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Medical Aid Year: 
Day to day Benefits: 

Doctors’ consultations and procedures paid at Specific Tariff4, Acute medication, Over-the-counter medication, Radiology & pathology, Optical, Dentistry dentists paid at 135% Profmed Tariff, Maternity benefits2 day-to-day benefits enhanced fees for m...

In Hospital Benefits
Hospital Rate of Payment: 
Hospitalisation1 ››doctors’ consultations and procedures paid at Specific Tariff4 ››maternity - post-delivery in general wards ››enhanced fees for midwives

Savvy options require use of the hospital Designated Service
Provider Network (DSPN). Voluntary use of a non-DSP will result in
a co-payment

Upfront Payments to hospitals: 

No co-payments for hospitalisation on the Premium options

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
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
Day-to-day benefits
Basic dentistry: 
dentists paid at 135% Profmed Tariff
Chronic Conditions
Chronic Conditions: 

40 chronic conditions plus relevant DTPs

Total Contributions
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