Hospital Rate of Payment:
Hospitalisation1
››doctors’ consultations and procedures paid at Specific Tariff4
››maternity - post-delivery in general wards
››enhanced fees for midwives
Upfront Payments to hospitals:
No co-payments for hospitalisation on the Premium options
Dialysis:
Unlimited peritoneal dialysis and haemodialysis
Oncology / Cancer:
Oncology - PET Scans: Bloch & Partners at Morningside Clinic
(applies to greater Johannesburg region only) Oncology - Radiation Therapy: Netcare (participating facilities
In Hospital Dentistry:
dentists paid at 135% Profmed Tariff
Rehabilitation, Hospice and Step-down facilities:
Alcohol and Drug Rehabilitation: South African National Council
on Alcoholism and Drug Dependence (SANCA), Physical Rehabilitation: Life Healthcare
HIV / AIDS:
3 - 6 months’ HIV exposure management, Subject to the use of the DSPN
International Travel Benefit:
R6 million per beneficiary per journey
››
R1 500 excess on out-of-hospital expenses
