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HEALTH SQUARED MILLENNIUM SELECT 2019

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Medical Aid Year: 
2019
In Hospital Benefits
Hospital Rate of Payment: 
Unlimited, subject to DSP network hospitals.
Hospitals: 

Subject to co-payment

for use of non-DSP. Procedure co-
payments may also be applicable.

Upfront Payments to hospitals: 

Arthroscopy R 4 000

Circumcision, Vasectomy R 3 000

Colonoscopy R 3 000

Conservative back / spine treatment R 6 000

Cystoscopy R 2 000

Dental Admissions R 3 000

Endometrial ablation R 4 000

Excision nail bed R 2 000

Gastroscopy R 5 000

Hernia Repair R 5 000

Hysterectomy R 6 000

Hysteroscopy R 6 000

Joint replacements R 12 000

Laparoscopic procedures R 4 000

Medical admission Co-pay (Including Maternity and
Psychitric admissions) R 2 500

Myringotomy R 2 500

Nasal surgery (including endoscopy) R 6 000

Reflux surgery R 12 000

Rotator Cuff Surgery R 10 000

Sigmoidoscopy R 1 500

Skin lesions R 2 000

Specialised radiology (MRI, CT,PET Scan ) per scan R 2 000

Spinal surgery R 12 000

Tonsillectomy and Adenoidectomy R 0

Tympanoplasty R 0

Urinary Incontinence Repair R 4 000

Use of Non-DSP Hospital (Network Options) 30% (Minimum R 7 000)

Varicose veins R 4 000

Casualty / Emergency Visits: 
Subject to MSA and ATB
Specialists: 
Non-Contracted Providers at 100% of Scheme Rate. Contracted Providers at 100% of Contracted Rate.
Other healthcare professionals eg. Physio, Occupational, Dietician: 
Subject to MSA and ATB
Radiology and pathology: 
R16 619 per family per annum. Subject to Scheme Protocols and PMB. Pre-auth required. Co-payment of R2 000 per incident. (In-and-out of hospital). 100% of Scheme Rate.
MRI and CT scans: 
R16 619 per family per annum. Subject to Scheme Protocols and PMB. Pre-auth required. Co-payment of R2 000 per incident. (In-and-out of hospital). 100% of Scheme Rate.
Dialysis: 
Unlimited at Network Provider. Subject to Scheme Protocols. Pre- auth required.
Organ Transplants: 
Unlimited, subject to PMB and Scheme Protocols.
Oncology / Cancer: 
Unlimited. Subject to ICON Network and standard protocols. Pre-auth required. 40% NON DSP CO payment
Neck and Back Operations: 
Limited to R65 966 per family per annum. Subject to Prosthesis Sub- Limits, Scheme Protocols.
Joint Replacements: 
Limited to R65 966 per family per annum. Subject to Prosthesis Sub- Limits, Scheme Protocols.
Prosthesis: 

Unlimited per family per annum. Subject to Prosthesis Sub-Limits, Scheme Protocols.

Overall Option Limit R65 966 per Event

Knee R50 082,

Hip R 45 440

Shoulder, Elbow, Ankle R58 068

External Fixator R 65 966

Medical and Surgical Appliances: 
R12 465 per family per annum Subject to PMB, Scheme Protocols and appliance sub-limits.
Maternity Confinements: 
Length of stay: 3 days & 2 nights.
In Hospital Dentistry: 
Subject to Scheme Protocols, MSA, ATB and sub-limits of: M R6 534 M+1 R9 014 M+2+ R10 715
Take home Medicine: 
Maximum of 7 days’ supply
Rehabilitation, Hospice and Step-down facilities: 
18 days per family per annum.
HIV / AIDS: 
HIV Management Programme
Ambulance Service: 
NETCARE
International Travel Benefit: 
Limited to emergency medical cover up to R2 million per beneficiary per incident
Day-to-day benefits
GP consultations: 

Non-Contracted Providers at
100% of Scheme Rate. Contracted
Providers at 100% of Contracted
Rate.

Specialist consultations: 

Non-Contracted Providers at
100% of Scheme Rate. Contracted
Providers at 100% of Contracted
Rate.

Acute medicine: 

Subject to MSA

Optometry benefits: 
Subject to MSA, ATB and sub-limit of R2 935 per beneficiary.
Basic dentistry: 
Subject to Scheme Protocols, MSA, ATB and sub-limits of: M R6 534 M+1 R9 014 M+2+ R10 715
Specialised Dentistry: 
Subject to Scheme Protocols, MSA, ATB and sub-limits of: M R6 534 M+1 R9 014 M+2+ R10 715
Orthodontics: 

Subject to MSA
1 per lifetime, for beneficiaries
under the age of 18 years.
Benefits on pre-authorisation
will be applied to cases assessed
as treatment mandatory, as per
orthodontic indices. Limited to
individuals younger than 18 years
of age. Orthognathic surgery is not
covered.

