Benefits
Synergy 2025 | Synergy 2026 | ||
Monthly premium: R380 per family for under 65yrs Monthly premium: R532 per family for 65yrs+ |
Monthly premium: R494 per family for under 65yrs Monthly premium: R688 per family for 65yrs+ |
||
In-hospital benefits | Medical Expense Shortfall Cover | Increases the Medical Aid rate up to 500%. Subject to OAL | Increases the Medical Aid rate up to 500%. Subject to OAL |
Co-payment Cover | Subject to OAL | Subject to OAL | |
Non-DSP Hospital Penalty Cover | R10500 per admission. Limited to 1 claim per family per annum and subject to OAL | R11500 per admission. Limited to 1 claim per family per annum and subject to OAL | |
Sub-limit Cover | R33000 per admission per insured. Limited to R60000 per family per annum. Subject to the OAL |
R36000 per admission per insured. Limited to R75000 per family per annum. Subject to the OAL |
|
In-hospital and out-of hospital Benefits | 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 R5500 per event and 1 claim per family per annum. Subject to OAL | Covers the cost of MRI and CT scans when there is no benefit available on your Medical Scheme. Limited to R6000 per event and 1 claim per family per annum. Subject to OAL |
Trauma Counselling 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 R3000 per consultation and R6 000 per family per annum. Subject to OAL | 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 R3300 per consultation and R6 500 per family per annum. Subject to OAL | |
Out-of hospital benefits | Co-payments for MRI, CT and PET scans | Subject to OAL | Subject to OAL |
Co-payments for Scopes | R6000 per admission. Limited to 2 claims per insured per annum. Subject to OAL. | R6500 per admission. Limited to 2 claims per insured per annum. Subject to OAL. | |
Sub-limit Cover for MRI, CT and PET scans | R33000 per event per insured. Limited to R60000 per family per annum. Subject to the OAL | R36000 per event per insured. Limited to R72000 per family per annum. Subject to the OAL | |
Casualty Benefit for Accidents | R12000 per event per insured. Subject to OAL | R13000 per event per insured. Subject to OAL | |
Casualty Benefit for Illness | R4000 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 | R4400 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 | |
Added benefits | Medical Scheme Contribution Waiver | Up to R7500 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 | Up to R8200 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 for 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 | Pays the premium for 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 | R13500 per insured on the policy in the event of accidental death and permanent and total disability | R14500 per insured on the policy in the event of accidental death and permanent and total disability | |
International Travel Cover | R5 million per insured (notification of travel required 48 hrs prior to departure) | R5 million per insured (notification of travel required 48 hrs prior to departure) | |
In-Hospital Dental Cover | Medical Expense Shortfall Cover | Increase 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 | Increase 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 R2500 per family per annum. Subject to the OAL | Increases the Medical Aid rate up to 500% for basic dentistry for children up to and including 12 years old. Limited to R3300 per family per annum. Subject to the OAL | |
Co-payment Cover | Subject to OAL | Subject to 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 to R24000 per admission and R50000 per family per annum. Subject to the Overall Annual Limit | 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 to R26000 per admission and R50000 per family per annum. Subject to the Overall Annual Limit | |
Sub-limit Cover | R24000 per admission and R50000 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 | R26000 per admission and R50000 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.
