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 |