Sizwe Plus:
cancer, maternity and mental health (2024)

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

We also have information on: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Other/Extra Benefits, Wellness and Preventative and Prosthetics

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Monthly Costs:

Plus 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R7,227	R6,893	R1,576
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= R13,280 Main+1= R27,980 Main+2= R30,540 Main+3= R33,630
Children Rates:
Income band:	This plan is only available to households with income in All income levelspm 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
.

Cancer/ Oncology benefits for :

Sizwe: Plus
Assume scheme pays all these costs, unless otherwise stated
Overall coverage (in and out of hospital):	Covered	Treatment required for PMB conditions is always paid by scheme, with no co-payment, if you follow the protocols. Most cancers are PMBs! More info here Most schemes require use of specific providers (DSPs) for oncology treatment.
♦️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
.

Maternity benefits for :

Sizwe: Plus
Assume scheme pays all these costs, unless otherwise stated
Hospital stay:		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.*
Consultations:	GP or midwife: 6 consults Specialist: 3 consults
Scans:	2 x 2D scans, paid by scheme 1x 3D scans, paid by scheme
Note:	If you are pregnant and don't have medical aid, your pregnancy will most likely be excluded for new cover, but your baby will be covered from birth. Read more about pregnancy cover if you don’t have medical aid.
♦️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
.

Mental Health benefits for :

Sizwe: Plus
Assume scheme pays all these costs, unless otherwise stated
In-hospital:	PMB: 21 days per person. Can be substituted with 15 consults in lieu of hospitalisation non-PMB: 14 days per family and R23,995 Alcoholism/Drug Rehab: R20,435 per family
Out-of-hospital:
Trauma:	Mental Health PMB conditions are covered for in and out of hospital treatment. 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
Note:	PMBs: Prescribed Minimum Benefits. Here is a list of PMB conditions: Mental Illness. 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
.

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

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All the medical aid jargon explained (2024)

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Sizwe Plus:
cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for :

Maternity benefits for :

Mental Health benefits for :

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

Also see these:

Sizwe Value Core:
cancer, maternity and mental health (2024)

Sizwe Value Core:
prosthetic benefits (2024)

Sizwe Value Core:
in-and-out of hospital benefits (2024)

Sizwe Value Core:
dentistry, optometry and wellness (2024)

Sizwe Silver Hospital:
prosthetic benefits (2024)

Sizwe Plus: cancer, maternity and mental health (2024)

Monthly Costs:

Cancer/ Oncology benefits for :

Maternity benefits for :

Mental Health benefits for :

Also see these:

Sizwe Plus:
cancer, maternity and mental health (2024)