|Health Cover||Waiting Periods||Cover Limits||Single||Dep(2-3)||Dep(4+)|
|General Practitioner (Doctor)||30 Days||Up to R 285 per visit||R2 005||R3 435||R4 225|
|Scripted Medication||30 Days||Up to R185 per script. Paid through Mediscor
electronic claim system. No over
|R1 135||R1 700||R1 985|
|Pathology||30 Days||Up to R395 per event.||R1 590||R3 120||R3 970|
|Radiology||30 Days||Up to R395 per event.||R1 590||R3 120||R3 970|
|Dentistry||90 Days||Up to R565 per visit. Max of 3 visits a year.||R1 645||R3 005||R4 255|
|Specialist Cover||90 Days||Not covered on this plan.|
|Maternity Pre Birth||7 Months applicable to new policies.
Thereafter waiting period of 4 months from date of conception.
|Up to R455 per visit. 3 Visits per Pregnancy.
Annual limit of R 1360.
|Optometry||12 Months||Up to R1 130 - Limited to claim this every
24 months per dependant.
|Maximum overall limits for Health Cover of:||Single: R9 310||2 or 3: R14 470||4 plus: R17 920|
|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 R153 000 per insured event. Up to R306 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 R45 000 per insured event p/p. Up to R91 000 per insured per year.
Excess:4-6 Months - 15% | 7 months onwards - 5%
|Dread Disease||6 Months||Up to R210 000 per defined disease per year.|
|Natural Birth and
|12 Months||Up to R45 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.