Sizwe Gold Ascend:
cancer, maternity and mental health (2025)

Contents:

This page has information on: Costs, Maternity, Oncology, Mental Health for Sizwe Gold Ascend

Terminology:

  • 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 Providers. Where stipulated, you must use 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.
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

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

Sizwe:Gold Ascend (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R4,468
  • R4,291
  • R1234
Savings:
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R7,589
  • Main+1= R11,239
  • Main+2= R13,152
  • Main+3= R15,041
  • Main+4= R16,953
  • Main+5= R18,854
  • Main+6+= R20,743
Children Rates:
  • Up to age 26
  • Only pay for 3 children
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Cancer/ Oncology benefits (2025):

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

Sizwe: Gold Ascend
Assume scheme pays all these costs, unless otherwise stated
Overall cancer coverage (in and out of hospital):
  • R240,786 per person, then 20% co-payment for non-PMBs
  • Note: Most cancers are PMBs, and treatment is paid in full by scheme. More info here
  • Most schemes require use of specific providers (DSPs) for oncology treatment.
Gap Cover:
Can cover the penalty in full
(Plans coming soon)

Maternity benefits (2025):

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

Sizwe: Gold Ascend
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:
  • 100% scheme rate
    • Usually covered for 2 nights for natural birth, and 3 nights for C-sections.
    • All newborns receive immediate full medical aid cover at birth, even if parents are on a waiting period.
Gap Cover:
Can cover most shortfalls
(Plans coming soon)
Consultations:
  • Antenatal: 10 consults
  • Vitamins: R283 per pregnancy
Scans:
  • 2 x 2D scans, paid by scheme
Note:

Mental Health benefits (2025):

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

Sizwe: Gold Ascend
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
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.
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R7,589
  • Main+1= R11,239
  • Main+2= R13,152
  • Main+3= R15,041
  • Main+4= R16,953
  • Main+5= R18,854
  • Main+6+= R20,743
Other Day-to-Day Funds:
FYI:
  • Mental Health PMB conditions are covered for in and out of hospital treatment, even on "hospital" plans. For a full list see here.
  • Example of PMB condition: Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse. Treatment includes hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts. Scheme will pay this in full, if you use a DSP.
In-hospital:
  • PMBs: 21 days admission
  • Alcoholism/Drug Addiction: 21 days admission
  • Otherwise, overall limit: R41,327 per person and R1,968 per day
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Out-of-hospital:
  • PMBs: 15 consults, in lieu of hospitalisation, paid by scheme
  • Otherwise, R5,747 per family
Other:
  • Traumatic event claims: 6 counselling sessions per person per year, for the year in which the trauma event occurred and the year after
    Important!
  • Unless specified, assume that all benefits 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.
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