- Foundation Medical Aid Plan

- Foundation

Foundation is an elementary primary healthcare plan for basic day-to-day cover and in-hospital benefits designed for low to medium income earners.

Overall Annual Limit	Unlimited subject to sub-limits 100% (Resolution Rate)
Provider	Network hospitals, R4 110 co-payment for use of non-network hospital
GP's & Specialists	Professional fees paid at 100% scheme tariff covered at DSP GPs and Specialists: Unlimited Radiology and Pathology: Unlimited Oncology: R80 904 per family per annum at ICON Network. Organ transplants: Limited to PMBs at State hospitals Dialysis: PMBs and subject to Network Internal prostheses: R37 685 Procedure based. Sub-limits apply / PMB cover. Mental health: PMBs at designated providers.
Chronic	25 PMBs + HIV, BPH & HRT

Saving / Day to Day / OHEB	Unlimited network GP visits, subject to authorisation after 4th visit Specialists limits: Subject to PMBs and referral by GP 2 non-network GP visits per year
Pooled Day to Day Benefit	No benefit / not applicable
Threshhold / Safety Net	Not applicable
Self-Payment Gap Before Threshold	Not applicable
Above Threshold Limits	Not applicable
Maternity Care	Subject to scheme protocols and PMBs. 2x2D scans, 9 visits to a GP or midwife

Contributions	Income Based: R0 - R4 840 Member: R961 Adult: R961 Child: R289 Income Based: R4 841 - R7 470 Member: R1 151 Adult: R1 151 Child: R397 Income Based: R7 471 - R10 210 Member: R1 492 Adult: R1 492 Child: R476 Income Based: R10 211+ Member: R2 255 Adult: R2 255 Child: R774

Income Based: R0 - R4 840
Member: R961
Adult: R961
Child: R289

Income Based: R4 841 - R7 470
Member: R1 151
Adult: R1 151
Child: R397

Income Based: R7 471 - R10 210
Member: R1 492
Adult: R1 492
Child: R476

Income Based: R10 211+
Member: R2 255
Adult: R2 255
Child: R774

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