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
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