- Flex Medical Aid Plan

- Flex

Flexible medical aid that includes unlimited hospitalisation at network hospitals; limited benefits for GP and specialist visits plus an annual benefit for any additional out-of-hospital needs; an annual allowance for preventative care; excellent maternity cover; cover for 29 chronic conditions; and international travel cover.

In Hospital Benefits

Overall Annual Limit

Unlimited subject to scheme protocols 100% (Health Squared)

Provider

Network hospitals

GP's & Specialists

GP's & Specialists: Unlimited

Radiology & Pathology: Unlimited

Oncology: Unlimited PMB Non-PMB treatment: R302 776per family per annum at ICON Network.

Organ Transplants: Limited to PMB

Dialysis: PMBs and subject to Network

Internal Prosthesis: Unlimited PMB Non-PMB: R50 000 Procedure based. Sub-limits apply.

Chronic

29 PMBs + additional

Out of Hospital Benefits

Saving / Day to Day / OHEB

GP visit limits

Member: 6 visits

Member+1: 10 visits

Member+2+: 13 visits

SAVINGS:

Member: R3 408

Adult: R3 060

Child: R1 056

Pooled Day to Day Benefit

No Benefit

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

Subject to registration, Max of 3 Specialist visits, R755 Over-the-counter products as per maternity programme, 2 X 2D scans & 1 X 3D scan

AT NETWORK

Contributions

Contributions

Member: R3 556

Adult: R3 195

Per Child: R1 106

 

 

 

 

 

 

 

 


Finding it difficult to make sense of all this? Not to worry, you can:

Finding it difficult to make sense of all this? Not to worry, you can:

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