BENEFITS | ACTIVATOR | ULTRA AFFORDABLE | ULTRA AFFORDABLE VALUE | STANDARD | SUPREME | EXTREME |
---|---|---|---|---|---|---|
Monthly Fees | Main: R1 917.00 Adult: R1 917.00 Child: R838.00 |
Income Below R10 000 Main: R1 306.00 Adult: R1 306.00 Child: R695.00 Income Above R10 000 Main: R1 923.00 Adult: R1 923.00 Child: R842.00 |
Income Below R10 000 Main: R1 203.00 Adult: R1 203.00 Child: R641.00 Income Above R10 000 Main: R1 771.00 Adult: R1 771.00 Child: R775.00 |
Main: R2 594.00 Adult: R2 463.00 Child: R863.00 |
Main: R3 124.00 Adult: R2 937.00 Child: R1 030.00 |
Main: R4 093.00 Adult: R3 847.00 Child: R1 371.00 |
GP Visits | Unlimited consultation at nominated GP | Unlimited but Managed | Unlimited but Managed at Nominated GP | Unlimited but Managed | Consultations subject to available family benefit | Consultations subject to available family benefit |
Specialist Visits | 5 visits per family per year | 5 visits per family per year | 5 visits per family per year | 10 visits per family per year | Consultations subject to available family benefit | Consultations subject to available family benefit |
Acute Medication | Unlimited as prescribed by Specialist | Unlimited as prescribed by Specialist | Unlimited as prescribed by Specialist | Unlimited as prescribed by Specialist | Acute medication as prescribed subject to available family benefit | Acute medication as prescribed subject to available family benefit |
Chronic Medication | CDL unlimited | CDL unlimited | CDL unlimited | CDL Unlimited + 6 additional | CDL Unlimited + 9 additional from Family Benefit | CDL Unlimited + 9 additional from Family Benefit |
Over The Counter Medication | Cover of R710 per beneficiary per year. Maximum of R145 per event | Cover of R710 per beneficiary per year. Maximum of R145 per event | Cover of 3 events per beneficiary per year, to a maximum of R135 per event | Cover of R850 per beneficiary per year. Maximum of R160 per event | Cover of R200 per beneficiary per year. Maximum of R2 400 per event | Cover of R255 per beneficiary per year. Maximum of R3 000 per event |
Terminal & Wound Care | R5 000 per family per year | R5 000 per family per year | R5 000 per family per year | R8 000 per family per year | R10 000 per family per year | R10 000 per family per year |
Optometry | Cover of R2 400 per beneficiary every 24 months | Cover of R2 400 per beneficiary every 24 months (Lenses and frames) | Cover of R2 400 per beneficiary every 24 months (Lenses and frames) | Cover of R3 000 per beneficiary every 24 months (Lenses and frames) | Cover of R3 600 per beneficiary every 24 months | Cover of R4 500 per beneficiary every 24 months |
Dental Care | Cover of R3 700 per beneficiary per year | Cover of R3 700 per beneficiary per year | Cover of R3 700 per beneficiary per year | Cover of R4 400 per beneficiary per year | Subject to available family benefit | Subject to available family benefit |
Specialised Care | - | - | - | - | - | Specialised dentistry R10 200 per family per year |
Appliances | R8 200 per family per year | R8 200 per family per year | R8 200 per family per year | R12 200 per family per year | R12 400 per family per year | R14 100 per family per year |
Scans | 2 per family per year RT, MRI and CAT |
1 per family per year RT, MRI and CAT |
1 per family per year RT, MRI and CAT |
2 per family per year RT, MRI and CAT |
2 per family per year RT, MRI and CAT |
3 per family per year RT, MRI and CAT |
Hospitalisation | Unlimited at all Hospitals | Unlimited at all Hospitals | Unlimited at all Hospitals | Unlimited at all Hospitals | Unlimited at all Hospitals | Unlimited at all Hospitals |
Internal Medical and Surgical Prostheses |
Vascular prosthesis R29 500 Functional items and recuperative prosthesis R10 100 Joint replacements R32 600 Major musculoskeletal prosthesis R20 100 |
Vascular prosthesis R29 500 Functional items and recuperative prosthesis R10 100 Joint replacements R32 600 Major musculoskeletal prosthesis R20 100 |
Vascular prosthesis R29 500 Functional items and recuperative prosthesis R10 100 Joint replacements R32 600 Major musculoskeletal prosthesis R20 100 |
Vascular prosthesis R37 000 Functional items and recuperative prosthesis R12 200 Joint replacements R41 600 Major musculoskeletal prosthesis R24 900 |
Vascular prosthesis R48 100 Functional items and recuperative prosthesis R17 100 Joint replacements R48 100 Major musculoskeletal prosthesis R28 800 |
Vascular prosthesis R62 200 Functional items and recuperative prosthesis R22 100 Joint replacements R62 200 Major musculoskeletal prosthesis R37 500 |
Plan Type | Hybrid | Entry | Entry | Comprehensive | Traditional, Fee for service | Traditional, Fee for service |