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 |
| 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
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