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

Network of Medshield hospitals

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 59 500 (25% co-payment for non PMB's and sub-limits may apply)

Chronic

26 PMB's plus additional 44 conditions

R14 000 per beneficiary to a maximum of R28 000 per family 

Out of Hospital Benefits

Saving / Day to Day / OHEB

SAVINGS:

Member: R14 268

Adult: R13 080

Child: R2 724

Pooled Day to Day Benefit

Not applicable

Threshhold / Safety Net

Member: R17 500

Adult: R16 100

Child: R3 300

Self-Payment Gap Before Threshold

May apply

Above Threshold Limits

Member: R4 800

Adult: R3 500

Child: R2 400

Maternity Care

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

Contributions

Contributions

Member: R5 943

Adult: R5 448

Per child: R1 137

 

 

 

 

 

 

 

 


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