Medshield - Premium Plus Medical Aid Plan

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

Any hospital in South Africa

GP's & Specialists

GP's & Specialists: Unlimited
Radiology & Pathology: Unlimited
Oncology limit: Unlimited. Sub-limits apply.
Organ Transplants: Unlimited
Dialysis: Network must be used or 40% co-payment
Internal Prosthesis: R 56 700 (Sub-limits may apply)

Chronic

26 PMB's and 54 additional conditions
R13 300 per beneficiary to a maximum of R26 600 per family

Out of Hospital Benefits

Saving / Day to Day / OHEB

SAVINGS:
Member: R12 888
Adult: R11 796
Child: R2 460

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Member: R16 700
Adult: R15 300
Child: R3 100

Self-Payment Gap Before Threshold

May apply

Above Threshold Limits

Member: R4 535
Adult: R3 400
Child: R2 270

Maternity Care

12 consultations, 2 x 2D scans, 1 amniocentesis per pregnancy
R500 for antenatal classes, 4 post natal consultations visits

Contributions

Contributions

Member: R 5 370
Adult: R4 917
Per child: R1026

 

 

 

 

 

 

 

 


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