Private hospitalisation | Unlimited at any private hospital |
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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 |
General Practitioner Consultations (Non-network providers) | 2x GP consultations per family |
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Primary Care Network Providers (GP, Physio and Psychology) | 3x consultations per family |
PMB CDL Conditions | 29 conditions covered |
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Preventative Care Benefit – Per Annum | R2 788 per family |
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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 |