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MEDIMED MEDISAVE STANDARD Under R9,000 2019

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Medical Aid Year: 
2019
In Hospital Benefits
Hospital Rate of Payment: 
Unlimited
Specialists: 
Unlimited
Other healthcare professionals eg. Physio, Occupational, Dietician: 
R3,000 per family
Radiology and pathology: 
Unlimited
MRI and CT scans: 
Unlimited
Dialysis: 
R100,000 per family
Organ Transplants: 
Combined limit with Dialysis
Oncology / Cancer: 
R200,000 per family Authorised through ICON
Neck and Back Operations: 
Spinal Fusion R22,000 per family
Prosthesis: 

INTERNAL PROSTHESIS
PRE-AUTHORISATION REQUIRED

R35,000 per family
Sub-limits:
Ÿ Spinal Fusion R22,000 per family
Ÿ Intra-occular lenses R2,500 per
lens
Ÿ Mesh R5,000 per family

EXTERNAL PROSTHESIS
PRE-AUTHORISATION REQUIRED

R4,000 per family

Medical and Surgical Appliances: 
Limited to R3000 per beneficiary and R6000 per family
In Hospital Dentistry: 
R10,000 per beneficiary Limited to impacted wisdom teeth and children under 12 years
Rehabilitation, Hospice and Step-down facilities: 
R10,000 per beneficiary
Treatment for Mental Health: 
R6,000 per beneficiary paid at 100% of the Medimed Scheme Tariff
HIV / AIDS: 
Unlimited Subject to managed care protocols
Ambulance Service: 
Unlimited Preferred provider Er24 24 hour contact number 084 124
Day-to-day benefits
GP consultations: 

Certain authorised procedures done in the provider's rooms will be paid
from the in-hospital benefit. Please contact the customer care team to
establish whether a planned procedure qualifies to be paid from this

Specialist consultations: 

Certain authorised procedures done in the provider's rooms will be paid
from the in-hospital benefit. Please contact the customer care team to
establish whether a planned procedure qualifies to be paid from this

Acute medicine: 

100% of MEDIMED Scheme Tariff

Over-the-counter (OTC) Medicine: 

100% of MEDIMED Scheme Tariff

Optometry benefits: 
R3,000 per beneficiary to a max of R6,000 per family every 2nd year.
Basic dentistry: 
100% of MEDIMED Scheme Tariff
Specialised Dentistry: 
100% of MEDIMED Scheme Tariff
MRI and CT Scans (Out of Hospital): 
100% of MEDIMED Scheme Tariff
Radiology and Pathology: 
100% of MEDIMED Scheme Tariff
Pregnancy benefits: 
2 Pre-natal visits · 2 2D scans · 1 Paediatrician visit · 1 maternity bag per pregnancy · Antenatal vitamins (R60 per month for 9 months payable from Acute Benefit)
Physiotherapy and Occupational Therapy day to day: 
100% of MEDIMED Scheme Tariff
Chronic Conditions
Chronic Conditions: 

CHRONIC DISEASE LIST
CONDITIONS

100% up to the momTYB Chronic
Drug Amount (CDA)

EXTENDED CHRONIC
CONDITIONS

100% of the momTYB Chronic Drug
Amount (CDA)
R2,000 per beneficiary
Overall maximum of R4,000 per
family

Preventative Care Benefits
Preventative Benefits: 

Cover for flu vaccinations, pap smear,
mammogram or breast scan, bone
density scan, prostate test,
cholesterol test, blood sugar test,
dental consultation and HIV test
R1,400 per beneficiary
Up to a maximum of R2,800 per
family

Total Contributions
Total Contribution Main Member: 
1830.00
Total Contribution Adult: 
1830.00
Total Contribution Child*: 
430.00
Medisave Standard Under R9,000
Risk Contributions
Risk Contribution Main Member: 
1830.00
Risk Contribution Adult: 
1830.00
Risk Contribution Child: 
430.00
Medical Aid Plan Name Term: 
Any