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Millennium

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Medical Aid Year: 
2020
Day to day Benefits: 

Subject to MSA and ATB

In Hospital Benefits
Hospital Rate of Payment: 
100% of Scheme Rate
Hospitals: 

PRIVATE HOSPITALS:Unlimited.
Procedure co-payments may also
be applicable. Subject to Scheme
Protocols and option-specific
exclusion list. For procedural and
admission co-payments,PROVINCIAL HOSPITALS:Unlimited. Subject to Scheme
Protocols.

Upfront Payments to hospitals: 

Unlimited.
Procedure co-payments may also
be applicable. Subject to Scheme
Protocols and option-specific
exclusion list. For procedural and
admission co-payments

Casualty / Emergency Visits: 
Subject to MSA and ATB
Specialists: 
Non-Contracted Providers at 100% of Scheme Rate. Contracted Providers at 100% of Contracted Rate.
Radiology and pathology: 
Subject to MSA and ATB
ICU and High Care: 
100% of Contracted Rate.
Dialysis: 
Unlimited at Network Provider. Subject to Scheme Protocols. Preauth required.
Oncology / Cancer: 
Unlimited. Subject to ICON Network and standard protocols. Pre-auth required. 40% NON DSP CO payment.
Joint Replacements: 
R 12 000
Prosthesis: 

Limited to R 65 966 per family per
annum. Subject to Prosthesis Sub-
Limits, Scheme Protocols.

Medical and Surgical Appliances: 
R12 465 per family per annum Subject to PMB, Scheme Protocols and appliance sub-limits.
Take home Medicine: 
Maximum of 7 days’ supply
Rehabilitation, Hospice and Step-down facilities: 
Limited to Network Providers and subject to PMB and Scheme Protocols. Non PMB limited to R20 776 per family per annum.
HIV / AIDS: 
HIV Management Programme.
International Travel Benefit: 
Limited to emergency medical cover up to R2 million per beneficiary per incident
Day-to-day benefits
GP consultations: 

Subject to MSA and ATB
Non-Contracted Providers at
100% of Scheme Rate. Contracted
Providers at 100% of Contracted
Rate.
CDL PMB consultations covered
separately. Subject to Disease
Management Protocols and preauth.

Specialist consultations: 

Subject to MSA and ATB
Non-Contracted Providers at
100% of Scheme Rate. Contracted
Providers at 100% of Contracted
Rate (Up to 220% of Scheme Rate)
CDL PMB consultations covered
separately. Subject to Disease
Management Protocols and preauth

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. Consultations:2 Annual check-ups per beneficiary per annum. 2 Emergency consultations per beneficiary per annum. Covered at 100% Scheme Rate.X-rays: Intra-Oral...
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. Ortho...

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: 
Subject to MSA and ATB
Chronic Conditions
Chronic Conditions: 

M R2 935
M+ R5 882
Benefits subject to stated sub-limits
and thereafter to PMB CDLs.

Total Contributions
Millennium
Medical Aid Plan Name Term: 
Any