SelfNET 2017

SelfNET – Networked

CareCross

Download Detailed Benefits:

Detailed Benefits 2017

A great medical aid option specifically designed in conjunction with our Designated Service Provider Network to cover everyday and accident events. Get the peace of mind that you and your family are covered.

  • Hospital cover – Subject to a DSP network, limited to PMB conditions.
  • 25 PMB chronic conditions
  • General Practitioners Consultations – Unlimited, 100% of Network Rate via the Network GP for all medically necessary consultations per beneficiary. Cover includes basic primary care services. Minor trauma treatment subject to the listed tariffs.
  • Specialist Practitioners Consultations – 100% of Network Rate via the Network provider, subject to a combined limit of R 1,070.00 per Beneficiary per year for cost of consultation, medication, procedures and radiology and pathology related to the authorised out of hospital specialised visit, limited to a maximum of R 2,140.00 per family per year.
  • Spectacles and Contact Lenses – One pair of clear standard mono-focal, bi-focal or multi-focal lenses plus standard frame from a selection OR one set of approved contact lenses to the value of R 460.00 per Beneficiary per 24 months at the Network Optometrist. Frames other than the pre-selection of frames limited to R 170.00.
  • Basic dentistry – 100% of the Network Rate, subject to the Network protocols and the use of the Network Dentist.
  • Basic Radiology – 100% of Network Rate, subject to the Network protocols, formulary and referral by a Network GP.
  • Basic Pathology – 100% of Network Rate, subject to the Network protocols, formulary and referral by a Network GP.
  • Unlimited MRI and CT scans in- and out- of hospital – R  100% of the Network Rate for MRI-, CT scans, performed in or out of hospital, subject to PMB regulation, obtaining a PAR, motivation and approval
  • Maternity – Subject to pre-authorisation and network provider referral process.