Benefits, cancer benefits, maternity benefits, Medimed Plan, mental health benefits, Scheme Plans

Medimed Essential C:
cancer, maternity and mental health (2025)

This page has information on: Costs, Maternity, Oncology, Mental Health for Medimed Essential C

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Terminology:

PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
DSPs: Designated Service Providers. Where stipulated, you must use 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.
All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Medimed:Essential C (2025)
	Main member:	Adult member:	Child member:
Total Cost pm:	R2,480	R2,480	R650 Pay for all children
Savings:	R2,976	R2,976	R780
Children Rates:	Pay for all children
Income band:	This plan is only available to households with income in R17,001-R23,000pm band. View other income bands

Medimed: Essential C
Overall cancer coverage (in and out of hospital):	R50,000 per family Shared with dialysis, organ transplant and oncology benefits Note: Most cancers are PMBs, and treatment is paid in full by scheme. More info here Most schemes require use of specific providers (DSPs) for oncology treatment.	Gap Cover: Can cover the penalty in full (Plans coming soon)

Medimed: Essential C

Assume scheme pays all these costs, unless otherwise stated

Note: Most cancers are PMBs, and treatment is paid in full by scheme. More info here
Most schemes require use of specific providers (DSPs) for oncology treatment.

Gap Cover:
Can cover the penalty in full
(Plans coming soon)

Medimed: Essential C
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:	Paid at 200% scheme rate Home delivery: R12,000 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.	Gap Cover: Can cover most shortfalls (Plans coming soon)
Consultations:	Antenatal: 3 consults Paediatrician: 1 consult Paid by scheme
Scans:	2 x 2D scans Paid by scheme
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.

Medimed: Essential C

Assume scheme pays all these costs, unless otherwise stated

	Main Member:	Adult:	Child:
Savings:	R2,976	R2,976	R780
Other Day-to-Day Funds:

Mental Health PMB conditions are covered for in and out of hospital treatment, even on "hospital" plans. 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. Scheme will pay this in full, if you use a DSP.

Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)

Important!

Unless specified, assume that all benefits 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.