Necesse student 2018 - Email: " Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
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September 2017
necesse student
2018
Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
Email: enquiries@classmed.co.zawhy medihelp
With a value-driven mindset we focus on fulfilling your health and wellness needs
and customise our products and services to ensure an individualised experience
when interacting with the Scheme in terms of the following four key areas:
• Products • Services • Value • Engagement
A SOUND HEALTHCARE PARTNER ENGAGEMENT
112 YEARS’ experience in the medical Member app
schemes industry With an electronic membership card
and instant benefit verification
As a SELF-ADMINISTERED medical scheme Medihelp
maintains complete control and tightly manages all
Call centre
administration costs 60 helpful consultants to assist you
LARGE AND RELIABLE
Medihelp is one of the five largest mySOS emergency
open medical schemes in South Africa This app ensures that you and your
loved ones can be located in an emergency
CLAIMS PAYMENT ABILITY is guaranteed with our
AA- rating awarded by Global Credit Rating Secured website
An online hub with all your Medihelp
CONSISTENCY service functionalities
Medihelp’s average beneficiary age of 37 years provides a
healthy risk pool to contribute to sustainability
OUR SOLVENCY LEVEL
Medihelp consistently maintains a solvency level well
above the industry requirement
PRODUCT
A tailor-made option to suit your lifestyle and health profile. What do you pay?
Full cover You pay only R474 if your
• 270 prescribed minimum benefits
• 26 chronic conditions monthly income does not exceed
R400 and if you can provide
No overall limit
for hospital cover us with a letter on an official
letterhead from your tertiary
Unlimited cover
for trauma and emergencies
institution confirming that you are
registered as a full-time student
Additional benefits
A choice of additional, separate benefits for preventive
care
Please note
An individualised, free wellness programme provides
This brochure only provides a summary of benefits. In
relevant health support and value during every life stage
case of a dispute, the registered Rules of Medihelp apply.
A complete list of benefits and all services excluded from
Join Medihelp MultiSport for runners, walkers and
benefits is available in the Medihelp Rules.
cyclists and get access to club gear at a discount and free
participation in Medihelp Exclusions may also include services which are not mentioned
promotional events in the Rules as well as services which in the opinion of the
Board of Trustees are not aimed at the generally accepted
A national network of private medical treatment of an actual or a suspected medical
condition or handicap, which is harmful or threatening to
healthcare providers
necessary bodily functions.
Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
Email: enquiries@classmed.co.zawhat are your benefits?
Hospital cover Emergency cover Doctors’ visits Specialist care X-rays & Prescribed medicine Dentistry Eye care
blood tests
preventive care benefits
Our preventive care benefits are designed to enable you to identify potential health problems.
Health tests Immunisation Back treatment programme
One test per student per year requested One immunisation per student per year 1 Document-Based Care (DBC) programme
by a Necesse network GP: requested by a Necesse network GP: per student per year at a DBC facility
• 1 blood glucose test (pathology: 4057) • 1 flu vaccine (subject to protocols and pre-authorisation)
• 1 cholesterol test (pathology: 4027) • 1 tetanus vaccine
* Benefits are subject to day-to-day benefits.
core benefits
These include benefits for major medical expenses such as hospitalisation, emergency benefits and
home care as an alternative to hospitalisation.
Trauma cover Emergency cover Essential cover
Unlimited cover for trauma that necessitates • Unlimited emergency cover in South Africa for We offer 100% cover for 270 conditions and
hospitalisation in the case of transport by road or air by Netcare 911 26 chronic diseases treated by designated
motor vehicle accidents, stab wounds, • R1 000 per student for outpatient emergency service providers and networks according to
gunshot wounds, head trauma, burns and unit services, non-network doctors’ visits, treatment protocols. This includes oncology,
near drowning. as well as medicine and services rendered by a HIV, prostheses and medical, surgical and
non-network medical doctor. orthopaedic appliances.
