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MEDIMED ESSENTIAL R14,001 to R18,000 2019

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Medical Aid Year: 
2019
In Hospital Benefits
Hospital Rate of Payment: 
Unlimited 100% at preferred providers 80% at non-preferred providers
Specialists: 
Unlimited
Other healthcare professionals eg. Physio, Occupational, Dietician: 
R2,000 per beneficiary
Radiology and pathology: 
BASIC RADIOLOGY Unlimited SPECIALISED RADIOLOGY PRE-AUTHORISATION REQUIRED In and out of hospital Overall maximum of R10,000 per family
Dialysis: 
R50,000 per family
Organ Transplants: 
Combined limit with Dialysis and Oncology
Oncology / Cancer: 
Combined limit with Dialysis Authorised through ICON
Prosthesis: 

INTERNAL PROSTHESIS R20,000 per family

EXTERNAL PROSTHESIS R3,000 per family
PRE-AUTHORISATION REQUIRED

Medical and Surgical Appliances: 
Subject to Medical Savings Account
In Hospital Dentistry: 
R8,000 per family Limited to impacted wisdom teeth and children under 12 years
Rehabilitation, Hospice and Step-down facilities: 
R6,000 per beneficiary
Treatment for Mental Health: 
R4,000 per beneficiary
HIV / AIDS: 
Unlimited Subject to managed care protocols
Day-to-day benefits
GP consultations: 

Unlimited

Specialist consultations: 

Unlimited

Acute medicine: 

Unlimited - prescribed by or dispensed from
selected GP
Medication is paid in accordance with a
medication formulary. This is to assist your
selected GP in cost-effectively managing your
condition.

Over-the-counter (OTC) Medicine: 

R120 per prescription up to a
maximum of R450 per family

Optometry benefits: 
2 year benefit per beneficiary for either contact lenses or glasses Benefit through PPN 086 110 3529
Basic dentistry: 
R3,200 per beneficiary up to a maximum of R5,500 per family One set of plastic dentures every two years
Specialised Dentistry: 
R3,200 per beneficiary up to a maximum of R5,500 per family One set of plastic dentures every two years
Radiology and Pathology: 
Unlimited upon referral from your selected GP
Pregnancy benefits: 
Ÿ 2 Pre-natal visits Ÿ 2 2D scans Ÿ 1 Paediatrician visit Ÿ 1 maternity bag per pregnancy Ÿ Antenatal vitamins (R60 per month for 9 months payable from Acute Benefit)
Chronic Conditions
Chronic Conditions: 

CHRONIC DISEASE LIST CONDITIONS 100% up to the momTYB Chronic Drug Amount (CDA)
Medication strictly in accordance with a medication formulary

Total Contributions
Total Contribution Main Member: 
1840.00
Total Contribution Adult: 
1840.00
Total Contribution Child*: 
470.00
Essential R14,001 to R18,000
Risk Contributions
Risk Contribution Main Member: 
1840.00
Risk Contribution Adult: 
1840.00
Risk Contribution Child: 
470.00
Medical Aid Plan Name Term: 
Any