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
Assume scheme pays all these costs, unless otherwise stated
Optometry:
One eye test and one pair of glasses, every 24 months
Can swop glasses for contact lenses
Note:
This section does not apply to opthamology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
Covered , for 65yrs+
Pneumonia vaccines:
Every five years, or once per lifetime for persons over the age of 65
Biometric Screening:
Covered
Child Immunisation:
Not covered
Pap Smear:
Covered , every 3 years
Mammogram:
Covered , every 2 years
If you qualify, you can get Breast MRI and once-off BRCA test for breast screening
PAS Test:
Covered
HIV Test:
Covered
Other:
Kids' assessment, including height, weight, head circumference and health and milestone tracking
Bowel cancer screening
Access to the WELLTH Fund. You get up to R10,000 per family for various out of hospital expenses including GP, eye, dental, hearing screenings and medical devices. Find out more .