Hospitalisation Radiology & pathology Alternative care to
100% cover for hospitalisation in a network • R27 700 per year for standard radiology, hospitalisation
hospital (subject to pre-authorisation and R20 200 per year for sub-acute care and
pathology and medical technologist
protocols) private nursing services as an alternative to
services in hospital
• R15 000 per year for specialised radiology hospitalisation
Physio- and occupational in and out of hospital. Services must be
therapy requested by a specialist on referral by a Appendectomy
R8 950 per year in hospital • Conventional procedure – unlimited
network GP and benefits are subject to
clinical protocols. • Laparoscopic procedure –
Clinical technologist services • MRI, CT imaging (subject to pre- R15 800 for hospital costs
R20 200 per year in hospital
authorisation) and angiography
* Benefits are paid at 100% of the Medihelp tariff (MT). Consult the registered Rules of Medihelp for definitions of the various tariffs paid by Medihelp for different services.
Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
Email: enquiries@classmed.co.zaday-to-day benefits
Day-to-day benefits include GP visits, dental procedures and eye care.
Consultations Optometry
• 9 network GP consultations Available per student in a 24-month cycle:
per student per year • 1 complete consultation
• R2 950 per student per year for • Spectacles or contact lenses
specialist care (subject to referral Spectacles
by a Necesse network GP and pre- • R200 for the frame
authorisation) • 1 pair of standard clear Aquity single
vision, bifocal or multifocal lenses
Other medical services Contact lenses
• R1 900 per student per year for • R450 per student
physiotherapy and occupational
therapy out of hospital, if requested Dental
by a network GP • Routine check-ups
• 100% of the Medihelp tariff for black • 4 fillings per student, 1 filling
and white X-rays and soft-tissue per tooth in 365 days
ultrasound scans (subject to codes) • Tooth extractions
• 100% for blood tests • Root canal treatment in the dentist’s
(subject to a list of pathology codes chair for 2 teeth per student per year
and tests), done by Lancet/PathCare • Laughing gas (in the dentist’s chair)
on request of a network GP • Extensive dental treatment under
conscious sedation in the dentist’s
Medicine chair (sedation cost), subject to pre-
• Acute medicine dispensed by a authorisation
dispensing network GP • X-rays
• A list of approved medicine obtained • 4 intra-oral X-rays per student
from a network pharmacy and per year
prescribed by a network GP or network • 1 extra-oral X-ray per student
dentist in a 3-year period
• Self-medication obtained from a
network pharmacy
• R100 per event
• R270 per student per year
explanation of terms
An emergency medical condition means any sudden Network benefit options offer benefits to members in
and unexpected onset of a health condition that requires collaboration with a medical provider network. Members
immediate medical or surgical treatment, where failure to must make use of the network to qualify for benefits and
provide such treatment would result in serious impairment prevent payments.
to bodily functions or serious dysfunction of a bodily organ
or part, or would place the person’s life in serious jeopardy. Prescribed minimum benefits (PMB) are paid for 26
An emergency medical condition must be certified as such chronic conditions on the CDL and 270 diagnoses with their
by a medical practitioner. Emergencies qualify for PMB and treatments as published in the Regulations of the Medical
must therefore also be registered for PMB (see also “PMB”). Schemes Act 131 of 1998. In terms of these Regulations,
medical schemes are compelled to grant benefits for
Hospital benefits refer to benefits for services rendered the diagnosis, treatment and care costs of any of these
by a hospital during a patient’s stay in hospital. Services conditions as well as emergency medical conditions (that
include ward accommodation and ward medicine, standard meet the published definition) without imposing any limits.
radiology and pathology, physiotherapy and other PMB are subject to pre-authorisation, protocols and the
supplementary services rendered during hospitalisation. utilisation of designated service providers, where applicable,
Hospital benefits are subject to pre-authorisation and e.g. Lancet/PathCare for pathology tests. Benefits for
an 80% benefit will apply to the hospital account if the PMB services are first funded from the related day-to-day
admission is not pre-authorised. Emergency admissions benefits.
must be registered on the first workday following the
admission. A 65% benefit applies for voluntary admission to * Benefits are paid at 100% of the Medihelp tariff (MT).
a non-network hospital. Consult the registered Rules of Medihelp for definitions of
the various tariffs paid by Medihelp for different services.
Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
Email: enquiries@classmed.co.zaA16783
necesse private hospital and day clinic network
Limpopo Gauteng Western Cape
City/town Name Practice No City/town Name Practice No City/town Name Practice No
Bela Bela St Vincent’s Hospital 5706548 Krugersdorp Pinehaven Hospital 604968 George Mediclinic Geneva 5709059
Lephalale Marapong Private Hospital 5708125 Netcare Waterfall City George Mediclinic George 5807905
Midrand 426024
Makhado Zoutpansberg Private Hospital 253871 Hospital Hermanus Mediclinic Hermanus 5709091
Polokwane Mediclinic Limpopo 5808189 Midrand Mediclinic Midstream 0579068 Knysna Knysna Private Hospital 5808960
Polokwane Mediclinic Limpopo Day Clinic 0603120 Pretoria Akasia Hospital 5808618 Mossel Bay Bayview Hospital 5808790
Thabazimbi Mediclinic Thabazimbi 5709202 Pretoria Bougainville Private Hospital 5808952 Oudtshoorn Mediclinic Klein Karoo 5808928
Tzaneen Mediclinic Tzaneen 132454 Life Groenkloof Hospital Paarl Mediclinic Paarl 5808251
Pretoria 5804043
(oncology only)
Plettenberg Bay Mediclinic Plettenberg Bay 283207
Free State Mediclinic Gynaecological
Pretoria 5703638 Somerset West Mediclinic Vergelegen 5808030
City/town Name Practice No Hospital
Stellenbosch Mediclinic Stellenbosch 5808405
Bethlehem Mediclinic Hoogland 5808707 Pretoria Mediclinic Heart Hospital 5808634
Strand Mediclinic Strand 5709075
Bloemfontein Mediclinic Bloemfontein 5808154
Pretoria Mediclinic Kloof 120928
Vredenburg West Coast Private Hospital 5808979
Koinonia Theatre
Pretoria Mediclinic Legae 5808499
Kroonstad (Dr LJ van Wyk) 7600658 Worcester Mediclinic Worcester 5808006
(dental procedures only) Pretoria Mediclinic Medforum 5807867
Kroonstad Kroon Hospital 5808383 Pretoria Mediclinic Muelmed 5808065 Northern Cape
Welkom Mediclinic Welkom 5808758 Pretoria Montana Private Hospital 5809002 City/town Name Practice No
Kathu Lenmed Health Kathu
North West Pretoria
Medkin Clinic
7700121 580619
(dental procedures only) Private Hospital
City/town Name Practice No
Kimberley Mediclinic Kimberley 5808049
Pretoria North Day Clinic
Brits Mediclinic Brits 5808723 Pretoria 7700156
(dental procedures only) Upington Mediclinic Upington 5808804
Klerksdorp Wilmed Park Private Hospital 5808812
Klerksdorp Sunningdale Hospital 5706696
Soweto/Lenasia Lenmed Clinic 5808324 KwaZulu-Natal
Lenmed Daxina Private
Soweto/Lenasia 490296 City/town Name Practice No
Marikana Andrew Saffy Memorial 78468 Hospital
Hospital Amanzimtoti Kingsway Hospital 5808200
East Rand N17 Private
Springs 5809029
Potchefstroom Mediclinic Potchefstroom 5808057 Hospital Ballito Alberlito Hospital 250562
Rustenburg Peglerae Hospital 5808359 Vanderbijlpark Mediclinic Emfuleni 5808375 Durban Chatsmed Garden Hospital 5808219
Rustenburg Ferncrest Hospital 5808391 PJ Schutte Theatre Unit Durban Bluff Medical & Dental Centre 7700687
Vanderbijlpark 7600534
(dental procedures only)
Vryburg Vryburg Private Hospital 5808553 Durban St Augustine’s Hospital 5802563
Vereeniging Mediclinic Vereeniging 5808081
