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IN HOSPITAL BENEFIT |
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150% Scheme Rate |
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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 34,000 |
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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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CHRONIC MEDICATION BENEFIT |
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150% Scheme Rate |
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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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100% Scheme Rate |
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Limits per annum: |
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Member |
R 2,832 |
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Member +Spouse |
R 5,028 |
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Member +Spouse +Child 1 |
R 5,880 |
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Member +Spouse +Child 2 |
R 6,732 |
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Member +Spouse +Child 3 |
R 7,584 |
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Member +Child 1 |
R 3,648 |
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Plus Basic Dentistry |
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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 1,279 |
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Spouse/Adult dependant |
R 991 |
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Per Child |
R 384 |
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|
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IN HOSPITAL BENEFIT |
|
| |
100% Scheme Rate |
|
| |
No Overall Annual Limit |
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| |
|
|
| |
Annual Sub-limits: |
|
| |
Oncology |
R 250,000 |
|
| |
Physical Rehabilitation |
R 34,000 |
|
| |
(per family) |
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|
| |
Take home medicine |
R 320 |
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(per admission) |
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Internal Prosthesis: |
R 30,500 |
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|
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CHRONIC MEDICATION BENEFIT |
|
| |
100% Scheme Rate |
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| |
27 PMB Chronic Disease Conditions |
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Add. 16 Chronic Disease Conditions |
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Annual limit: |
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Single |
R 6,900 |
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Per Family |
R 13,800 |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
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Limits per annum: |
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Member |
R 3,100 |
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Member + 1 |
R 4,700 |
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Member + 2 |
R 5,100 |
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Member + 3 |
R 5,500 |
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Member + 4 + |
R 5,900 |
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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 basic and advanced Dentistry |
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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 1,795 |
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Spouse/Adult dependant |
R 1,533 |
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Per Child |
R 525 |
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|
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IN HOSPITAL BENEFIT |
|
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100% Scheme Rate |
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R1,000,000 per family per annum |
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Co-payments apply for certain |
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| |
procedures |
|
| |
Annual Sub-limits: |
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| |
Oncology |
R 115,000 |
|
| |
Physical Rehabilitation |
R 34,000 |
|
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(per family) |
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|
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Take home medicine |
R 250 |
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(per admission) |
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|
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|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% Scheme Rate |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary, |
|
| |
only from Pharmacy Direct |
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| |
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|
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
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Limits per annum: |
|
| |
Member |
R 1,400 |
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Member + 1 |
R 2,600 |
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Member + 2 |
R 3,000 |
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Member + 3 |
R 3,300 |
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Member + 4 + |
R 3,600 |
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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 basic Dentistry |
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and Optometry |
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ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
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| |
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MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,159 |
|
| |
Spouse/Adult dependant |
R 907 |
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Per Child |
R 369 |
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