Sizwe Essential Copper A:
prosthetic benefits (2024)

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Monthly Costs:

Copper Core A 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R1,870	R1870	R649 Pay for all children
Savings (per year):	No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:	Child rates up to age 25. Grandchildren included. Pay for all children
Income band:	This plan is only available to households with income in R0-R8,500pm band. View other income bands
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:♦️ Inhospital \| 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
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Sizwe: Copper Core A
Overal Limit:	Overall:R20,435 per family External: R9,705, from above limit	Prosthetics required for PMB conditions are always paid paid in full* by scheme, with no co-payment, if you follow the protocols. More info here*
Sub-limits:	Instrumentation and disc prostheses including all components and fixation devices for back/spine: PMB only Joint replacements: PMB only Internal sphincters and stimulators: PMB only Neurostimulators/Internal nerve stimulator for Parkinson’s Disease: No benefit
Note:	PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs 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:♦️ Inhospital \| 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
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Always consult with your broker before making final decisions regarding your healthcare cover.

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