• Cape Medical Plan, rehealth, Scheme Plans

Cape Medical MyHealth 100 Saver:
prosthetic benefits (20245)

Contents:

This page has information on: Costs and Prosthetics for Cape Medical 100 Saver

Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Providers. Where stipulated, you must use 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.
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

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

Cape Medical :MyHealth 100 Saver (2025)
Main member: Adult member: Child member:
Total Cost pm:
  • R3,447
  • R3,447
  • R520
Savings:
  • R4,200
  • R4,200
  • R660
Children Rates:
  • Under 21yrs
  • Under 21yrs

Prosthetics benefits (2025):

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

Cape Medical : MyHealth 100 Saver
Assume scheme pays all these costs, unless otherwise stated
Overall Limit:
  • Internal: : R56,538 per person
  • External: No cover
  • Prosthetics required for PMB conditions are always paid in full by scheme, with no co-payment, if you follow the protocols. More info here
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Sub-limits:
  • Cardiac stents: R17,668 per stent
  • Trans-vaginal tape: R12,077
  • Intra-ocular lenses: R3,547 per lens
  • Patches used in incisional hernia repair: R4,830
  • Patches used in groin hernia repair: R1,618
  • Joint replacements: R56,538
  • Pacemakers, including leads: R56,538
  • Bi-lateral joint replacements: R113,076
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Note:
  • PMBs: Prescribed Minimum Benefits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here.
  • DSPs: Designated Service Providers. Where stipulated, you must use 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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    Important!
  • Unless specified, assume that all benefits 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.

More Information