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Medihelp Prime 3: prosthetic benefits (2021)

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This page shows the Prosthetic 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

Prosthetics:

Prime 3
Overal Limit: When will this be updated?
Sub-limits: Internal
  • EVARS prosthesis: R135,600
  • Vascular/cardiac prosthesis: R58,000
  • Health-essential functional prosthesis: R64,300
  • • Intra-ocular lenses: R4,300 per lens, subject to health-essential limit • Hip, knee and shoulder replacements (non-PMB): subject to health-essential limit
  • Implantable hearing devices: R250,000
  • Prosthesis with reconstructive or restorative surgery, and external breast prostheses in and out of hospital: R9,900
External
  • Artificial eyes:R4,850
  • Artificial limbs: R4,850
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 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
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

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Hi! I'm Eve Dmochowska, rehealth's founder.

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