|Health Cover||Waiting Periods||Cover Limits||Single||Dep(2-3)||Dep(4+)|
|General Practitioner (Doctor)||30 Days||Up to R 295 per visit||R2 585||R4 300||R5 160|
|Scripted Medication||30 Days||Up to R220 per script. Paid through Mediscor
electronic claim system. No over
|R1 420||R1 870||R2 270|
|Pathology||30 Days||Up to R510 per event.||R2 720||R3 630||R4 650|
|Radiology||30 Days||Up to R510 per event.||R2 040||R3 630||R5 105|
|Dentistry||90 Days||Up to R680 per visit. Max of 4 visits a year.||R2 670||R3 400||R4 535|
|Specialist Cover||90 Days||
Up to R1 700 per visit. 3 visits per family per year.
Referral from GP required and subject to authorisation.
|Maternity Pre Birth||7 Months applicable to new policies.
Thereafter waiting period of 4 months from date of conception.
|Up to R455 per visit. 4 Visits per Pregnancy.
Annual limit of R 1815.
|Optometry||12 Months||Up to R1 130 - Limited to claim this every
24 months per dependant.
|Maximum overall limits for Health Cover of:||Single: R16 470||2 or 3: R22 910||4 plus: R27 490|
|Hospital Risk Cover||Waiting Periods||Cover Limits||Excess|
|Emergency Illness||90 Days||Up to R4500 for life threatening emergency illness
in casualty units.
Excess:4 months plus - R200
|Emergency Accident||Immediate||Up to R4500 for accident events in casualty units
that does not result in admission.
Excess:0-3 Months - 15 % | 4 months plus -R200
|Accident Cover||Immediate||Up to R250 000 per insured event. Up to R500 000 per family
Excess: R500 | Contact sport -15% of claim amount
(12 months waiting period)
|Illness In Hospital||90 days
Certain conditions are excluded for 12 months.
|Up to R57 000 per insured event p/p. Up to R114 000 per insured per year.
Excess:4-6 Months - 15% | 7 months onwards - 5%
|Dread Disease||6 Months||Up to R283 000 per defined disease per year.|
|Natural Birth and
|12 Months||Up to R57 000 per insured event p/p. Cover forms part
of illness and operations annual limits.
Excess: 10% of claim amount.
|Accident Disability||Immediate||Up to R147 000 for the duration fo the policy.
only principal insured is covered.
|Family Death Cover||Accidental Death:
|Principal Insured: R11 340 | Spouse/Partner:R11 340 | Children 14-21 yrs:R11 340
Children 6-13 yrs R5 670 | Children 1-5 yrs R2 835
Children unborn(28 weeks) ro Oyrs: R1 420
|Immediate||Trauma and assault counselling, Accidental HIV protection services.
Accidental HIV infection treatment.
|Repatriation||Immediate||Up to R11 300 per insured person. Repatriation of mortal remains to funeral home.|
|Immediate||24 hr Medical assistance with an emergency dedicated line.
In the event of a justifiable,life-threatening medical emergency,
the insured will be transported by ambulance to the nearest
appropriate medical facility.