Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
100% scheme rate
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.
Consultations:
Consults: 12 consults, paid by scheme
1 consult from nurse home visit, day after return from hospital
1 consult from nurse home visit, 2 weeks after above visit
Scans:
2 x 2D scans
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.
Assume scheme pays all these costs, unless otherwise stated
In-hospital:
PMBs: Covered in full at DSP, up to 21 days admission
Alcoholism/Drug Addiction: 21 days admission
Out-of-hospital:
PMBs: 10+ consults
Trauma:
Covers certain day-to-day claims that form part of the recovery following specific traumatic events, such as near drowning, poisoning, severe allergic reaction and external and internal head injuries.
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