Hospital Rate of Payment:
Specialists:
Savings first.Limited to M = R3 110, M1+ = R5 541(Subject to overall day-to-day limit)
Dialysis:
100% Scheme tariff.Subject to pre-authorisation.
Joint Replacements:
Joint replacement surgery (except forPMBs). PMBs subject to prosthesis limits:• Hip replacement and other major jointsR32 910• Knee replacement R43 721• Minor joints R13 434
Medical and Surgical Appliances:
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.