BENEFITS

Overall Annual Limit (OAL) – R150 000 per insured per annum
Benefits for in-hospital treatment
Medical Expense Shortfall Cover Increases the medical aid rate up to 500%. (e.g. Specialists, GPs, Anaesthetists, Radiology, Pathology, etc.). Subject to the Overall Annual Limit
Benefits for out-of-hospital treatment
Casualty Benefit (Accidents only) R6 000 per event per insured. Subject to the Overall Annual Limit
ADDED BENEFITS
International Travel Cover R5 000 000 per insured

Waiting Periods

  • A 3-month general waiting period applies to all benefits, with exception of benefits providing cover up to 500% should the commencement of the policy be in line with the commencement date of the medical scheme
  • A 9-month waiting period on pregnancy/childbirth
  • A 12-month waiting period on: hysterectomy (except where malignancy can be proven), hysteroscopies and endometrial ablations; joint replacements and spinal investigations, treatment or surgery (except in the event of an accident); tonsillectomy, myringotomy, grommets, adenoids, wisdom teeth and treatment or surgery for a hernia (except as a result of emergency surgery), treatment and/or surgery for cataracts, gastroscopies, colonoscopies and pre-diagnosed cancer
Please note that this is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership.
Disclaimer: This document is a summary for information purposes only and does not supersede the policy terms and conditions. In the event of any discrepancy, the policy, terms and conditions will prevail. Underwritten by Lombard Insurance Company Limited.