Assume scheme pays all these costs, unless otherwise stated |
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Child: |
- No savings account option on this plan
- The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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- PMBs only
- Covered in full at DSP, up to 21 days admission
- Alcoholism/Drug Addiction: 21 days admission
- If non-DSPs are used, claims are limited to R42,000 per person, in and out of hospital
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- PMBs: 10+ consults, paid by scheme
- If non-DSPs are used, claims are limited to R1,000 per consult and R42,000 per person, in and out of hospital
- Otherwise, no benefit
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- Traumatic event claims: 6 counselling sessions per person per year, for the year in which the trauma event occurred and the year after
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- PMBs: Prescribed Minimum Benefits. Here is a list of PMB conditions: Mental Illness.
- DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
- Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
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View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
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Compare any two plans, side by side |
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Find all other open medical aid plans here.
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