• Medshield Plan, Scheme Plans

Medshield MediCurve:
in-and-out of hospital benefits (2025)

Contents:

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Medshield MediCurve. Please consult and verify with the scheme or your broker for full benefits, and an explanation of all the "fine print".

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.

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medshield:MediCurve (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R1,821
  • R1,821
  • R483
Savings:
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:
  • Under 21yrs, or students under 28 yrs
  • Pay for all children
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In-hospital Procedures (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medshield: MediCurve
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:
  • Paid in full
 Gap Cover:
Can push payout up to 700% scheme rate
(Plans coming soon)
Hospital Choice:
  • Compact Hospital Network
Penalty for using other hospital:
  • 30% penalty
 Gap Cover:
Can cover the penalty in full
(Plans coming soon)
Co-payments: In-hospital or Day Clinic:
  • Endoscopic Procedures: R2,000 co-payment
  • Oral Surgery: R4,000 co-payment
  • Maxillo-facial Surgery: R4,000 co-payment
  • Wisdom teeth, day clinic: R1,800 co-payment
  • Wisdom Teeth, Apicoectomy: R4,000 co-payment
  • Hysterectomy: R5,000 co-payment
  • Elective Caesarian: R10,000 co-payment
Note:
  • If you use a DSP (designated service provider), you never have to pay a co-payment for protocol treatment of a PMB (Prescribed Minimum Benefit). More info here
  • There might be other co-payments, especially if you don't use a DSP for a PMB or when buying medicine.
 Gap Cover:
Can cover most co-payments
(Plans coming soon)
Specialised Radiology:
  • CT scans, MUGA, MRI, Radio Isotope studies, CT Colonography: R6,200 per family, in and out-of hospital, unless PMB
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • No co-payment if done in rooms
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • Physio: R3,300 per person
Transplants:
  • PMBs only
Dialysis:
  • PMBs only
Exclusions:
  • NB: See scheme's rules for all exclusions. All schemes have plenty!
 Gap Cover:
Coming soon
Alternatives to hospitals:
  • Physical rehab, sub-acute facilities, nursing, hospice: R34,000 per family, for PMBs
  • Terminal care: R30,000 per family
Casualty/ER:
  • 2 facility fees per family
Gap Cover:
Can cover ER claims
(Plans coming soon)
Other:
  • Overall in-hospital limit: R1 million, excluding PMB treatment
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

Out-of-hospital Procedures (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medshield: MediCurve
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:
PMBs out of hospital:
  • All schemes must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine.
  • PMB benefits must never be paid from your savings account.
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
GP consultations:
  • nominated GP consults: 5-9 consults per family
  • Nurse consult: Unlimited
  • Nurse-led video consult: Unlimited
Childcare: . Gap Cover:
Can pay for child ER visits
(Plans coming soon)
Specialist consultations:
  • 1 consult per family with R250 co-payment
Pathology:
  • PMBs only
General radiology:
  • PMBs only
Specialised radiology:
  • CT scans, MUGA, MRI, Radio Isotope studies, CT Colonography: R6,200 per family, in and out-of hospital
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • No co-payment if done in rooms
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • PMBs only
General Appliances:
  • PMBs only
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • No benefit
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

Medication Benefit (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Medshield: MediCurve
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:
Chronic:
  • 25% co-payment for non-formulary
Acute (prescribed) medication:
  • M= R650
    M1= R1,350
    M2+= R1,700
Over-the-counter:
  • R500 per family, limited to R250 per script
Birth Control:
  • IUD and alternatives: 1 device, every 2-5 years
  • Pills: R185 per female per month, from acute medicine benefit
On Discharge:
  • R500 per admission
Biological:
  • PMBs only
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

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