Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
100% scheme rate
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: 9 consults with GP, gynaecologist or midwife
Post-natal: 1 consult with GP, gynaecologist or midwife
Lactation consult:1 consult
Maternity supplements: R133 per month, for 9 months
Scans:
2 x 2D ultrasound scans
Note:
If you are pregnant and don't have medical aid, your pregnancy will most likely be excluded for new cover, but your baby will be covered from birth. Read more about pregnancy cover if you don’t have medical aid.
Assume scheme pays all these costs, unless otherwise stated
In-hospital:
PMBs: 21 days per person
Alcoholism/Drug Addiction: 21 days per person or R37,352 per person
Out-of-hospital:
PMBs: 10+ consults, paid by scheme
Otherwise, from day-to-day benefit
Trauma:
Mental Health PMB conditions are covered for in and out of hospital treatment. For a full list see here.
Example of PMB condition: Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse. Treatment includes hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts
