Medihelp MedPrime: prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Medihelp MedPrime We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative Find all the open medical aid plans here. Compare any two plans side by side, instantly. Monthly Costs: MedPrime 2024 prices Main member: Adult member: Child member: Total Cost pm: R4,782 R4,044 R1,398 Only pay for 2 children under 18yrs Savings: R5,760 R4,824 R1,656 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R6,900 Main+1= R12,700 Children Rates: Child rates up to age 26. Only pay for 2 children under 18yrs Note: 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 ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Medihelp plans, with costs and brief summary . You'll get the printable guide as well as a weekly newsletter 🙂 Prosthetics benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Medihelp: MedPrime Overal Limit: Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here Sub-limits: EVARS prosthesis: R155,600 per person Vascular/cardiac prosthesis: R66,500 per person Prosthesis with reconstructive surgery: R11,300 per family, in and out of hospital Health essential prosthesis, incl hip, knee and shoulder replacements: R73,800 per person Intraocular lenses: R4,900 per lens 2 lenses per person, and from Health Essential limit, above External breast prostheses: Day to day benefit External: Artificial eye: R5,450 per family, every 3 years Artificial limbs: R5,450per family, every 3 years Note: PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here. DSPs: Designated Service Provders. Where stipulated, you must use specific 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 ♦️View all the other benefits for this plan:♦️ Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics You can also: ♦️Compare any two plans, side by side | ♦️View all the Medihelp plans, with costs and brief summary .

Always consult with your broker before making final decisions regarding your healthcare cover.

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