Hospital Plan

Monthly Premiums

The rates below are for Individuals under the age of 60, per insured per month.
If you are a member as part of a Group/ Company, your rate may be different.

Principal

R260 PM

Adult Dependent

R220 PM

Child Dependent

R160 PM

The rates below are for Individuals over the age of 60, per insured per month.

Principal

R365 PM

Adult Dependent

R315 PM

Benefits
in-hospital Maternity Benefit
In-Hospital Accident Benefit
In-Hospital Illness Benefit
ICU Benefit
In-hospital specilised radiology (MRI Scans, ct scans etc)
Post-Hospital Accident Rehabilitation
casualty benefit for accidents
casualty benefit for illness
out-of-hospital maternity benefit
general practitioner visits (GP/doctor)
in-room procedures
out-of-network general practitioner consultations (gp)
pharmacy clinic nurse care
specialist benefit
acute medication
over-the-counter medication (OTC)
chronic medication. refer to our chronic disease list (CDL)
radiology
pathology
dentistry
optometry
DESCRIPTIONS
No Benefit.
R475 000 per member per event, inclusive of all costs. Maximum of R1 500 000 per policy per annum. Pre-authorisation required.
R70 000 per member per event, inclusive of all costs. Conditions which have a gradual progression are excluded. Pre-authorisation required. Limited to R500 000 per policy per annum.
Included in Hospital Benefits.
Included in Hospital Benefits.
R10 000 per member per event for physiotherapy and occupational therapy – home care/wound care. Pre-authorisation required.
R30 000 per policy per annum. Cover accumulates to the initial event and overall Accident Cover benefits. Pre-authorisation required.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.
No Benefit.

ADDITIONAL BENEFITS

Hospital Footprint

Access to all private hospitals accepting health insurance products. Pre-authorisation required

VALUE ADDED BENEFITS

24-hour Emergency Medical Services

Unlimited 24/7 Private Emergency Medical Services. Pre-authorisation required.

MediClub Client Assistance Programme

Personal Health Advisor – Clinically trained Personal Health Advisor available for telephonic consultations and advice 24/7.
Credit and Debt Assist – a full range of debt management and financial planning services.
Legal Assist – telephonic legal advice from qualified attorneys.
Trauma Counselling – Trauma debriefing by a qualified nurses who are, where necessary able to refer the insured to the next level of counselling.

Accidental Death
Benefit

Principal: R15 000
Adult Dependant: R10 000
Child Dependant: R8 000

PHARMACY CLINIC NURSE-BASED CARE

Nurse-Based Care

Care from qualified nurses at over 700 pharmacy Wellness Clinics. Visit them in store at your convenience or book an appointment for a consultation. Nurses will give you a medical referral if necessary. Available at all Network Pharmacies with contracted Clinics.

• General Member Wellness

• Women’s Health

General Members Wellness

  • Glucose and Cholesterol screening / testing /              monitoring.
  • Treatment of wounds.
  • Administration of injections, including annual flu injection.
  • Hb, Malaria and Urine Screening.
  • Syringing of ears.
  • Advice on how to best manage your status and health.

Women's Health

Caring advice women can rely on, offering all types of female health assessments such as pregnancy testing, breast screening, pap smear testing and other female screenings.

Assistance Managing Chronic Conditions

Nurses will help you manage your chronic condition and assist you with monitoring and
advice, including but not limited to:
• Diabetes Hba1C and foot screening.
• Blood pressure and lipogram testing, BMI monitoring.
• Peak flow and nebulization. Control asthma by getting rescue medication directly into the lungs.
• HIV screening, testing and counselling: Learn your HIV status and get psychological help after testing positive.
A counselling session is offered pre-testing as well.

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