Profmed ProSecure A Savvy medical aid plan: 2020

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Always consult with your broker before making final decisions regarding your healthcare cover.

ProSecure Savvy A
Total Cost pm:

Main member:

R2,494

Adult:

R2,494

Child:

R1,130
Savings (per year):
  • No savings option on this plan
Extended Fund: RM =R11,425
M+ =R17,367
Max per family: R22,394
R R
Income band:

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IN HOSPITAL PROCEDURES:
ProSecure Savvy A
Scheme Benefits: Notes and Links:
non-Network Specialists:
network Specialists:
non-Network GPs:
network GPs:
Hospital Choice:
Penalty for using other hospital:
  • n/a
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 R10,000 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 R165,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R165,000 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):
ProSecure Savvy A
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
Savings /yr: No savings option on this plan
Extended Fund: RM =R11,425
M+ =R17,367
Max per family: R22,394
R R
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:
ProSecure Savvy A
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):
ProSecure Savvy A
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):

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DENTISTRY:
ProSecure Savvy A
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:
ProSecure Savvy A
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:
ProSecure Savvy A
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:
ProSecure Savvy A
Scheme Benefits Notes and Links:
In-hospital:
Out-of-hospital:
Trauma:

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OTHER BENEFITS:
ProSecure Savvy A
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:
ProSecure Savvy A
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:
ProSecure Savvy A
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