Benefit options 2020 - Medihelp
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Hospital plan Benefit options 2020
Contents (Click on the contents below to read more)
01 A sustainable
choice
08 Benefits 19 Summary of exclusions
8 Core benefits 20 Prime hospital network
3 Product overview 13 Day-to-day benefits 21 Our healthcare partners
4 Contribution table 18 Deductibles 22 Explanation of terms
5 Benefit comparison 24 Contact us
6 Added insured benefits
7 Chronic illness and PMB cover
General disclaimer
This brochure is intended for marketing purposes and contains only a summary of Medihelp’s benefits. On joining Medihelp, members will receive detailed information. In case of a
dispute, the registered Rules of Medihelp apply, which are available on request. The information in this brochure is subject to approval by the Council for Medical Schemes. The content
of this brochure may change from time to time. Please refer to Medihelp’s website for an updated brochure or consult Medihelp’s Rules for the latest information. We encourage you
to seek financial advice about your healthcare cover by speaking to your financial adviser.Back to contents
A sustainable choice Consistent service delivery
There are various ways in which you can engage with us:
114
years
More than a century’s
experience Phone Email Live chat
202 097 Large enough to be trusted,
Medihelp’s digital service platforms:
lives small enough to care
Member Member
Hands- In-house systems, service & Website
Zone App
on claims processing
AA- Ability to pay your claims is Download/email your e-membership card
rating highly rated and tax certificate
View your benefits, track and submit claims
Financially Solvency levels above industry Update your contact details
sound requirements - 28,65%
Apply for hospital authorisation
Locate a healthcare provider near you
Membership is growing and
not ageing Access, update and share your Medihelp health data
based on screening test results and claims received
1Back to contents
2
Product simplicity and value
10 10 benefit options 2 Prime range - only pay for
options to choose from only 2 children younger than 18 years,
the rest receive free cover
Products include comprehensive,
savings, network solutions 270 Full cover for 270 prescribed
and a hospital plan PMB minimum benefits and
26 chronic conditions
Unlimited cover for trauma
and emergencies
HealthPrint, a free online wellness
No programme provides relevant value
No overall annual limit
limit on hospital cover
and health support
Comprehensive An emergency app ensures that you
added insured benefits can be located in an emergency
26
years
Pay child dependant rates
until kids are 26 years old Care programmes assist members
with specific healthcare needsBack to contents
Product overview
Network/non-network
Prime2
Savings Network/non-network
Prime3 Elite Network/non-network
Comprehensive Comprehensive
This hospital plan is ideal if you are Prime 2 provides hospital cover either at A generous 25% medical savings account With ample pooled insured cover
healthy and want access to private any facility or through a network (pay for day-to-day medical expenses and a for day-to-day medical expenses,
healthcare at an affordable price. Minor 22% less for the network option). A 15% special GP consultation benefit for comprehensive hospital cover and added
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GPs, specialists, medicine &
other day-to-day services
Insured pooled benefits
Child GP consultations – R1 000
DAY-TO-DAY
DAY-TO-DAY
DAY-TO-DAY
DAY-TO-DAY
M = R9 450 | M+2 = R17 700
M+1 = R15 000 | M+3+ = R18 700
Child GP consultations – R2 000
Selected day-to-day services 25% Insured dental benefits
15% Savings account
Insured pooled benefits Savings account
M = R1 200 | M+1+ = R2 400 Insured optometry benefits
Pregnancy & baby benefits Pregnancy & baby benefits EMS Pregnancy & baby benefits
INSURED
INSURED
INSURED
ADDED
ADDED
ADDED
INSURED
ADDED
Women’s & men’s health tests Women’s & men’s health tests Selection of Women’s & men’s health tests
screenings & immunisations
Screenings & immunisations Screenings & immunisations Screenings & immunisations
Specialised radiology Specialised radiology Specialised radiology Specialised radiology
CORE BENEFITS
CORE BENEFITS
CORE BENEFITS
CORE BENEFITS
EMS Post-hospital Trauma cover EMS Post-hospital Trauma cover EMS Post-hospital Trauma cover EMS Post-hospital Trauma cover
Hospital benefits (no AOL) Hospital benefits (no AOL) Hospital benefits (no AOL) Hospital benefits (no AOL)
Network or non-network Network or non-network at any hospital Network or non-network
270 PMB conditions 26 chronic 270 PMB conditions 26 chronic 270 PMB conditions 26 chronic 270 PMB conditions 26 chronic