Durban Pinetown Medicross Theatre 7700954
Gauteng
Eastern Cape Durban Parklands Hospital 5802466
City/town Name Practice No
City/town Name Practice No Empangeni Empangeni Garden Clinic 5708494
Alberton Clinton Clinic 5708877
East London Life Beacon Bay Hospital 357669 Howick Mediclinic Howick 122092
Alberton Union Hospital 5804981
Kokstad Kokstad Private Hospital 174602
Grahamstown Settlers Hospital 348090
Lakeview Hospital
Benoni 5709121 Margate Margate Private Hospital 5808529
(dental procedures only) Humansdorp Isivivana Private Hospital
168386
(maternity & neonatal only) Newcastle Mediclinic Newcastle 5808871
Benoni Linmed Hospital 5808588
Port Alfred Port Alfred Hospital 328871 Nongoma Nongoma Private Hospital 147362
Boksburg Medical &
Boksburg Dental Centre 7700741 Port Elizabeth Greenacres Hospital 5807875 Pietermaritzburg Mediclinic Pietermaritzburg 5808073
(dental procedures only) Port Elizabeth Medical Forum Theatre 7700873 Pinetown Malvern Medical & Dental 7700695
Centre
Boksburg Sunward Park Hospital 5808227 Queenstown Life Queenstown Private
5709156
Hospital Pongola Pongola Hospital 5707803
Bronkhorstspruit Bronkhorstspruit Hospital 5808561
Uitenhage Cuyler Clinic 5808642 Port Shepstone Hibiscus Hospital 5808901
Suikerbosrand Clinic
Heidelberg 5808987
(maternity & neonatal only) Western Cape Richards Bay The Bay Hospital 5808472
Garden City Clinic City/town Name Practice No Shelly Beach Shelly Beach Day Clinic 380059
Johannesburg 5805988
(maternity & neonatal only) Tongaat Victoria Hospital 5708567
Atlantis Wesfleur Private Clinic 7700814
Johannesburg Mediclinic Morningside 5807824 Umhlanga Umhlanga Hospital 5808936
Cape Town Mediclinic Cape Gate 366714
Johannesburg Mediclinic Sandton 5805139 Cape Town Mediclinic Cape Town 5808995 Mpumalanga
Johannesburg Mulbarton Hospital 5808278 Cape Town Mediclinic Constantiaberg 5807999 City/town Name Practice No
Parklane Clinic Cape Town Mediclinic Durbanville 5808766
Johannesburg 5803004 Barberton Mediclinic Barberton 5709148
(maternity & neonatal only)
Mediclinic Durbanville eMalahleni eMalahleni Private Hospital 413615
Cape Town 592781
Johannesburg Rand Clinic 5804620 Day Hospital
eMalahleni eMalahleni Day Hospital 7700520
Wits University Donald Cape Town Mediclinic Louis Leipoldt 5806860
Johannesburg 5806682 Ermelo Mediclinic Ermelo 5808863
Gordon Medical Centre Cape Town Mediclinic Milnerton 5808669
Middelburg Middelburg Private Hospital 5808243
Birchmed Surgical Centre Cape Town Mediclinic Panorama 5807913
Kempton Park 7700504 Nelspruit Mediclinic Nelspruit 5808340
(dental procedures only) Cape Town Melomed Gatesville 5808103
Krugersdorp Krugersdorp Private Hospital 5808111 Secunda Mediclinic Secunda 540110
Ceres Ceres Private Hospital 5709032
Krugersdorp Protea Clinic 7700369 Trichardt Mediclinic Highveld 5807956
086 0100 678
www.medihelp.co.za
Medihelp is an authorised financial services provider (FSP No 15738)
Classique medical aid consultants cc ( A0328 ) Contact: 0217978885
Email: enquiries@classmed.co.zaYou can also read
