Hospital Rate of Payment:
Co-payment of R3 619 on all endoscopicinvestigations if done in a privatehospital. Any other facility,no co-payment.
Upfront Payments to hospitals:
Co-payment of R3 619 on all endoscopic
investigations if done in a private
hospital. Any other facility,
no co-payment.
Specialists:
Savings account. FP and specialistconsultations only at Bestmed DSPsat network tariffs.
Joint Replacements:
Joint replacement surgery (except forPMBs). PMBs subject to prosthesis limits:• Hip replacement and other major jointsR31 779• Knee replacement R39 322• Minor joints R12 101
Medical and Surgical Appliances:
In Hospital Dentistry:
Preventative care benefits.Optometry.Preventative dentistry.Maternity benefits.
Take home Medicine:
100% Scheme tariff.Limited to 7 days’ medicine.
Rehabilitation, Hospice and Step-down facilities:
Treatment for Mental Health:
100% Scheme tariff.Limited to 21 days per beneficiary.
HIV / AIDS:
100% Scheme tariff. Subject to preauthorisationand DSPs.
International Travel Benefit:
Up to R10 million and a maximum of90 days. Services rendered by BryteInsurance and managed by ER24.
