(Homeopaths, Dieticians, Clinical psychologists, Speech therapists, Physiotherapy, Chiropractors & Occupational therapists)
Comprehensive
(High Cover)
Subject to Savings first, then limit of M=R2,956 | M1+R6,212. Subject to overall day-to-day limit
Subject to Savings and ATB
Subject to available Savings and Threshold.
DEB limits: M-R23,500 | M+1-R31,950 | M+2-R38,900 | M+3-R45,150 before and after threshold
Subject to Savings. Limit of R19,400 pfpa once Threshold is reached
R4,300 per person (pooled per family)
Subject to Savings, if available. (Unlimited once Threshold is reached)
Limit of R3,183 per beneficiary, R5,545 per family
Subject to day-to-day limit and PMB
Comprehensive
(High Cover)
Subject to Savings first, then limit of M=R3,500 | M1+R7,000. Subject to overall day-to-day limit
Subject to Savings
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Subject to Savings, if available. (Unlimited once Threshold is reached)
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Comprehensive
(Medium to High Cover)
Subject to Savings first, then limit of M=R4,852 | M1+R10,071. Subject to overall day-to-day limit
Subject to Savings and ATB
Subject to available Savings and Threshold.
DEB limits: M-R14,050 | M+1-R19,850 | M+2-R25,700 | M+3-R30,350 before and after threshold
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Subjec to Savings and Day-to-Day Benefits, after Savings is depleted
Subject to Savings, if available
Limit of R2,978 per beneficiary, R4,929 per family
Subject to day-to-day limit and PMB
Comprehensive
(Medium to High Cover)
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Subject to Day-to-Day Benefits. Sub-limits:
Limits: M=R3,200 | M+1=R4,790 |
M+2=R5,330 | M+3+=R6,390
Subject to available Savings and Threshold.
DEB limits: M-R14,050 | M+1-R19,850 | M+2-R25,700 | M+3-R30,350 before and after threshold
Subject to Savings or self-funded
Subjec to Savings and Day-to-Day Benefits, after Savings is depleted
Subject to Savings, if available
Limit of R2,978 per beneficiary, R4,929 per family
Subject to day-to-day limit and PMB
Comprehensive
(Medium to High Cover)
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Subject to Day-to-Day Benefits. Sub-limits:
Limits: M=R3,200 | M+1=R4,790 |
M+2=R5,330 | M+3+=R6,390
Subject to available Savings and Threshold.
DEB limits: M-R9,300 | M+1-R14,050 | M+2- R17,450 | M+3-R21,000 before and after threshold
Subject to Savings or self-funded
Subjec to Savings and Day-to-Day Benefits, after Savings is depleted
Subject to Savings, if available
Limit of R2,978 per beneficiary, R4,929 per family
Subject to day-to-day limit and PMB
Hospital & Savings
(Low to Medium Cover)
Subject to Savings
Subject to Savings
Subject to available Savings
Subject to Savings or self-funded
Subject to Savings
Subject to Savings, if available
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Hospital & Savings
(Low to Medium Cover)
Subject to Savings
Subject to Day-to-Day Benefits. Sub-limits:
Limits: M=R2,130 | M+1=R2,660 |
M+2+=R3,200
Subject to available Savings
Subject to Savings or self-funded
Limit of M:R2,400 | M+:R3,750 for physiotheraphy treatment and material
Subject to Savings, if available
Subject to PPS Wallet, if available
Hospital & Savings
(Low to Medium Cover)
Subject to Savings
Subject to Day-to-Day Benefits. Sub-limits:
Limits: M=R2,130 | M+1=R2,660 |
M+2+=R3,200
Subject to available Savings
Subject to Savings or self-funded
Subject to Savings and Day-to-Day Benefits, after Savings is depleted
Subject to Savings, if available
Subject to PPS Wallet, if available
Hospital & Savings
(Low to Medium Cover)
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Subject to Savings
Subject to available Savings
Subject to Savings or self-funded
Subject to Savings and Day-to-Day Benefits, after Savings is depleted
Subject to Savings, if available
Subject to PPS Wallet, if available
Capitation
(Low Cover)
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4 consultations for sport-related injuries at a physiotherapist only. R65 co-payment applies
Sport Injuries: 4 visits to either Physio, Bio or Chiro. Subject to referral of Smart Network GP
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Subject to Health Saver, if available
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Capitation
(Low Cover)
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2 consultations for sport-related injuries at a physiotherapist only. R120 co-payment applies
No Benefit
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No Benefit
Subject to Health Saver, if available
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Hospital Plan
(Hospitalization Cover)
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Subject to BENEFIT BOOSTER
No Benefit
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Hospital Plan
(Hospitalization Cover)
No Benefit
Subject to BENEFIT BOOSTER
No Benefit
Subject to Savings or self-funded
No Benefits
Subject to Health Saver, if available
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Hospital Plan
(Hospitalization Cover)
No Benefit
Subject to BENEFIT BOOSTER
No Benefit
Subject to Savings or self-funded
No Benefit
Subject to Health Saver, if available
Subject to PPS Wallet, if available
Primary Care
(Network & Income Based)
No Benefit
Subject to PMB
No Benefit
Subject to Savings or self-funded
Limited to Prescribed Minimum Benefits at State facilities
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