Comprehensive cover for hospitalisation and most in-hospital services via an unrestricted network of hospitals. Certain categories subject to Rand limits

100% of cost at contracted rate, unlimited for Bankmed Network Specialists (DSPs)
100% of Scheme Rate for non-DSPs

Chronic medication limit:

Limited to R27 395 pbpa (Insured Benefit) and paid as follows:

• 100% of the Scheme’s Maximum Medical Aid Prices (MMAP) for Bankmed Network GPs (DSPs) or Bankmed Pharmacy Network (DSP)
• 80% of Scheme’s Maximum Medical Aid Prices (MMAP) for non-DSPs
• Continued benefits for PMBs after depletion of annual limit, subject to PMB regulations

This Plan has a Medical Savings Account (MSA) only

This Plan has access to all Netcare, National Hospital Network (NHN), Life Healthcare, Mediclinic and Clinix hospitals, any other independent private hospitals contracted to the Scheme

Deductibles: Member to pay hospital or day clinic on admission

For certain procedures performed in-hospital and at a day clinic a deductible will apply, except for emergencies, readmissions within six weeks of discharge, confinements and PMB-related conditions

• Day clinics: R310 per admission
• Private hospitals: R775 per admission
• Dental admissions to private hospitals: R2 295 per admission.