MRI and CT Scans (Out of Hospital): 
R16 619 per family per annum. Subject to Scheme Protocols and PMB. Pre-auth required. Co-payment of R2 000 per incident. (In-and-out of hospital). 100% of Scheme Rate.
Radiology and Pathology: 
R16 619 per family per annum. Subject to Scheme Protocols and PMB. Pre-auth required. Co-payment of R2 000 per incident. (In-and-out of hospital). 100% of Scheme Rate.
Pregnancy benefits: 
100% of Contracted Rate. Including: Surgical operations & procedures Theatre fees Labour and recovery wards Ward accommodation Intensive care and high care units X-rays and pathology Ultrasound scans (other than for pregnancy) Blood transfusions
Chronic Conditions
Chronic Conditions: 

CDL CONDITIONS

ADDISON'S DISEASE, ASTHMA, BIPOLAR MOOD DISORDER, BRONCHIECTASIS, CARDIAC DYSRHYTHMIAS, CARDIAC FAILURE, CARDIOMYOPATHY, COPD, CROHN'S DISEASE, CHRONIC RENAL FAILURE, CORONARY ARTERY DISEASE, DIABETES INSIPIDUS, DIABETES MELLITUS TYPE 1, DIABETES MELLITUS TYPE 2, EPILEPSY, GLAUCOMA, HAEMOPHILIA, HIV, HYPERLIPIDAEMIA, HYPERTENSION, HYPOTHYROIDISM, MULTIPLE SCLEROSIS, PARKINSON'S DISEASE, RHEUMATOID ARTHRITIS, SCHIZOPHRENIA, SLE, ULCERATIVE COLITIS

Additional Chronic Conditions

ADHD, ALZHEIMER'S DISEASE, ANKYLOSING SPONDYLITIS, CYSTIC FIBROSIS, ENDOMETRIOSIS, GORD/GERD, GOUT, OBSESSIVE COMPULSIVE DISORDER, OSTEOPOROSIS, OSTEOARTHRITIS, PAGET’S DISEASE, PSORIASIS, WILSON’S DISEASE, ALLERGIC RHINITIS, ANGINA PECTORIS, CEREBROVASCULAR ACCIDENT (STROKE), CUSHING’S SYNDROME, DELUSIONAL DISORDER, ECZEMA, HYPERTHYRODISM, IDIOPATHIC THROMBOCYTOPENIC PURPURA, INTERSTITIAL FIBROSIS OF THE LUNG, MAJOR DEPRESSION, MENIERE’S SYNDROME, MOTOR NEURON DISEASE, MYASTENIA GRAVIS, PERIPHERAL VASCULAR DISEASE, PITUITARY ADENOMA, SCLERODERMA, URINARY INCONTINENCE

Preventative Care Benefits
Preventative Benefits: 

R2 762 per family per annum, Scheme Rate applies.

Screening Benefit:

Blood Pressure, Blood Sugar, Cholesterol, Body Mass Index R130 per beneficiary over the age of 18 years. Only at pharmacy.

HIV Test 1 Test per beneficiary per annum.

Mammogram (screening) 1 Examination per female beneficiary per annum over the age of 40 years

Pap smears 1 Test per beneficiary per annum.

PSA Testing 1 Test per beneficiary per annum over the age of 45 years.

Vaccinations:

Flu 1 dose Flu vaccination per beneficiary per annum.

Childhood immunisations Childhood immunisations as recommended by the Department of Health up to 18 months. Subject

to limit of R2 077

HPV Vaccine (Cervical cancer prevention) 1 course (3 doses per registeredschedule) per female beneficiaryper life between 9 and 25 years of age.

Oral Contraception R1 668 per female beneficiary per annum - R139 per month.

Clinic Nurse Consultation Subject to Preferred Provider Only :

Additional 15 min Consult + Flu vacine , Mother Ante-Natal visit, Mother and Well Baby Consult (incl admin of Immunisation)  Subject to PDC referral

Total Contributions
Total Contribution Main Member: 
4908.00
Total Contribution Adult: 
4207.00
Total Contribution Child*: 
1142.00
MILLENNIUM SELECT
Annual Medical Savings Account
Annual Medical Savings Main Member: 
12312.00
Annual Medical Savings Adult: 
10536.00
Annual Medical Savings Child*: 
2868.00
Annual Threshold Amounts
Above Threshold Benefit Limits
Above Threshold Benefit Main Member: 
6141.00
Above Threshold Benefit Adult: 
5237.00
Above Threshold Benefit Child*: 
858.00
Risk Contributions
Risk Contribution Main Member: 
4908.00
Risk Contribution Adult: 
4207.00
Risk Contribution Child: 
1142.00
Medical Aid Plan Name Term: 
Any