Sizwe Platinum Enhanced:
prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Sizwe Platinum Enhanced We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative Find all the open medical aid plans here. Compare any two plans side by side, instantly. Monthly Costs: Platinum Enhanced 2024 prices Main member: Adult member: Child member: Total Cost pm: R4,746 R4,456 R1297 Only pay for 3 children Savings: R12804 R11232 R3276 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R11,362 Main+1= R16,287 Main+2= R18,740 Main+3= R20,392 Main+4= R22,855 Main+5= R25,329 Main+6+= R27,639 Children Rates: Child rates up to age 25. Grandchildren included. Only pay for 3 children Income band: This plan is only available to households with income in All income levelspm band. View other income bands Note: Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list. All treatments and procedures are subject to authorisation and protocols All benefits are listed as an indication only. Please verify with your broker and scheme ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Sizwe plans, with costs and brief summary . You'll get the printable guide as well as a weekly newsletter 🙂 Prosthetics benefits (2021): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Sizwe: Platinum Enhanced Overal Limit: R65,052 per family, unless PMB Sub-limits apply Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here Sub-limits: Internal: Joints - hip and knee (partial and total). 1 per person Spine: two levels, in one procedure, or by authorisation. Cardiac: pacemaker, internal defibrillators, grafts and valves. Vascular stents: 2 per family Cardiac stents: 3 per family Note: PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here. 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 ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Sizwe plans, with costs and brief summary .

Always consult with your broker before making final decisions regarding your healthcare cover.

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