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Medihelp MedElite: cancer, maternity and mental health (2024)

This page has information on: Costs, Maternity, Oncology, Mental Health for Medihelp MedElite

We also have information on: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Other/Extra Benefits, Wellness and Preventative and Prosthetics

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Monthly Costs:

MedElite 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R7,368
  • R6,900
  • R1,998
  • Pay for all children
Savings:
  • R8,856
  • R8,280
  • R2,376
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R13,900
  • Main+1= R16,100
  • Main+2= R18,400
  • Main+3= R20,700
Children Rates:
  • Child rates up to age 26.
  • Pay for all children
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

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Cancer/ Oncology benefits for 2024:

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medihelp: MedElite
Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):
  • Non-PMB: R476,700 per family
 Treatment required for PMB conditions is always paid by scheme, with no co-payment, if you follow the protocols. Most cancers are PMBs! More info here

Most schemes require use of specific providers (DSPs) for oncology treatment.
♦️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 Medihelp plans, with costs and brief summary
.
.
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Maternity benefits for 2024:

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medihelp: MedElite
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
  • 100% scheme rate
  • Home birth: R15,600 per event
 Usually covered for 2 nights for natural birth, and 3 nights for C-sections. All newborns receive immediate full medical aid cover at birth, even if parents are on a waiting period.
Consultations:
  • Consults: 10 consults with GP, gynaecologist or midwife
  • Post-natal: 2 consults with dietician, lactation specialist, antenatal classes
  • Lactation consult: 1 consult
  • Iron supplements: 9 months
  • Folic Acid supplements: 9 months
Scans:
  • 2 x 2D scans
Note:
♦️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 Medihelp plans, with costs and brief summary
.
.
.

Mental Health benefits for 2024:

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(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medihelp: MedElite
Assume scheme pays all these costs, unless otherwise stated
In-hospital:
  • PMBs: 21 days admission
  • Alcoholism/Drug Addiction: 21 days admission
  • Otherwise, R42,100 per person and R58,400 per family, counting PMBs
Out-of-hospital:
  • PMBs: 10+ consults, paid by scheme
  • Otherwise, from day-to-day benefit
  • After savings are depleted, sublimits apply as follows (from overall day-to-day limit):
    • M= R3,200
    • M1= R4,200
    • M2= R5,300
    • M3+= R6,300
  • Shared with GP, Specialists, Physio, Psychology, Psychiatric Nursing, Supplementary Services
Trauma:
Note:
  • 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
♦️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 Medihelp plans, with costs and brief summary
.

    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

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