Medshield - MediCore Medical Aid Plan

Medshield - MediCore

Medshield MediCore (previously a plan offered by Oxygen, which merged with the Medshield Scheme) is a pure hospital plan, making it an ideal choice for young, healthy individuals. Cover is unlimited at network hospitals, and specified procedures are paid at 200% of the scheme rate. The plan includes generous maternity benefits. There's unlimited cover for cancer as a Prescribed Minimum Benefit (PMB), and a chronic medicine benefit applies for 26 chronic conditions. Beneficiaries have access to the Netcare ambulance service and wellness screenings.

In Hospital Benefits

Overall Annual Limit

Unlimited at 200% of Medshield's rate for certain procedures & 100% for others

Provider

Network of Medshield hospitals

GP's & Specialists

Co-payments apply

GPs & specialists: Unlimited

Radiology & Pathology: limits may apply

Oncology: limited to PMBs

Organ transplants & dialysis: limited to PMBs only

Internal Prosthesis: R32 1000 (25% co-pay for non-PMB's and sub-limits may apply)

Chronic

26 PMB's at DSPs

Out of Hospital Benefits

Saving / Day to Day / OHEB

Not applicable

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

6 consultations, 2 x 2D scans, 6 antenatal consultations, 4 post natal consultations

Contributions

Contributions

Member: R2 610

Adult: R2 208

Per Child: R603

 

 

 

 

 

 

 

 


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