Sizwe Access Saver 25:
in-and-out of hospital benefits (2025)

What's on this page:

  1. Monthly Costs (2025)
  2. In-hospital Procedures ():
  3. Out-of-hospital Procedures ():
  4. Medication Benefit ():
This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Sizwe Access Saver 25%.

Monthly Costs (2025)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Access Saver 25 2025 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R3,371
  • R2,911
  • R676
Savings:
  • R10080
  • R8736
  • R1992
Children Rates:
  • Up to age 25. Grandchildren included.
Income band:
Note:
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
  • All treatments and procedures are subject to authorisation and protocols
  • All benefits are listed as an indication only. Please verify with your broker and scheme
View all the other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity
Cancer | Mental Health | Dentistry | Optometry
Other/Extra Benefits | Wellness | Prosthetics

You can also:
Compare any two plans, side by side | View all the Sizwe plans, with costs and brief summary.

Find all other open medical aid plans here.
.

In-hospital Procedures ():

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Sizwe: Access Saver 25
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
non-Network Specialists:
  • PMB protocols
 Scheme rate is set by Sizwe
network Specialists:
  • PMB protocols
non-Network GPs:
  • PMB protocols
network GPs:
  • PMB protocols
Hospital Choice:
  • Network Hospital
Day Hospitals:
  • Some minor procedures are only paid if done in day hospitals or doctor's rooms, or
Penalty for using other hospital:
  • 10% penalty if you voluntarily choose another hospital
 You don't pay a penalty if admission was unavoidable due an emergency
Other Co-payments:
  • Colonoscopy: R1,583 co payment
  • Facet joint injections: R1,583 co payment
  • Gastroscopy: R3,165 co payment
  • Cystoscopy: R3,165 co payment
  • Hysteroscopy: R3,165 co payment
  • Flexible sigmoidoscopy: R3,165 co payment
  • Percutaneous radiofrequency ablations: R3,165 co payment
  • Percutaneous rhizotomies: R3,165 co payment
  • Elective caesarean delivery: R5,275 co payment
  • Joint replacements: R5,275 co payment
  • Umbilical hernia repair: R5,275 co payment
  • Hysterectomy: R5,275 co payment
  • Functional nasal surgery: R5,275 co payment
 * There might be other co-payments if you don't use scheme-chosen provider for some services.

* Treatment required for PMB level care is always paid by scheme, with no co-payment, if you follow the protocols.
That means that these co-payments might not apply in your case! More info here
Specialised Radiology:
  • 2 scans per person, in and out of hospital, with a 10% co-payment
 No limits or co-payments for PMB level care and/or for emergency
Scopes: No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • PMBs only
No limits or co-payments for PMB level care and/or for emergency
Transplants:
  • 100% scheme rate , at DSP and from protocols
Dialysis:
    • PMBs only
Exclusions: Exclusions:
  • Note: All schemes have extensive exclusions. We've tried to list the major ones here, but please consult your scheme or broker to get the full list.
 * Treatment required for PMB level of care is always paid by scheme, if you follow the protocols. It cannot be excluded. More info here.

Alternatives to hospitals:
  • Rehab facilities: 14 days per person
  • Private nursing: 14 days per person
  • Step-down facilities: 14 days per person
Casualty:
Other:
  • All benefits fromPMBs
  • Back and neck surgery: PMBs only
  • Laparoscopic hospitalisation: R5,000 co-payments may apply if done outside day hospital
Note:
  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
View all the other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity
Cancer | Mental Health | Dentistry | Optometry
Other/Extra Benefits | Wellness | Prosthetics

You can also:
Compare any two plans, side by side | View all the Sizwe plans, with costs and brief summary.

Find all other open medical aid plans here.
.

Out-of-hospital Procedures ():

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Sizwe: Access Saver 25
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings:
  • R10080
  • R8736
  • R1992
PMBs out of hospital:
  • All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine
  • The benefit is paid by the scheme, and not out of your savings account
  • If you have no day-to-day funds, you still have cover for PMBs
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
General info:
GP consultations:
  • From day-to-day benefit
  • After depleted, 4 additional consults
 Treatment required for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Childcare:
Specialists consultations:
  • From day-to-day benefit
  • After depleted, 1 additional consults with paediatrician or gynaecologist
 Treatment required for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Pathology:
  • R3,725 per person for radiology and pathology
  • Strong>R2,890 per person sub limit
  • From day-to-day benefit
General radiology:
  • R3,725 per person for radiology and pathology
  • Strong>R2,255 per person sub limit
  • From day-to-day benefit
Specialised radiology:
  • MRI, PET, CT Scan: 2 scans per person
 Scans required for PMB level care are paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Scopes: No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • Homeopathy, Naturopathy, Chiropractor and Podiatry fromPMBs and Protocols: From day-to-day benefit
  • Audiology, Speech therapy, Dieticians, Hearing Aid Acousticians, Occupational Therapy, Orthotics, Social Workers, and Speech Therapy: From day-to-day benefit, limited to R2,600 per family
  • Biokinetics & Physiotherapy: From day-to-day benefit
General Appliances:
1.1. Hearing Aids:
1.2. Wheelchairs:
Note:
  • PMBs: Prescribed Minimum Benefits. To read more about PMBs click here
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
View all the other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity
Cancer | Mental Health | Dentistry | Optometry
Other/Extra Benefits | Wellness | Prosthetics

You can also:
Compare any two plans, side by side | View all the Sizwe plans, with costs and brief summary.

Find all other open medical aid plans here.
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

Medication Benefit ():

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Sizwe: Access Saver 25
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings:
  • R10080
  • R8736
  • R1992
Chronic: You might be required to use specific pharmacies and be limited to specific medicines
Acute (presrcibed) medication:
Over-the-counter:
Birth Control:
On Discharge:
  • No benefit
Biological:
  • PMBs only
Treatment that is required (by law) for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here.)
Note:
  • Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
  • Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
  • PMBs: Prescribed Minimum Benfits. To read more about PMBs click here
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
View all the other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity
Cancer | Mental Health | Dentistry | Optometry
Other/Extra Benefits | Wellness | Prosthetics

You can also:
Compare any two plans, side by side | View all the Sizwe plans, with costs and brief summary.

Find all other open medical aid plans here.
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.


Psssttt….

Medical Aid Tips

Squeeze the most out of your medical aid!

Every Friday, we help 10,000+ South Africans with tips and exclusive healthcare deals.

Come join us, and find out things your medical aid does not want you to know!

    Built with Kit


    Coming Soon