Premier is the umbrella sheltering your entire family. It offers a vast range of benefits to cater for unforeseen medical expense shortfalls and provides comprehensive cancer benefits.

Download brochure 2021

Benefits

Premier 2021 Premier 2022
Monthly premium: R460 per family for under 65yrs
Monthly premium: R665 per family for 65yrs+
Monthly premium: R487 per family for under 65yrs
Monthly premium: R699 per family for 65yrs+
In-hospital benefits Medical Expense Shortfall Cover Increases the Medical Aid rate up to 600%. Subject to OAL Increases the Medical Aid rate up to 600%. Subject to OAL
Co-payment Cover Subject to OAL Subject to OAL
Non-DSP Hospital Penalty Cover R12 000 per admission. Limited to 2 claims per family per annum and subject to OAL R13 000 per admission. Limited to 2 claims per family per annum and subject to OAL
Sub-limit Cover R35 000 per admission. Subject to OAL R35 000 per admission. Subject to OAL
Trauma Recovery Cover Provides cover for when the Medical Scheme has imposed a sub-limit on a step-down facility for physical rehabilitation as a result of an accident which occurred while on the Policy. Limited to R2 000 per admission per insured and R10 000 per family per annum. Subject to OAL Provides cover for when the Medical Scheme has imposed a sub-limit on a step-down facility for physical rehabilitation as a result of an accident which occurred while on the Policy. Limited to R2 500 per admission per insured and R10 000 per family per annum. Subject to OAL
In-hospital and out-of hospital Benefits Traditional Cancer Cover Pays for treatment in a private facility, including sub-limits, deductibles or co-payments related to cancer treatment. Subject to the OAL Pays for treatment in a private facility, including sub-limits, deductibles or co-payments related to cancer treatment. Subject to the OAL
Biological Cancer Drug Cover Provides cover for Biological Cancer Drugs when the Medical Scheme imposes a sub-limit. Subject to formulary and OAL Provides cover for Biological Cancer Drugs when the Medical Scheme imposes a sub-limit. Subject to formulary and OAL
Innovative Cancer Drug Cover Provides cover for Innovative Cancer Drugs. Limited to R10 000 per claim. Subject to OAL
Breast Cancer Prevention Cover Increases the Medical Aid rate up to 600% for a Prophylactic Mastectomy. Subject to OAL (Clinical Entry Criteria applies) Increases the Medical Aid rate up to 600% for a Prophylactic Mastectomy. Subject to OAL (Clinical Entry Criteria applies)
Breast Cancer Reconstruction Cover Increases the medical aid rate up to 600% for a breast reconstruction post mastectomy due to Cancer for the affected breast. Reconstruction of the unaffected breast for the purposes of symmetry, where there is no benefit on the Insured person’s Medical Scheme is limited to R20 000 per insured person, per lifetime Subject to OAL Increases the medical aid rate up to 600% for a breast reconstruction post mastectomy due to Cancer for the affected breast. Reconstruction of the unaffected breast for the purposes of symmetry, where there is no benefit on the Insured person’s Medical Scheme is limited to R20 000 per insured person, per lifetime Subject to OAL
MRI and CT scan Cover Provides cover for MRI and CT scans when there is no benefit available on your Medical Scheme. Limited to R5 500 per event and 2 claims per family per annum. Subject to OAL Provides cover for MRI and CT scans when there is no benefit available on your Medical Scheme. Limited to R6 000 per event and 2 claims 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 R1 000 per consultation and R8 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 R1 500 per consultation and R8 000 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 R3 000 per admission. Limited to 2 claims per insured per annum. Subject to OAL. R3 500 per admission. Limited to 2 claims per insured per annum. Subject to OAL.
Sub-limit Cover for MRI, CT and PET scans R35 000 per event per insured. Subject to the OAL. R35 000 per event per insured. Subject to the OAL
Casualty Benefit for Accidents R14 000 per event per insured. Subject to OAL R14 500 per event per insured. Subject to OAL
Casualty Benefit for Illness R2 500 per event. Limited to 3 claims per family per annum. Subject to OAL. Treatment is restricted to between the hours of 7pm – 6am Mondays to Fridays, Saturdays, Sundays and Public Holidays R3 000 per event. Limited to 3 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 Cancer Diagnosis Benefit Once off payment of for first diagnosis of Cancer based on stage at time of diagnosis
Stage 1: R5 000
Stage 2: R15 000
Stage 3: R20 000
Stage 4: R25 000
Once off payment of for first diagnosis of Cancer based on stage at time of diagnosis
Stage 1: R5 000
Stage 2: R15 000
Stage 3: R20 000
Stage 4: R25 000
Medical Scheme Contribution Waiver Up to R6 000 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 R6 000 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 Premier 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 Premier 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 R30 000 per insured on the policy in the event of accidental death and permanent and total disability R30 000 per insured on the policy in the event of accidental death and permanent and total disability
Critical Illness Benefit R10 000 per insured on the policy in the event of death due to a critical illness (excludes cancer) R10 000 per insured on the policy in the event of death due to a critical illness (excludes cancer)
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 Increases the medical aid rate up to 600% 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 Increases the medical aid rate up to 600% 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 600% for basic dentistry for children up to and including 12 years. Limited to R3 000 per family per annum. Subject to 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 R50 000 per family per annum. Subject to the OAL 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 R50 000 per family per annum. Subject to the OAL
Sub-limit Cover R30 000 per admission per insured 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 R30 000 per admission per insured 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

Overall Annual Limit (OAL) – R177 800 per insured per annum (2022 year)

Additional Information

Biological Cancer Drugs

Click the button below to view the lists of the Biological Cancer Drugs covered under Premier.

List of Drugs

Waiting Periods

Click the button to review the Waiting Periods and Exceptions

Waiting Periods
Exceptions
Turnberry Premier