Medshield - MediPlus Medical Aid Plan

Medshield - MediPlus

The perfect product for middle income families with high day-to-day medical costs. This plan includes unlimited hospital cover at network hospitals, maternity consultations, dentistry and limited GP and optometry cover.

In Hospital Benefits

Overall Annual Limit

Unlimited at 100% (Medshield's Rate)

Provider

Mediplus Prime option:

Network of Medshield Prime hospitals Network (Extended)

 

Mediplus Compact option:

Network of Medshield Compact hospital Network (Limited)

GP's & Specialists

GP's & Specialists: Unlimited

Radiology & Pathology: Unlimited

Oncology limit: R296 500 Subject to ICON protocols

Organ Transplants: R172 940 dsp's

Dialysis: R216 180 per family per year and subject to pre-authorisation and the use of a DSP. If DSP is not used a 40% co-payment will be applicable.

Internal Prosthesis: R42 650 per family per annum with a 20% upfront copayment for non-PMB. Sub-limit for Hips & Knees is R37 300 per beneficiary and subject to prosthesis and devices internal limit

Chronic

26 PMB conditions + additional 14.

R7 850 per beneficiary to a maximum of R15 700 per family

Out of Hospital Benefits

Saving / Day to Day / OHEB

DAY-TO-DAY

Member: R9 850

Member+1: R13 755

Member+2: R15 385

Member+3: R17 130

Member+4: R19 000

Pooled Day to Day Benefit

Day-to-day limits
Some benefits are separate

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

8 Consultations for Ante-Natal Classes & Postnatal Midwife, 1 Amniocentesis, 12 Ante-Natal consultations, 2 x 2D Scans, Midwife paid up to 200% of Scheme Tariff / Rate.

Contributions

Contributions

Mediplus Prime option:

Member: R4 539

Adult: R3 240

Per Child: R1 017

 

Mediplus Compact option:

Member: R4 125

Adult: R2 943

Per Child: R927

 

 

 

 

 

 

 


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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