Health Squared - Flex Medical Aid Plan

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: R308 5296 per family per annum at ICON Network.

Organ Transplants: R132 733 per family. PMBs

Dialysis: PMBs and subject to Network

Internal Prosthesis: Sub-limits apply, NON-PMB overall annual limit: R63 214 pfpa & 25% co-payment applies to certain procedures

Chronic

26 PMBs + additional

Out of Hospital Benefits

Saving / Day to Day / OHEB

Member: 6 visits

Member+1: 10 visits

Member+2: 13 visits

Specialists limits

Member: 2 visits

Member+: 3 visits Basic Optometry & Dentistry (subject to scheme rules)

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, R708 Over-the-counter products as per maternity programme, 2 scans & 1 3D scan

Contributions

Contributions

Member: R3 106

Adult: R2 790

Per Child: R966

 

 

 

 

 

 

 

 


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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