Schemes A, B and C are tiered to offer three levels of medical aid cover. Scheme A is the entry-level option while Scheme C is the executive health plan option.
If you are looking for a basic outpatient, affordable health option, then Scheme A Standard is for you.
DESCRIPTION | SCHEME A STANDARD | SCHEME A | SCHEME B | SCHEME C |
---|---|---|---|---|
RECOMMENDED FOR: | LOW INCOME relatively healthy employees with a limited budget. | Low Income relatively healthy employees. | Individual and Corporate clients | Executives and those who travel frequently. |
CONTRIBUTIONS & BENEFITS: | ‘day to day’ affordable health care only | Affordable and Comprehensive | Affordable, Competitive and Comprehensive | International Medical Travel Extension through a strategic partner CHARTIS. |
COVER: | Comprehensive Care to keep member healthy. | Comprehensive | Comprehensive | Comprehensive & Executive |
OVERALL ANNUAL LIMITS: |
SINGLE: FAMILY: |
SINGLE: P274,145.00 FAMILY: P290,772.00 |
SINGLE: P866,532.00 FAMILY: P1009,686.00 |
SINGLE: P1,351,121.00 FAMILY: P1,785,000.00 |
PENSIONER MEMBERSHIP: | 30-50% Discounted subscriptions at pensioner membership. | 30-50% Discounted subscriptions at pensioner membership. | 30-50% discounted subscriptions at pensioner membership. | 30-50% Discounted subscriptions defaulted to Scheme B benefits. |
EMERGENCY MEDICAL SERVICES (Air & Ground Ambulance Cover): | FULL COVER : South Africa, Zimbabwe, Namibia, Lesotho & Swaziland. | FULL COVER : South Africa, Zimbabwe, Namibia, Lesotho & Swaziland. | FULL COVER: South Africa, Zimbabwe, Namibia, Lesotho & Swaziland. | FULL REGIONAL AND INTERNATIONAL COVER THROUGH CHARTIS an International Insurance. |
SCHEME A STANDARD | SCHEME A | SCHEME B | SCHEME C | |
---|---|---|---|---|
10% co-payment | ||||
VAT | ||||
Outpatient | ||||
Hospital Cover | ||||
Managed Care | ||||
Chronic medication | ||||
Safe Male circumcision | ||||
Screening & Prevention | ||||
Waiver of Premiums | ||||
MRI Cover | ||||
Funeral Cover | ||||
BOMbaby Programme | ||||
Alternative treatment | ||||
P1 million travel insurance | ||||
Annual Executive Med Exam | ||||
Delivery of chronic conditions |
SCHEME A | SCHEME B | SCHEME C | ||||
---|---|---|---|---|---|---|
BENEFIT CATEGORY | SINGLE | FAMILY | SINGLE | FAMILY | SINGLE | FAMILY |
Overall Scheme Benefit | P274,145 | P290,772 | P866,532 | P1,009,686 | P1,351,121 | P1,785,000 |
In-Patient Dread Disease Cover | In-Patient Dread Disease Cover | 240,000 | P813,225 | P931,350 | P1,249,500 | P1,,485,750 |
Hospitalization | P85,000 | P100,000 | P374,500 | P487,000 | P724,500 | P960,750 |
Maternity Cover | P85,000 | P100,000 | P374,500 | P487,000 | P724,500 | P960,750 |
Out-patient Cover (Unlimited Consult; Invest; Drugs) | P16,790 | P16,790 | P30,255 | P43,545 | P43,798 | P60,638 |
Chronic Medication (excl. HIV Benefit) | P10,500 | P12,600 | P37,800 | P44,100 | P50,400 | P67,200 |
ARV DRUGS & Monitoring per person @ P1,000 per month | 12,600 | P12,600 | P12,600 | P12,600 | P12,600 | P12,600 |
Dental Cover | P3,842 | P4,672 | P4,672 | P10,163 | P8,256 | P14,175 |
Optical/Ophthalmic(Inclusive of appliance limit) | AS PER BENEFIT SCHEDULE | AS PER BENEFIT SCHEDULE | AS PER BENEFIT SCHEDULE | AS PER BENEFIT SCHEDULE | AS PER BENEFIT SCHEDULE | AS PER BENEFIT SCHEDULE |
Appliances | P5,250 | P6,195 | P9,450 | P11,340 | P11,340 | P13,650 |
Allied health services(rehab & alternative | P2,909 | P4,541 | P7,881 | P11,294 | P10.924 | P17,174 |
Severe Illness Benefit (PM & Spouse | P20,000 | P20,000 | P20,000 | |||
Child Dependant | P4,000 | P4,000 | P4,000 | |||
Funeral (PM ,Spouse & child dep.(14-21) | P10,000 | P10,000 | P10,000 | |||
Child(6-13years) | P5,000 | P5,000 | P5,000 | |||
Child (1-5 years) | P2,500 | P2,500 | P2,500 | |||
Under 1 year | P1,500 | P1,500 | P1,500 |
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find out about this scheme | |
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Immediate Family Subscription | |
Parents Subscription |
TOTAL SUBSCRIPTION |