Sizwe Titanium Executive:
in-and-out of hospital benefits (2025)

What's on this page:

This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Sizwe Titanium Executive.

Monthly Costs (2025)

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

Titanium Executive 2025 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R9,788
  • R8,661
  • R2,000
  • Only pay for 3 children
Savings:
  • R24432
  • R21624
  • R5004
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5335
  • R4422
  • R2023
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Unlimited
  • Unlimited
  • Unlimited
Children Rates:
  • Up to age 25. Grandchildren included.
  • Only pay for 3 children
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: Titanium Executive
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
non-Network Specialists:
  • 300% scheme tariff
 Scheme rate is set by Sizwe
network Specialists:
  • 300% scheme tariff
non-Network GPs:
  • 100% scheme tariff
network GPs:
  • 300% scheme tariff
Hospital Choice:
  • Choose any hospital
Day Hospitals:
Penalty for using other hospital:
  • n/a
 You don't pay a penalty if admission was unavoidable due an emergency
Other Co-payments:
  • 100% scheme rate , at DSP and from protocols
 * 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:
  • PMBs only
 No limits or co-payments for PMB level care and/or for emergency
Scopes:
  • MRI, CT Scan, Angiogram: R43,138 per family, in and out of hospital
 No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • 100% scheme rate
No limits or co-payments for PMB level care and/or for emergency
Transplants:
  • Some minor procedures are only paid if done in day hospitals or doctor's rooms, or
Dialysis:
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:
  • There is a day-to-day limit for physiotherapy, radiology, pathology and acute medication
  • M =R18,019
    M1 =R24,355
    M2 =R27,376
    M3 =R30,523
    M4 =R33,701
    M5 =R36,857
    M6 =R39,995
Casualty:
  • 2 x 2D scans, paid by scheme
  • 2 x haemoglobin tests
  • 1 x blood group test
  • 1 x VDRL test for syphillis
  • 1 x HIV Elisa test
Other:
  • M =12 consults
  • M1 =20 consults
  • M2 =25 consults
  • M3 =29 consults
  • M4 =30 consults
  • M5 =31 consults
  • M6 =32 consults
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: Titanium Executive
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings:
  • R24432
  • R21624
  • R5004
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5335
  • R4422
  • R2023
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Unlimited
  • Unlimited
  • Unlimited
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: 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: Treatment required for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Pathology:
  • MRI, PET, CT Scan:R43,138 per family, in and out of hospital.
General radiology:
  • R3,196 per person and R5,385 per family
  • Limited to: speech therapy, podiatry, occupational therapy, social worker, dietics, audiology, homeopathy, educational psychologits, biokineticist and registered counsellor
  • Chiropractors: R2,310 per person
Specialised radiology: Scans required for PMB level care are paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Scopes:
  • MRI, CT Scan, Angiogram: R43,138 per family, in and out of hospital
 No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • 100% scheme rate
General Appliances:
  • R19,987 per family. One unit every 3 years
1.1. Hearing Aids:
  • 100% scheme rate
1.2. Wheelchairs:
  • No benefit
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: Titanium Executive
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings:
  • R24432
  • R21624
  • R5004
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5335
  • R4422
  • R2023
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • Unlimited
  • Unlimited
  • Unlimited
Chronic:
  • Benefit shared with Acute Medicine benefit
 You might be required to use specific pharmacies and be limited to specific medicines
Acute (presrcibed) medication:
  • R2,905 per family
Over-the-counter:
Consult:1 test per person every 2 years
Frames:R1,116 per person
Single lensesR185 per lens
Bifocals:R420 per lens
MultifocalsR745 per lens
ContactsR1,884 with guidelines
Refractive Surgery:R19,134 per family
Birth Control:
  • PMBs: 10+ consults, paid by scheme
  • R18,366 per family for psychologists and psychiatrists for mental health disorders
On Discharge:
  • 21 days per person, including 6 in-hospital consults with psychiatrist
    • R48,300 per person per admission and R2,300 per day
  • Can be substituted with 10 consults in lieu of hospitalisation
  • Alcoholism/Drug Addiction: 3 days withdrawal treatment plus 21 days rehab at an appropriate facility
Biological:
  • 7 days supply
 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.


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