Out-of-hospital, scheme pays for some: specialised radiology, maternity, alternative to hospitalisation, optometry, some non-surgical procedures including scopes,preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB. .

View all plans in this scheme

IN HOSPITAL PROCEDURES:
Payout Rate for Specialists:
Hospital Choice:
Specialised Radiology:
Supplementary Services: (Physio, etc)
Transplants:
Co-payments:
Alternatives to hospitals:

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OUT OF HOSPITAL BENEFITS:
GP consultations:
Specialists consultations:
Pathology:
General radiology:
Specialised radiology:
Supplementary Services: (Physio, etc)

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MATERNITY BENEFITS:
Hospital stay:
Consultations:
Scans:

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CANCER (ONCOLOGY):
Overall coverage (in and out of hospital):	Note: All oncology benefits are assessed on a case-by-case basis, and are subject to protocols, preferred providers and scheme rules. Benefit covers out-of-hospital treatment too, like chemotherapy.

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DENTISTRY:
Dentistry:
Orthodontics:
Maxillo Facial Surgery:

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MEDICATION:
Chronic:
Acute (presrcibed) medication:
Over-the-counter:
Birth Control:
On Discharge:
Notes:

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OPTOMETRY:
Optometry:

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MENTAL HEALTH:
In-hospital:
Out-of-hospital:

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OTHER BENEFITS:
General Appliances:
1.1. Hearing Aids:
1.2. Wheelchairs:
Dialysis:
HIV:
Emergency Transport:
International Coverage:
Other:

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WELLNESS/PREVENTATIVE BENEFITS:
Flu vaccination:
Pneumonia vaccines:
Back Rehabilitation Programme:
Biometric Screening:
Child Immunisation:
Pap Smear:
Mammogram:
PAS Test:
HIV Test:

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PROSTHESIS:
Overal Limit:
Sub-limits:

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