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Medihelp Prime 3: cancer, maternity and mental health (2021)

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This page shows the Oncology(cancer), Maternity and Mental Health Benefits for Medihelp Prime 3.

Pricing:

Prime 3
Main member: Adult member: Child member:
Total Cost pm: R3,828 R3,240 R1,116
Pay for max 2 children under 18yrs
Savings: R4608 R3888 R1368
Children Rates:
  • Under 26yrs
  • Pay for max 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 other benefits:
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

Cancer/Oncology:

Prime 3
Overall coverage (in and out of hospital):
  • non-PMB: R273,700 per family
  • Bone marrow/stem cell transplants: PMB only
Note:
  • PMBs: Prescribed Minimum Benfits. Read about how cancer is covered as a PMB.
  • See what treatment is covered for which cancer, under the PMB law
  • 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 other benefits:
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

Maternity:

Prime 3
Hospital stay:
  • 100% scheme rate
  • Home delivery: R13 500, including the professional nursing fees, equipment, material and medicine.
Consultations:
  • 10 antenatal and post-natal consultations at a midwife/GP/gynaecologist
  • 2 antenatal and post-natal consultations at a dietician/breastfeeding specialist/antenatal classes
  • 9 months’ antenatal iron supplements
  • 9 months’ antenatal folic acid supplements
Scans:
  • Two 2D ultrasound scans
Note:
View other benefits:
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

Mental Health:

Prime 3
In-hospital:
  • R30,400 per person and R40,800 per family
Out-of-hospital:
  • Psychiatrist:R30,400 per person and R40,800 per family
  • Psychologist: from day-to-day benefit
Trauma: When will this be updated?
Note:
  • PMBs: Prescribed Minimum Benfits. Here is a list of PMB conditions: Mental Illness.
  • 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 other benefits:
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

    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

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