Selfmed 80% vs MED Elite

For Unlimited hospitalisation & Chronic:
Selfmed 80% or MED Elite

Both these options offer members unlimited emergency hospitalisation at the Scheme’s Designated hospital providers.

Both also offer coverage for 65 Chronic conditions (Med Elite’s annual limit is a generous R32 340 whereas Selfmed 80% has an extended limit of R50 300 p.a.). The Selfmed 80% option offers generous day-to-day benefits which cover specialists at 80% of cost both in- and out- of hospital – so you have complete peace of mind that all practitioners’ costs only ever incur a maximum 20% co-payment.





Selfmed 80%

    • Unlimited hospital cover at any private hospital in South Africa, paid at 100% of Agreed Tariff
    • Specialist covered at 80% of Cost in- and out- of hospital
    • Joint Replacements covered (co-payments may apply/ individual sub-limits apply)
    • Generous Oncology benefits, cover for Biological drugs
    • 65 Chronic Conditions covered up to R 50,300.00 per family per year
    • Optometry
      • 80% of Scheme Tariff in respect of consultation and spectacles/ contact lenses limited to R10,900 per family per 24 month cycle
      • All optical benefits are subject to the Opticlear Network protocol
    • Ante-natal Classes paid at cost (R 1,790.00)
    • Student dependants qualify for minor contributions up to the age of 25

     

     

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MED Elite

    • Unlimited hospital cover at any of the Scheme’s Designated Hospitals, paid at 100% of Agreed Tariff
    • Joint Replacements covered (co-payments may apply/individual sublimits apply)
    • Generous Oncology Benefits, cover for Biological drugs
    • 65 Chronic Conditions covered up to R 32,340.00
    • Ante-natal Classes and Foetal Scans R 1,790.00
    • Benefits for Mammogram and Pap Smear
    • Certain clinical procedures (Gastroscopy and Colonoscopy) covered in Doctor’s room
    • MRI-,CT scans in and out of hospital
    • Benefits for Non-Elective Maxilla-Facial and Oral Surgery

 

 

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