Health Squared - Optimum Medical Aid Plan

Health Squared - Optimum

Ideal for healthy families with older children, Health Squared’s Optimum plan offers comprehensive benefits and a good degree of flexibility. It includes unlimited hospitalisation; a medical savings account; and a generous benefit booster for selected out-of-hospital expenses. It also features extensive chronic disease and preventative care benefits; excellent maternity benefits; and enhanced cover for investigative and surgical procedures performed in consulting rooms.

In Hospital Benefits

Overall Annual Limit

Unlimited subject to scheme protocols 100% ( Health Squared)

Provider

Any hospital; network where stated

GP's & Specialists

Professional fees paid at 100% of scheme tariff
GPs and specialists: Unlimited
Radiology and pathology: Unlimited
Oncology: Unlimited at ICON network
Organ transplants: Limited to prescribed minimum benefits (PMBs)
Dialysis: PMBs and subject to network
Internal prosthesis: sub-limits apply: R131 670

Chronic

26PMBs

Out of Hospital Benefits

Saving / Day to Day / OHEB

SAVINGS

Member: R9 072

Adult: R7 572

Child: R3 108

Pooled Day to Day Benefit

Benefit Booster

Member: R7 790

Member+1: R9 436

Member+2: R10 863

Member+3: R12 339

Member+4+: R13 935

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

Subject to registration
Consultations are subject to MSA
4 scans

Contributions

Contributions

Member: R5 046

Adult: R4 207

Per Child: R1 727

 

 

 

 

 

 

 

 


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