Risk Benefit

Private hospitalisation Unlimited at any private hospital
Professional Fees 100% of Scheme Rate
Casualty | Emergency Room Benefit Trauma and PMB: Unlimited
Maternity Benefit Normal Delivery: 3 days and 2 nights
Caesarean Section: 4 days and 3 nights
Antenatal Care 2x 2D scans
Internal Prostheses PMB: Unlimited
Subject to Scheme Protocols
Oncology PMB: Unlimited
Non-PMB: R201 348
Subject to ICON protocols
Specialised Radiology: CT, MRI, PET Scans Unlimited PMB and trauma cover
Non-PMB: R8 850
Emergency evacuation and Ambulance services Netcare 911
100% of Scheme Rate – Unlimited

Day-to-Day Benefit

General Practitioner Consultations (Non-network providers) 2x GP consultations per family
Primary Care Network Providers (GP, Physio and Psychology) 3x consultations per family

Chronic Condition Benefit

PMB CDL Conditions 29 conditions covered

Preventative Care Benefit

Preventative Care Benefit – Per Annum R2 788 per family
Pap smears 1 test per female beneficiary
HIV Test 1 Test per beneficiary
Vaccinations: Flu 1 dose Flu vaccination per beneficiary
Childhood immunisations Childhood immunisations up to 18 months: R2 097
Oral Contraception R1 116 per female beneficiary per annum – R93 per month