Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):
R250 000 per person
Includes In- and out-of-hospital benefits for oncologist consultations, chemotherapy, radiotherapy (including brachytherapy), MRT / CT / PET and bone scans, pathology tests, medication and materials
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.
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
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:
From day-to-day benefit
Scans:
From day-to-day benefit
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.
