Monthly Premiums
The rates below are for individuals, per member per month. If you are a member as part of a Group / Company, your rate may be different.
Principal
Age 0 – 59
R255 p/m
Age 60+
R350 p/m
Adult Dependent
Age 0 – 59
R160 p/m
Age 60+
R250 p/m
Child Dependent
Age 0 – 18
R140 p/m
Age 0 – 26 Students
R140 p/m
Benefits
| Description | Benefit Detail |
|---|---|
| In-Hospital Accident Benefit | R400 000 per member per event. Limited to R1 500 000 per policy per annum. Pre-authorisation required |
| ICU Benefit | Included in Hospital Benefits. |
| Post-Hospital Accident Rehabilitation | R10 000 per member per event for physiotherapy, occupational therapy and home care / wound care. Pre-authorisation required |
| Casualty Benefit — Accidents | R30 000 per policy per annum. Accumulates to overall Accident Cover limit. Pre-authorisation required |
| Casualty Benefit — Illness | R15 000 in the event of stabilisation of an Emergency Illness per policy. Pre-authorisation required |
| GP / Doctor Visits | 2 GP consultations at a contracted network doctor per member. Network GPs only |
| In-Room Procedures | Defined list of procedures a network GP can perform in-rooms at no additional charge. |
| Pharmacy Clinic Nurse Care | 3 visits per member per annum at all networked pharmacies with contracted clinics, providing clinic services for a defined list of procedures. |
| Prescribed Medication — Acute & OTC | R1 500 per member per annum. Maximum R190 per script combined benefit. Acute medication cost is averaged per category as defined by the approved generic medicine list. If you opt for more expensive medication, you will be liable for the additional costs. |
Additional Benefits
Hospital Footprint
Access to all private hospitals accepting health insurance products. Pre-authorisation is required for all hospital admissions on 086 000 2402.
Value Added Benefits
24-Hour Emergency Medical Services
24-hour cover for private ambulances and emergency medical evacuation in the event of emergencies. Pre-authorisation required.
Client Assistance Programme
- Personal Health Advisor: Clinically trained advisor available 24/7.
- Credit & Debit Assist: Debt management and financial planning services.
- Legal Assist: Telephonic legal advice from qualified attorneys.
- Trauma Counselling: Debriefing by qualified nurses with referral to higher-level counselling if needed.
Accidental Death Benefit
Lump sum payout in the event of an unintentional accidental death of a member: R15 000 main member, R10 000 adult dependant, R8 000 child dependant.
Nurse-Based Pharmacy Care
Care from qualified nurses at over 700 pharmacy wellness clinics — in store or by appointment. Nurses provide medical referrals where necessary. Available at all contracted Mediscor pharmacies, including Dis-Chem, Clicks and Medirite.
Pre-authorisation may be required after the 10th visit.
General Member Wellness
- Glucose and cholesterol screening, testing and monitoring
- Treatment of wounds
- Administration of injections, including annual flu injection
- Hb, Malaria and Urine Screening
- Syringing of ears
- Advice on managing your health status
Women's Health
- Pregnancy testing
- Breast screening
- Pap smear testing
- Other female health assessments and screenings
Chronic Condition Management
- Diabetes HbA1c and foot screening
- Blood pressure and lipogram testing, BMI monitoring
- Peak flow and nebulisation — control asthma with rescue medication directly into the lungs
- HIV screening, testing, counselling and psychological support post-testing