Profmed: ProActive Premium medical aid plan: 2019

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

ProActive Premium
2019 Costs:
Total Cost pm:

Main member:

R1,658

Adult:

R1,532

Child:

R646
Savings (per year):
  • No savings option on this plan
NEED HELP?
We can help you manage or change this plan.
Click here to start.

IN HOSPITAL PROCEDURES:
ProActive Premium
Scheme Benefits: Notes and Links:
Specialists: Gap Cover
  • Gap cover is available for this plan. Budget about R350 for a fully comprehensive gap cover that will increase the scheme rate to 500% and pay most co-payments and increase sublimits.
Hospital Choice:
Specialised Radiology:
Supplementary Services: (Physio, etc)
Transplants:
Co-payments:
Alternatives to hospitals:
Casualty:
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 R150,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R150,000 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)
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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.

.
.
.
.
OUT OF HOSPITAL BENEFITS (non-PMB):
ProActive Premium
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
General info:
GP consultations:
Childcare:
Specialists consultations:
Pathology:
General radiology:
Specialised radiology:
Supplementary Services: (Physio, etc)
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
MATERNITY BENEFITS:
ProActive Premium
Scheme Benefits Notes and Links:
Hospital stay:
Consultations:
Scans:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
CANCER (ONCOLOGY):
ProActive Premium
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
DENTISTRY:
ProActive Premium
Scheme Benefits Notes and Links:
Standard Dentistry:
Specialised Dentistry:
In-Hospital Dentistry:
Orthodontics:
Maxillo Facial Surgery:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
MEDICATION:
ProActive Premium
Scheme Benefits: Notes and Links:
Chronic:
Acute (presrcibed) medication:
Over-the-counter:
Birth Control:
On Discharge:
Biological:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
OPTOMETRY:
ProActive Premium
Scheme Benefits: Notes and Links:
Optometry:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
MENTAL HEALTH:
ProActive Premium
Scheme Benefits Notes and Links:
In-hospital:
Out-of-hospital: /td>
Trauma:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
OTHER BENEFITS:
ProActive Premium
Scheme Benefits Notes and Links:
General Appliances:
  • No benefit
1.1. Hearing Aids:
1.2. Wheelchairs:
Dialysis:
HIV:
Emergency Transport:
International Insurance:
Other:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
WELLNESS/PREVENTATIVE BENEFITS:
ProActive Premium
Scheme Benefits: Notes and Links:
Flu vaccination:
Pneumonia vaccines:
Back Rehabilitation Programme:
Biometric Screening:
Child Immunisation:
Pap Smear:
Mammogram:
PAS Test:
HIV Test:
Other:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

.
.
PROSTHETICS:
ProActive Premium
Scheme Benefits: Notes and Links:
Overal Limit:
Sub-limits:
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.


    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