Benefits
Medical Expense Shortfall Cover
Increases the Medical Aid rate up to 500%. Subject to the OAL
Co-payment Cover
Subject to the OAL
Non-DSP Hospital Penalty Cover
R9 700 per admission. Limited to 1 claim per family per annum and subject to OAL
Sub-limit Cover
R31 000 per admission per insured. Limited to R70 000 per family per annum. Subject to the OAL
MRI And CT Scan Cover
Covers the cost of MRI and CT scans when there is no benefit available on your Medical Scheme. Limited to R5 000 per event and 1 claim per family per annum. Subject to OAL
Trauma Care Cover
Covers the cost of trauma counselling consultations with a registered healthcare provider after a member has been diagnosed with a critical illness, a victim of a violent crime or experienced the death of an immediate family member. Limited to R2 500 per consultation and R6 000 per family per annum. Subject to OAL
Co-payments for MRI, CT and PET Scans
Subject to the OAL
Co-payments for Scopes
R5 000 per admission. Limited to 2 claims per insured per annum. Subject to OAL
Sub-limit Cover for MRI, CT and PET Scans
R31 000 per event per insured. Limited to R70 000 per family per annum. Subject to the OAL
Casualty Benefit for Accidents
R10 000 per event per insured. Subject to OAL
Casualty Benefit for Illness
R3 500 per event. Limited to 2 claims per family per annum. Subject to OAL. Treatment is restricted to between the hours of 6pm – 6am Mondays to Fridays, Saturdays, Sundays and Public Holidays
Medical Scheme Contribution Waiver
Up to R6 600 per month for 6 months; in the event of death or permanent and total disability as a result of an accident, of the Medical Scheme Contribution Payer
Gap Premium Waiver
Pays the premium of your Policy for 12 months; in the event of death or permanent and total disability as a result of an accident, of the contribution payer
Personal Accident Benefit
R12 000 per insured on the Policy in the event of accidental death or permanent and total disability due to an accident
International Travel Cover
R5 million per insured (notification of travel required 48 hrs prior to departure)
Medical Expense Shortfall Cover
Increases the medical aid rate up to 500% for impacted wisdom teeth, reconstructive maxillofacial surgery due to an accident (which occurred while on the Policy) and oral cancer (which was diagnosed while on the Policy). Subject to the OAL
Basic Dental Medical Expense Shortfall Cover for Children
Increases the Medical Aid rate up to 500% for basic dentistry for children up to and including 12 years old. Limited to R2 500 per family per annum. Subject to the OAL
Co-payment Cover
Subject to the OAL
Sub-limit and Co-payment Cover for Dental Implants
Covers the cost of dental implants for reconstructive maxillofacial surgery due to an accident (which occurred while on the Policy) and oral cancer (which) was diagnosed while on the Policy). Limited R22 000 per admission and to R50 000 per family per annum. Subject to the OAL
Sub-limit Cover
R22 000 per admission and R50 000 per family for impacted wisdom teeth, orthognathic surgery, reconstructive maxillofacial surgery due to an accident (which occurred while on the Policy) and oral cancer (which was diagnosed while on the Policy). Subject to the OAL
Additional Information
Waiting Periods
Click the button to review the Waiting Periods and Exceptions.