Risk Benefit

Private hospitalisation Unlimited at DSP private hospitals
Professional Fees 100% of Scheme Rate
Casualty | Emergency Room Benefit Trauma and PMB: Unlimited
Non-PMB: R1 879
Maternity Benefit Normal Delivery: 3 days and 2 nights
Caesarean Section: 4 days and 3 nights
Antenatal Care Maternity Programme Included: 3x GP and Specialist consultations
2x 2D scans and 1x 3D scan
Welcome gift: R708
Internal Prostheses PMB: Unlimited
Non-PMB: R63 214
Oncology PMB: Unlimited
Non-PMB: R308 529
Subject to ICON protocols
Specialised Radiology: CT, MRI, PET Scans Unlimited PMB and trauma cover
Non-PMB: R11 133

Day-to-Day Benefit

General Practitioner Consultations (Non-network providers) Member: 4 consultations
Member +1: 7 consultations
Member +2+: 9 consultations
Primary Care Network Providers (GP, Physio and Psychology) Member: 6 consultations
Member +1: 10 consultations
Member +2+: 13 consultations
Specialist consultations Single Member: 2 consultations
Family: 3 consultations
Conservative Dentistry M: R3 894
M+: R6 262
Advanced Dentistry – Includes cover for crowns and bridges R6 264 per family
Optometry 1 consultation per beneficiary in 24 months
Includes frame and lenses (single vision, bifocal or multifocal lenses)
Limited to R2 557 per beneficiary
Additional Medication (Acute) Single Member: R2 652
Family: R3 427
With a sub-limit on Over-the-Counter Medication (OTC) Single Member: R678
Family: R 1 025
Additional Day-to-day Benefit
Flexi Benefit
Single Member: R2 675
Family: R3 394
Alternative Healthcare Services Subject to Flexi Benefit
Radiology and Pathology Subject to Flexi Benefit
Speech Therapy and Audiology Subject to Flexi Benefit
Physiotherapy and Psychology – Non-network providers Subject to MSA
Primary Care Network providers – (GP, Physio and Psychology) Included in Primary Care Network (PCN) Benefit

Chronic Condition Benefit

PMB CDL Conditions 29 conditions covered
Additional Chronic Benefit Specified conditions Subject to Additional Medicine Benefit and sub-limit for ADHD

Preventative Care Benefit

Preventative Care Benefit – Per Annum R2 999 per family
Blood Pressure, Blood Sugar and Cholesterol test, Body Mass Index R139 per beneficiary
Mammogram (screening) Female beneficiary > 40 years
Pap smears 1 test per female beneficiary
PSA Testing Male beneficiary > 45 years
HIV Test 1 Test per beneficiary
Vaccinations: Flu 1 dose Flu vaccination per beneficiary
Childhood immunisations Up to 18 months: R2 211
Oral Contraception R1 776 per female beneficiary per annum – R148 per month