Profmed: ProActive B Savvy medical aid plan: 2020

View all plans in this scheme.
Always consult with your broker before making final decisions regarding your healthcare cover.

ProActive Savvy B
2020 Costs:
Total Cost pm:

Main member:

R1,218

Adult:

R1,218

Child:

R545
Savings (per year):
  • No savings option on this plan
Income band:



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IN HOSPITAL PROCEDURES:
ProActive Savvy B
Scheme Benefits: Notes and Links:
non-Network Specialists:
network Specialists:
  • The Blue Plan gap cover will increase this to 500% scheme rate
non-Network GPs:
  • The Blue Plan gap cover will increase this to 500% scheme rate
network GPs:
  • The Blue Plan gap cover will increase this to 500% scheme rate
Hospital Choice:
Penalty for using other hospital:
Specialised Radiology:
Supplementary Services: (Physio, etc)
  • The Blue Plan gap cover will increase this to 500% scheme rate
Transplants:
Co-payments:
Alternatives to hospitals:
Casualty:
  • Both the Blue Plan and Red Plan gap cover will pay up to R20,000 per person for unpaid casualty costs in event of emergency
Other:
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R157,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R157,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)



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All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

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OUT OF HOSPITAL BENEFITS (non-PMB):
ProActive Savvy B
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
Savings /yr: No savings option on this plan
General info:
  • Consider getting Primary Health Care (PHC) (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
GP consultations:
  • See Primary Health Care benefit above
Childcare:
Specialists consultations:
  • See Primary Health Care benefit above
Pathology:
  • See Primary Health Care benefit above
General radiology:
  • See Primary Health Care benefit above
Specialised radiology:
Supplementary Services: (Physio, etc)



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MATERNITY BENEFITS:
ProActive Savvy B
Scheme Benefits Notes and Links:
Hospital stay:
  • The Blue Plan gap cover will increase this to 500% scheme rate
Consultations:
Scans:



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CANCER (ONCOLOGY):
ProActive Savvy B
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):



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DENTISTRY:
ProActive Savvy B
Scheme Benefits Notes and Links:
Standard Dentistry:
  • Consider getting Primary Health Care (medical insurance) that will cover you for a lot of out of hospital claims, including standard dentistry like scaling, polishing, fillings, extractions, root canals and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Specialised Dentistry:
In-Hospital Dentistry:
Orthodontics:
Maxillo Facial Surgery:



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MEDICATION:
ProActive Savvy B
Scheme Benefits: Notes and Links:
Chronic:
Acute (presrcibed) medication:
  • Consider getting Primary Health Care (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Over-the-counter:
Birth Control:
On Discharge:
Biological:



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OPTOMETRY:
ProActive Savvy B
Scheme Benefits: Notes and Links:
Optometry:
  • Consider getting Primary Health Care (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here



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MENTAL HEALTH:
ProActive Savvy B
Scheme Benefits Notes and Links:
In-hospital:
Out-of-hospital:
Trauma:



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OTHER BENEFITS:
ProActive Savvy B
Scheme Benefits Notes and Links:
General Appliances:
1.1. Hearing Aids:
1.2. Wheelchairs:
Dialysis:
International Insurance:
Other:



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WELLNESS/PREVENTATIVE BENEFITS:
ProActive Savvy B
Scheme Benefits: Notes and Links:
Flu vaccination:
Pneumonia vaccines:
Biometric Screening:
Child Immunisation:
Pap Smear:
Mammogram:
PAS Test:
HIV Test:
Other:



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PROSTHETICS:
ProActive Savvy B
Scheme Benefits: Notes and Links:
Overal Limit:
Sub-limits:



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    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