Ideal for healthy families with older children, Health Squared’s Optimum plan offers comprehensive benefits and a good degree of flexibility. It includes unlimited hospitalisation; a medical savings account; and a generous benefit booster for selected out-of-hospital expenses. It also features extensive chronic disease and preventative care benefits; excellent maternity benefits; and enhanced cover for investigative and surgical procedures performed in consulting rooms.
In Hospital Benefits
| Overall Annual Limit |
Unlimited subject to scheme protocols 100% (Health Squared) |
|---|---|
| Provider |
Any hospital; network where stated |
| GP's & Specialists |
Professional fees paid at 100% Scheme Tariff GP's & Specialists: Unlimited Radiology & Pathology: Unlimited Oncology: Unlimited at ICON Network. Specialised Medicine: R100 000 single & R200 000 family Organ Transplants: Limited to PMB Dialysis: Subject to Network & PMB's Internal Prosthesis: Sub-limits apply: R65 000 |
| Chronic |
29 PMBs |
Out of Hospital Benefits
| Saving / Day to Day / OHEB |
SAVINGS Member: R10 248 Adult: R8 544 Child: R3 504 |
|---|---|
| Pooled Day to Day Benefit |
Benefit Booster Member: R8 097 Member+1: R9 807 Member+2: R11 290 Member+3: R12 824 Member+4+: R11 484 |
| Threshhold / Safety Net |
Not applicable |
| Self-Payment Gap Before Threshold |
Not applicable |
| Above Threshold Limits |
Not applicable |
| Maternity Care |
Subject to registration, Consultations are subject to MSA, 4 X 2D scans |
Contributions
| Contributions |
Member: R6 100 Adult: R5 086 Per Child: R2 087
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