Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

Out-of-hospital, scheme pays for some: Preventative dentistry, wound care, specialised radiology, contraceptives, maternity care, pap smear, mammogram, PSA screening and some preventative benefits. Limits apply. Most else paid from savings or from out of pocket, unless PMB. .

View all plans in this scheme

IN HOSPITAL PROCEDURES:
Payout Rate for Specialists:

Hospital Choice:
Specialised Radiology:
Supplementary Services: (Physio, etc)
Transplants:
Co-payments:
Alternatives to hospitals:

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OUT OF HOSPITAL BENEFITS:
GP consultations:
Specialists consultations:
Pathology:
General radiology:
Specialised radiology:
Supplementary Services: (Physio, etc)

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MATERNITY BENEFITS:
Hospital stay:
Consultations:
Scans:

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CANCER (ONCOLOGY):
Overall coverage (in and out of hospital):
Note: All oncology benefits are assessed on a case-by-case basis, and are subject to protocols, preferred providers and scheme rules. Benefit covers out-of-hospital treatment too, like chemotherapy.

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DENTISTRY:
Dentistry:
Orthodontics:
Maxillo Facial Surgery:

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MEDICATION:
Chronic:
Acute (presrcibed) medication:
Over-the-counter:
Birth Control:
On Discharge:
Notes:

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OPTOMETRY:
Optometry:

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MENTAL HEALTH:
In-hospital:

Out-of-hospital:

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OTHER BENEFITS:
General Appliances:
1.1. Hearing Aids:
1.2. Wheelchairs:
Dialysis:
HIV:
Emergency Transport:
International Coverage:
Other:

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WELLNESS/PREVENTATIVE BENEFITS:
Flu vaccination:
Pneumonia vaccines:
Back Rehabilitation Programme:
Biometric Screening:
Child Immunisation:
Pap Smear:
Mammogram:
PAS Test:
HIV Test:

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PROSTHESIS:
Overal Limit:
Sub-limits:

    Important!

  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • "Unlimited" benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised