Medshield - Premium Plus
Medshield Premium Plus offers extensive out of hospital savings and covers members at a network of excellent private hospitals at 200% of the scheme's rate. A separate maternity benefit is provided and there's a chronic benefit for 26 PMB conditions and 54 additional conditions.
In Hospital Benefits
| Overall Annual Limit |
Unlimited at 200% (Medshield's Rate) |
|---|---|
| Provider |
Network of Medshield hospitals |
| GP's & Specialists |
GP's & Specialists: Unlimited Radiology & Pathology: Unlimited Oncology limit: Unlimited. Sub-limits apply. Organ Transplants: Unlimited Dialysis: Unlimited Network must be used or 40% co-payment Internal Prosthesis: R73 450 per family per annum with a 25% upfront copayment for non-PMB. Sub-limit for Hips and knees is R37 300 per beneficiary and subject to prosthesis and devices internal limit. |
| Chronic |
26 PMB's plus additional 54 conditions R1 7325 per beneficiary to a maximum of R34 650 per family |
Out of Hospital Benefits
| Saving / Day to Day / OHEB |
SAVINGS Member: R18 816 Adult: R17 244 Child: R3 600 |
|---|---|
| Pooled Day to Day Benefit |
Not applicable |
| Threshhold / Safety Net |
Member: R21 100 Adult: R19 450 Child: R3 960 |
| Self-Payment Gap Before Threshold |
May apply |
| Above Threshold Limits |
Member: R5 730 Adult: R4 135 Child: R2 865 |
| Maternity Care |
8 Consultations for Ante-Natal Classes and postnatal Midwife, 1 Amniocentesis, 12 Ante-Natal consultations, 2 x 2D Scans, Midwife paid up to 200% of Scheme Tariff / Rate. |
Contributions
| Contributions |
Member: R7 842 Adult: R7 185 Per child: R1 500
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