Provides cover for hospitalisation and certain out of hospital procedures, provided the treatment is clinically appropriate and has been pre-authorised.
Provides for day-to-day medical expenses such as doctors’ visits, prescribed medication, emergency rooms, etc.
Covers certain life-threatening conditions that need ongoing treatment. It includes cover for the 26 chronic conditions which form part of the prescribed minimum benefits (PMB).
IN HOSPITAL COVER
Covers the difference, up to 500%, between what a specialist ( e.g. specialists, surgeons, anesthetists, radiologists, pathologists) charges you and what your medical scheme will pay on their medical scheme rate.
SHORTFALLS
Covers shortfalls (in hospital or at an out-patient facility) on the following procedures: MRI, PET & CT Scans, Gastroscopy, Colonoscopy, Endoscopy, etc.
CO-PAYMENT COVER
Covers upfront co-payments that are required by some medical schemes for hospital admissions, scans and certain surgical procedures.
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