|
|
| |
IN HOSPITAL BENEFIT |
|
| |
150% Scheme Rate |
|
| |
No Overall Annual Limit |
|
| |
Co-payments apply for certain |
|
| |
procedures |
|
| |
*R275 Take Home Medicine |
|
| |
Annual Sub-limits: |
|
| |
Oncology |
R 250,000 |
|
| |
Psychiatric Treatment |
R 23,500 |
|
| |
Hospice Care |
R 12,000 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
150% Scheme Rate |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary, |
|
| |
only from Pharmacy Direct |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
|
| |
Limits per annum: |
|
| |
Member |
R 2,868 |
|
| |
Member +Spouse |
R 5,088 |
|
| |
Member +Spouse +Child 1 |
R 5,952 |
|
| |
Member +Spouse +Child 2 |
R 6,816 |
|
| |
Member +Spouse +Child 3 |
R 7,680 |
|
| |
Member +Child 1 |
R 3,732 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
Plus Basic Dentistry |
|
| |
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,406 |
|
| |
Spouse/Adult dependant |
R 1,089 |
|
| |
Per Child |
R 422 |
|
| |
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
100% Scheme Rate |
|
| |
No Overall Annual Limit |
|
| |
*R340 Take Home Medicine |
|
| |
|
|
| |
|
|
| |
Annual Sub-limits: |
|
| |
Oncology |
R 250,000 |
|
| |
Psychiatric Treatment |
R29,500 |
|
| |
Hospice Care |
R12,000 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% Scheme Rate |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Add. 16 Chronic Disease Conditions |
|
| |
Annual limit: |
|
| |
Single |
R 7,000 |
|
| |
Per Family |
R 14,000 |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
|
| |
Limits per annum: |
|
| |
Member |
R 3,300 |
|
| |
Member + 1 |
R 5,000 |
|
| |
Member + 2 |
R 5,400 |
|
| |
Member + 3 |
R 5,800 |
|
| |
Member + 4 + |
R 6,200 |
|
| |
Network GP Limit: |
|
| |
Member |
R3, 000 |
|
| |
Member + 1 |
R 4, 500 |
|
| |
Member + 2 |
R 4, 900 |
|
| |
Member + 3 |
R 5,200 |
|
| |
Member + 4 + |
R 5, 600 |
|
| |
Plus basic and advanced Dentistry |
|
| |
and Optometry |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,973 |
|
| |
Spouse/Adult dependant |
R 1,707 |
|
| |
Per Child |
R 577 |
|
| |
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
100% Scheme Rate |
|
| |
R1,000,000 per family per annum |
|
| |
Co-payments apply for certain |
|
| |
procedures |
|
| |
*R275 Take Home Medicine |
|
| |
Annual Sub-limits: |
|
| |
Oncology |
R 120,000 |
|
| |
Psychiatric Treatment |
R11,500 |
|
| |
Hospice Care |
R12,000 |
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% Scheme Rate |
|
| |
27 PMB Chronic Disease Conditions |
|
| |
Subject to scheme formulary, |
|
| |
only from Pharmacy Direct |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% Scheme Rate |
|
| |
Limits per annum: |
|
| |
Member |
R 1,500 |
|
| |
Member + 1 |
R 2,750 |
|
| |
Member + 2 |
R 3,200 |
|
| |
Member + 3 |
R 3,500 |
|
| |
Member + 4 + |
R 3,800 |
|
| |
Network GP Limit: |
|
| |
Member |
R 1,400 |
|
| |
Member + 1 |
R 2,700 |
|
| |
Member + 2 |
R3, 100 |
|
| |
Member + 3 |
R3, 400 |
|
| |
Member + 4 + |
R3, 800 |
|
| |
Plus basic Dentistry |
|
| |
and Optometry |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,274 |
|
| |
Spouse/Adult dependant |
R 997 |
|
| |
Per Child |
R 406 |
|
| |
|
|
|
|