No matter your age, if you are looking to be covered for life’s unexpected tumbles, our hospital plans give unlimited cover for planned and unplanned hospital stays.
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff. Limited to 7 days' medicine
Treatment in mental health clinic
100% Scheme tariff. Limited to 21 days' per beneficiary
Treatment of chemical and substance abuse
100% Scheme tariff. Limited to 21 days or R32 299 per beneficiary. Subject to network facilities.
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (PMBs only)
Major medical maxillo-facial surgery strictly related to certain conditions
No benefit.
(PMBs only at DSP day hospitals).
Dental and oral surgery (In- or out of hospital)
PMBs only at DSP day hospitals.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R78 846 per family.
Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Items utilised towards treating or supporting a bodily function
Sub-limits per beneficiary:
Functional R14 106
Pacemaker (dual chamber) R42 986
Vascular R231 470
Endovascular and catheter-based procedures - no benefit
Spinal R31 470
Artificial disc - no benefit
Drug-eluting stents - PMBs and DSP products only
Mesh R11 044
Gynaecology/Urology R9 025
Lens implants R6 887 a lens per eye
Prosthesis – External
No benefit. (PMBs only).
Exclusions Limits and co-payments applicable. Preferred provider network available.
Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
Hip replacement and other major joints R33 130
Knee replacement R40 848
Minor joints R12 706
Orthopaedic and medical appliances
100% Scheme tariff.
Pathology
100% Scheme tariff.
Basic radiology
100% Scheme tariff.
Specialised diagnostic imaging
100% Scheme tariff.
Oncology
100% Scheme tariff.
Mammary surgery
100% Scheme tariff.
Peritoneal dialysis and haemodialysis
100% Scheme tariff.
Confinements
100% Scheme tariff.
HIV and AIDS
100% Scheme tariff. Subject to preauthorisation and DSPs.
Refractive surgery and stabilise vision
PMBs only
Midwife-assisted births
100% Scheme tariff.
Supplementary services
100% Scheme tariff.
Alternatives to hospitalisation
100% Scheme tariff.
Palliative care and Home-based care in lieu of hospitalisation
100% Scheme tariff, limited to R24 000 per annum. Subject to available benefit, pre-authorisation and treatment plan.
Emergency evacuation
Services rendered by ER24
Day procedures at a day-hospital facility
Day procedures at a day-hospital facility funded at 100% Scheme tariff. Subject to pre-authorisation. DSPs apply for PMBs
International travel cover
Up to R10 million and a maximum of 90 days. Services rendered by Bryte Insurance and managed by ER24.
Co-payments
Co-payment of R3 800 on all endoscopic investigations and specialised diagnostic imaging if done in a private hospital.
Any other facility, no co-payment.
Co-payment for voluntary use of non-network hospital R11 874 for network option.
None.
100% of Scheme tariff subject to registration with Halocare.
2 primary care consultations at Dis-Chem Pharmacies limited to R359 per consultation.
None.
None.
None.
100% Scheme tariff.
None.
None.
None.
None.
100% Scheme tariff. Limited to R5 343 per family, (excluding PET scans).
Oncology programme at 100% of Scheme tariff. DSP applies.
100% Scheme tariff. Subject to pre-authorisation and DSPs.
100% Scheme tariff. Subject to pre-authorisation and DSPs.
None.
100% Scheme tariff.
Co-payment of 40% for non-formulary medicine.
No benefit.
PMBs only as per funding protocol.
No benefit.
No benefit.
100% of Scheme tariff subject to registration with Halocare.
2 primary care consultations.
100% Scheme tariff.
Limited to R3 527 per family.
Oncology programme at 100% of Scheme tariff.
Subject to preauthorisation. DSP applies.
100% Scheme tariff.
100% Scheme tariff.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits
Add Dependants
* You are able to reduce your premium to R1 511 by opting for the Beat1 Network option. Please ask a sales consultant for more information.
No matter your age, if you are looking to be covered for life's unexpected tumbles, our hospital plans give unlimited cover for planned and unplanned hospital stays.
Value benefits
Preventative care benefits
Contraceptive benefit
Wound care benefit
International travel cover
Additional information
In-hospital benefits are paid.
Some preventative care benefits are available.
Out-of-hospital benefits are paid from your own pocket.
Contributions
Member: R1 680
Adult dependant: R1 303
Child dependant: R706
Maximum child dependants: 4
Child dependants under the age of 21 years and registered students up to the age of 26 years, in accordance with the Rules, are regarded as child dependants.
Get personalised pricing
call for more information 
