Suremed Explorer B:
cancer, maternity and mental health (2024)

This page: Costs | Maternity | Oncology | Mental Health Suremed Explorer B We also show benefits for: In-hospital | Out of hospital | Medicine | Dentistry | Optometry | Other/Extra Benefits | Wellness and Preventative | Prosthetics Find all the open medical aid plans here. Compare any two plans side by side, instantly. Monthly Costs: Explorer B 2024 prices Main member: Adult member: Child member: Total Cost pm: R1,775 R1570 R790 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: Pay for all children Income band: This plan is only available to households with income in R8,501-R13,000pm 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 Suremed plans, with costs and brief summary . . . Cancer/ Oncology benefits for : (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Suremed: Explorer B Assume scheme pays all these costs, unless otherwise stated Overall coverage (in and out of hospital): Unlimited Dentures: 1 set acrylic per family, every 24 months, limited to R3,700 and 20% co-payment 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 Suremed plans, with costs and brief summary . . . Maternity benefits for : (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Suremed: Explorer B Assume scheme pays all these costs, unless otherwise stated Hospital stay: 2 antenatal consults Paediatrician: 1 visit Ante-natal vitamins: R65 per month 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: 2 x 2D scans, paid by scheme Scans: PMBs only 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 Suremed plans, with costs and brief summary . . . Mental Health benefits for : \ (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Suremed: Explorer B Assume scheme pays all these costs, unless otherwise stated In-hospital: PMBs only Out-of-hospital: 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 Trauma: Private nurse and step down facilities: R12,500 per family Terminal care: R20,000 per family, for end-of-life costs 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 Suremed plans, with costs and brief summary .

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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