Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
Natural birth: 3 days private ward
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:: 12 consults with GP, gynae or midwife
Short payment on consults: additional R1,440
Vitamins: R2,440
Classes:R2,440 for first pregnancy
Scans:
2 x 2D 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: Covered in full at DSP, up to 21 days admission
Alcoholism/Drug Addiction: 21 days admission
Overall limit: R24,000 per family, unless PMB
Out-of-hospital:
PMBs: 10+ consults, paid by scheme
Otherwise, R20,000, from above limit; unless PMB
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
