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% Scheme Tariff
GP's & Specialists: Unlimited
Radiology & Pathology: Unlimited
Oncology: Unlimited at ICON Network.
Organ Transplants: Limited to PMB
Dialysis: Subject to Network & PMB's
Internal Prosthesis: Sub-limits apply, NON-PMB overall annual limit: R134 172 pfpa

Chronic

26PMBs

Out of Hospital Benefits

Saving / Day to Day / OHEB

SAVINGS

Member: R9 240

Adult:R7 704

Child:R3 840

Pooled Day to Day Benefit

Benefit Booster

Member: R7 938

Member+1: R9 615

Member+2: R11 069

Member+3: R12 573

Member+4+:R14 200

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 500

Adult: R4 586

Per Child: R1 522

 

 

 

 

 

 

 

 


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

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