |
R 813 |
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Per Child |
R 316 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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No Overall Annual Limit |
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Annual Sub-limits: |
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Oncology |
R 200,000 |
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Physical Rehabilitation |
R 30,000 |
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(per family) |
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Take home medicine |
R 250 |
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(per admission) |
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Internal Prosthesis: |
R 27,000 |
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Organ Transplants |
R 250,000 |
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Renal Dialysis |
R 200,000 |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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| |
45 PMB Chronic Disease Conditions |
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Annual limit: |
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Single |
R 6,500 |
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Per Family |
R 13,000 |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
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100% MSR |
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Limits per annum: |
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Member |
R 2,500 |
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Member + 1 |
R 3,800 |
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Member + 2 |
R 4,100 |
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Member + 3 |
R 4,400 |
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Member + 4 + |
R 4,700 |
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Seperate Network GP Limit: |
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Member |
R3, 000 |
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Member + 1 |
R 4, 500 |
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Member + 2 |
R 4, 900 |
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Member + 3 |
R 5,200 |
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Member + 4 + |
R 5, 600 |
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Plus Dentistry, Radiology, Pathology |
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and Optometry |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,514 |
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Spouse/Adult dependant |
R 1,310 |
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Per Child |
R 442 |
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IN HOSPITAL BENEFIT |
|
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100% MSR |
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R600,000 per family per annum |
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Annual Sub-limits: |
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Oncology |
R 100,000 |
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Physical Rehabilitation |
R 30,000 |
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(per family) |
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Take home medicine |
R 250 |
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(per admission) |
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Internal Prosthesis: |
R 16,500 |
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|
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CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary, |
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| |
only from Pharmacy Direct |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% NHRPL Rate |
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Limits per annum: |
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Member |
R 1,200 |
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Member + 1 |
R 2,300 |
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Member + 2 |
R 2,600 |
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Member + 3 |
R 2,900 |
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Member + 4 + |
R 3,200 |
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Seperate Network GP Limit: |
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Member |
R 1,400 |
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Member + 1 |
R 2,700 |
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Member + 2 |
R3, 100 |
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Member + 3 |
R3, 400 |
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Member + 4 + |
R3, 800 |
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Plus Dentistry, Radiology, Pathology |
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and Optometry |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 977 |
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| |
Spouse/Adult dependant |
R 765 |
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Per Child |
R 311 |
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