Medshield - MediSaver
Medshield MediSaver is a cost-effective, network-based, comprehensive plan designed for young families and individuals. The plan offers unlimited in-hospital benefits at network facilities. Medicines are paid at 100% of the lower cost of the product, and consultations and treatment in-hospital are paid at 100% of the negotiated tariff. Co-payments apply to all non-PMB services and products. Maternity benefits out of hospital are paid from risk, and members have use of a savings account to settle day-to-day healthcare costs.
In Hospital Benefits
| Overall Annual Limit |
Unlimited at 100% (Medshield's Rate) |
|---|---|
| Provider |
Network of Medshield hospitals |
| GP's & Specialists |
Co-payments apply: GP's & Specialists: OAL Radiology & Pathology: Unlimited Oncology limit: R389 100 subject to ICON protocols Organ Transplants: R 309 100 Dialysis: R309 100 per family per year and subject to PreAuthorisation and the use of a DSP. If DSP is not used a 40% co-payment will be applicable. Internal Prosthesis: R51 500 per family per annum with a 25% 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 PMBs+1 at DSPs |
Out of Hospital Benefits
| Saving / Day to Day / OHEB |
SAVINGS Member: R8 148 Adult: R6 744 Child: R1 980 |
|---|---|
| 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 |
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 |
Member: R4 524 Adult: R3 747 Per child: R1 101
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