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Suremed Challenger: in-and-out of hospital benefits (2021)

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This page shows the In-hospital, Out-of-hospital and Medicine benefits for Suremed Challenger.

Pricing:

Challanger
Main member: Adult member: Child member:
Total Cost pm: R5,030 R3760 R995
(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, though. See below, and see benefits.
Children Rates:
  • (Pay for all children)
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 other benefits:
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 Suremed plans, with costs and brief summary

In-hospital Procedures:

Challanger
non-Network Specialists:
  • 150% specific scheme tariff
network Specialists:
  • 150% specific scheme tariff
non-Network GPs:
  • 150% specific scheme tariff
network GPs:
  • 150% specific scheme tariff
Hospital Choice:
  • Choose any hospital
Penalty for using other hospital:
  • n/a
Specialised Radiology:
  • R18,700 per family, in and out of hospital.
Supplementary Services: (Physio, etc)
  • Physiotherapy: R6,000 per family, unless PMB
Transplants:
  • R170,000 per family, unless PMB
Dialysis:
  • Unlimited
Day Hospitals: .
Co-payments:
  • n/a
Alternatives to hospitals:
  • Private nurse and step down facilities: R20,000 per family
  • Terminal Care: R20,000 per family, for end-of-life costs
Casualty:
  • Paid from GP benefit, up to R500
Other: .
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
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones here, but you must consult with your scheme to get the full list.
View other benefits:
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 Suremed plans, with costs and brief summary

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.



Out-of-hospital Procedures:

Challanger
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings /yr: No savings option on this plan
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:
  • R5,150 per person and R14,000 per family
  • Shared with specialist benefit
Childcare: .
Specialists consultations:
  • R5,150 per person and R14,000 per family
  • Shared with GP benefit
Pathology:
  • Unlimited
General radiology:
  • Unlimited
Specialised radiology:
  • R18,700 per family, in and out of hospital.
Supplementary Services: (Physio, etc)
  • R2,250 per person and R5,700 per family
  • Shared with paramedical, supplementary and mental health
General Appliances:
  • R9,300 per family, in and out of hospital
  • Oxygen: R6,000
  • Other sublimits apply
1.1. Hearing Aids:
  • R5,000 per family. One unit every 3 years
1.2. Wheelchairs:
  • See "General Appliances" limit
Note:
  • 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 other benefits:
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 Suremed plans, with costs and brief summary

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 cover:

Challanger
Summary of day-to-day benefits:
Main Member: Adult: Child:
Savings /yr: No savings option on this plan
Chronic: .
Acute (presrcibed) medication:
  • R6,600 per person and R20,000 per family
  • 20% co-payment once R3,700 per person is reached.
Over-the-counter:
  • R170 per script and R1,630 per family
  • Shared with acute medicine benefit
Birth Control: .
On Discharge:
  • R500 per event supply
Biological:
  • No benefit, unless PMB
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 other benefits:
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 Suremed plans, with costs and brief summary

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.

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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