Day-to-Day Benefit
| The following services are covered from your Medical Savings Account (MSA) General Practitioner Consultations Specialist Consultations Conservative Dentistry Alternative Healthcare Services Radiology and Pathology Physiotherapy Speech Therapy and Audiology Additional Medication (Acute) Over-the-Counter Medication (OTC) |
Member: R18 408 Adult dependent: R17 820 Child dependent: R6 564 |
|---|---|
| BenefitBooster Psychology and Psychiatry Advanced Dentistry (Includes cover for crowns, bridges, implants, dentures, periodontics and orthodontic) Optometry |
Annual Limits: M: R10 398 M+1: R12 635 M+2: R14 316 M+3: R17 442 M+4+: R19 567 |
Risk Benefit
| Private hospitalisation | Unlimited at any private hospital Planned PMB’s: Network hospitals |
|---|---|
| Professional Fees | 100% of Scheme Rate |
| Casualty | Emergency Room Benefit | Trauma and PMB: Unlimited. Non-PMB: Subject to MSA |
| Maternity Benefit | Normal Delivery: 3 days and 2 nights Caesarean Section: 4 days and 3 nights |
| Antenatal Care | Maternity Programme Consultations (MSA) and 3x 2D scans (Risk) Antenatal classes: R570 (Risk) |
| Internal Prostheses | PMB: Unlimited Non-PMB: R81 520 |
| Oncology | Unlimited. Subject to ICON protocols |
| Specialised Radiology: MRI and CT Scans |
Unlimited PMB and trauma cover Non-PMB: R24 934 |
| Emergency evacuation and Ambulance services | Netcare 911 100% of Scheme Rate Unlimited |
Preventative Care Benefit
| Preventative Care Benefit Subject to BenefitBooster Blood Pressure test Blood Sugar test Cholesterol test Body Mass Index Pap Smear Mammogram Screening |
Sub-limit: R2 795 |
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Chronic Condition Benefit
| PMB CDL Conditions | Unlimited |
|---|---|
| Additional Chronic Benefit Specified conditions | Subject to MSA |