Health Squared Millennium medical aid plan: 2020

View all plans in this scheme.
Always consult with your broker before making final decisions regarding your healthcare cover.

Millennium
Total Cost pm:

Main member:

R5,941

Adult:

R5,086

Child:

R1384
Savings: R10692 R9144 R2484
Self Payment Gap:
R6142 R4867 R1221
Above Threshold: 6417 5473 897

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IN HOSPITAL PROCEDURES:
Millennium
Scheme Benefits: Notes and Links:
non-Network Specialists:
  • 100% scheme rate
network Specialists:
  • 100% scheme rate
non-Network GPs:
  • 100% scheme rate
network GPs:
  • 100% scheme rate
Hospital Choice:
  • Choose any hospital
Penalty for using other hospital:
  • n/a
  • n/a
Specialised Radiology:
  • R17,367 per family, unless PMB
  • R2,090 co-payment
Supplementary Services: (Physio, etc)
  • Physiotherapy: 100% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
Transplants:
  • PMB only
Co-payments:
  • Cystoscopy, Excision nail bed, skin lesions, specialised radiology: R2,090 co-payment
  • Myringotomy: R2,612 co-payment
  • Circumcision, Vasectomy, colonoscopy, dental admissions: R3,135 co-payment
  • Arthroscopy: R4,000 co-payment
  • Endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins: R4,180 co-payment
  • Gatroscopy, Hernia repair: R5,225 co-payment
  • Nasal surgery, conservative neck and back/spine treatment, hysteroscopy, hysterectomy: R6,270 co-payment
  • Tonisllectomy, Adenoidectomy, Tympanoplasty: no co-payment
  • Rotator cuff surgery: R5,000 co-payment
  • Joint replacement, Spinal surgery: R12,450 co-payment
  • reflux surgery: R12,540 co-payment
Alternatives to hospitals:
  • Home nursing: 10 days
  • Rehab and subacute facilities: 18 days per family
Casualty:
  • PMB: Paid by scheme
  • Otherwise: from day-to-day benefit
  • Both the Blue Plan and Red Plan gap cover will pay up to R10,000 per person for unpaid casualty costs in event of emergency
Other: 2020 benefits coming soon
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R165,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R165,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)

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All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

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OUT OF HOSPITAL BENEFITS (non-PMB):
Millennium
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
Self Payment Gap:
R6142 R4867 R1221
General info:
  • Consider getting Primary Health Care (PHC) (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
GP consultations:
  • From day-to-day benefit, unless PMB
  • See Primary Health Care benefit above
Childcare: 2020 benefits coming soon
Specialists consultations:
  • From day-to-day benefit, unless PMB
  • Up to 220% scheme rate
  • See Primary Health Care benefit above
Pathology:
  • From day-to-day benefit, unless PMB
  • See Primary Health Care benefit above
General radiology:
  • From day-to-day benefit, unless PMB
  • See Primary Health Care benefit above
Specialised radiology:
  • R17,367 per family, unless PMB
  • R2,090 co-payment
Supplementary Services: (Physio, etc)
  • From day-to-day benefit, unless PMB

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MATERNITY BENEFITS:
Millennium
Scheme Benefits Notes and Links:
Hospital stay:
  • 100% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
Consultations:
  • From day-to-day benefits
Scans:
  • 2 x 2D scans, paid by scheme

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CANCER (ONCOLOGY):
Millennium
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):
  • Unlimited, subject to specific protocols and formularies

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DENTISTRY:
Millennium
Scheme Benefits Notes and Links:
Standard Dentistry:
  • Otherwise, from day-to-day benefit
  • Sublimits:
    • M =R6,828
    • M1 =R9,420
    • M2+ =R11,197
  • Consider getting Primary Health Care (medical insurance) that will cover you for a lot of out of hospital claims, including standard dentistry like scaling, polishing, fillings, extractions, root canals and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Specialised Dentistry:
  • Shared with standard dentistry
In-Hospital Dentistry:
  • Impacted wisdom teeth and treatment for children under 5yrs
  • R3,135 co-payment
Orthodontics:
  • Shared with standard dentistry
Maxillo Facial Surgery: 2020 benefits coming soon

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MEDICATION:
Millennium
Scheme Benefits: Notes and Links:
Chronic:
  • All medical aid plans pay for treatment of the 27 CDL conditions as required by law. This includes medicine as well as GP or specialist consults, tests etc. Find out more
  • An additional 30 non-CDL conditions are covered on this plan
  • Overall limit: R3,067 per person. Therafter, only PMB conditions continue to be covered
Acute (presrcibed) medication:
  • From day-to-day benefit, unless PMB
  • Consider getting Primary Health Care (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Over-the-counter:
  • From day-to-day benefit, unless PMB
Birth Control:
  • From day-to-day benefit (savings), subject to preventative care benefit sublimit of R2,897 per family
  • This sublimit is shared with most of the preventative care benefits
On Discharge:
  • 7 days supply
Biological: 2020 benefits coming soon

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OPTOMETRY:
Millennium
Scheme Benefits: Notes and Links:
Optometry:
  • From day-to-day benefit, up to R3,067 per person, every 2 years
  • Consider getting Primary Health Care (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here

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MENTAL HEALTH:
Millennium
Scheme Benefits Notes and Links:
In-hospital:
  • PMB: Unlimited, per protocol
  • non-PMB: R21,711 per family
Out-of-hospital:
  • From day-to-day benefit, unless PMB
Trauma: 2020 benefits coming soon

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OTHER BENEFITS:
Millennium
Scheme Benefits Notes and Links:
General Appliances:
  • External: R13,026 per family, subject to sublimits. (Speak to us about a ful list of these sublimits)
1.1. Hearing Aids:
  • R13,026 per family, every year )with a 3yr lifespan per appliance) and subject to above "External Appliances" limit
1.2. Wheelchairs:
  • R7,235 per family, every 3 years and subject to above "External Appliances" limit
Dialysis:
  • PMB only
International Insurance: 2020 benefits coming soon
Other:

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WELLNESS/PREVENTATIVE BENEFITS:
Millennium
Scheme Benefits: Notes and Links:
Flu vaccination:
  • Covered, subject to R2,886 sublimit for preventative care
Pneumonia vaccines:
  • No benefit
Biometric Screening:
  • Covered, subject to R2,886 sublimit for preventative care
Child Immunisation:
  • Covered, subject to R2,886 sublimit for preventative care
Pap Smear:
  • Covered, subject to R2,886 sublimit for preventative care
Mammogram:
  • Covered, subject to R2,886 sublimit for preventative care
PAS Test:
  • Covered, subject to R2,886 sublimit for preventative care
HIV Test:
  • Covered, subject to R2,886 sublimit for preventative care
Other:
  • HPV vaccine, subject to R2,886 sublimit for preventative care

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PROSTHETICS:
Millennium
Scheme Benefits: Notes and Links:
Overal Limit:
  • Overall limit: R64,934
Sub-limits:
  • Speak to us about specific sub-limits

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    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