Diagnosis, treatment & care illnesses (CDL) Diagnosis, treatment & care illnesses (CDL) Diagnosis, treatment & care illnesses (CDL) Diagnosis, treatment & care illnesses (CDL)
3Back to contents
4
Contribution table
Hospital plan Savings Savings Comprehensive
Non- Non-
Network Network Non-network Network
network network
R2 160 (R324 savings contribution R2 772 (R414 savings contribution
Principal R2 598 (R648 savings contribution included
R1 626 R2 082 included per month and R3 888 included per month and R4 968 R2 964 R3 618
member per month and R7 776 per year)
per year) per year)
R1 776 (R264 savings contribution R2 280 (R342 savings contribution
R2 136 (R534 savings contribution included
Dependant R1 338 R1 716 included per month and R3 168 included per month and R4 104 R2 508 R3 060
per month and R6 408 per year)
per year) per year)
Child R648 (R96 savings contribution R828 (R120 savings contribution
R780 (R192 savings contribution included
dependant R492 R630 included per month and R1 152 included per month and R1 440 R864 R1 056Back to contents
Benefit comparison
Hospital plan Savings Savings Comprehensive
Network Non-network Network Non-network Network Non-network
INSURED DAY-TO-DAY BENEFITS DAY-TO-DAY MEDICAL EXPENSES DAY-TO-DAY MEDICAL EXPENSES INSURED DAY-TO-DAY POOLED BENEFITS
M = R1 200 per year 15% medical savings account 25% medical savings account M = R9 450 per year
M+ = R2 400 per year M+1 = R15 000 per year
Day-to-day benefits
GPs, specialists, physiotherapy, acute and CHILD CARE BENEFITS CHILD CARE BENEFITS M+2 = R17 700 per year
self-medication M+ = R2 000 per year M+ = R1 000 per year M+3+ = R18 700 per year
GP consultations for children ≥2 toBack to contents
6
Added insured benefits
These benefits are provided in addition to other insured benefits and available annually unless otherwise indicated and codes may apply.
Enhanced Routine Screening and
Women’s maternity Child screening & Men’s immunisation Supporting
health benefits benefits immunisation health for over 50s wellness
Prime range Prime range & Unify Prime range & Unify Prime range & Unify Prime range Prime range Prime range & Unify
• A mammogram for • Free registration on the Child flu vaccination Available at • A prostate test (PSA • Women over 50 years • Maintain a healthy weight
women 40 years and older HealthPrint pregnancy at Clicks/Dis-Chem Clicks/Dis-Chem level) requested by a have access to one bone Participation in Medihelp’s
requested by a medical and baby programme pharmacy clinics pharmacy clinics medical doctor for mineral density test HealthPrint BMI programme
doctor (per 2-year cycle) • Flu vaccination at per person: men 40 years and older requested by a medical
Clicks/Dis-Chem • A combo test (blood doctor One dietician consultation
Prime range
pharmacy clinics glucose, cholesterol, • A Pneumovax vaccine per registered HealthPrint
Prime range & Unify • Babies under a year Prime range & Unify
BMI & blood pressure in a 5-year cycle per member if a BMI test result
• A pap smear requested by receive two additional • A flu vaccination at
measurement)/ person older than 55 indicates a BMI higher
a medical doctor Prime range visits to a GP or Clicks/Dis-Chem than 30
individual test (blood pharmacy clinics years registered on
(per 3-year cycle) • 12 ante- & postnatal specialist
glucose or cholesterol) Medihelp’s asthma/
• A flu vaccination at consultations per family • Full schedule of standard • An alternative to surgery
• HIV testing, counselling COPD programme
Clicks/Dis-Chem • Two 2D ultrasound child immunisations Back treatment at a
& support • A faecal occult blood
pharmacy clinics scans per family covered up to 7 years Document Based Care
• A tetanus vaccine test (FOBT) for
at Dis-Chem and Clicks facility for patients who
• A flu vaccination people over 50 years
pharmacy clinics qualify for this benefit
Prime range Prime range & Unify • Chronic Care programme
Two HPV vaccinations • A flu vaccination at People who suffer from
for girls and boys between Clicks/Dis-Chem high blood pressure, high
10-14 years or three pharmacy clinics cholesterol and diabetes
between 15-26 years simultaneously have access
to Medihelp’s Chronic Care
programme, which will
provide personal support
through a care coordinator
to assist in maintaining and
optimising their well-beingBack to contents
Chronic illness and PMB cover
You are covered for the diagnosis, treatment and care of 270 conditions (DTPs), the treatment of 26 chronic diseases (CDL), and medical emergencies
defined as prescribed minimum benefits (PMB) in terms of the Medical Schemes Act 131 of 1998 and its Regulations:
270 diagnoses 26 chronic conditions Medical emergencies
The Regulations define a list of Addison’s disease What is an emergency?
270 diagnoses and treatment Asthma An emergency is the sudden and
pairs (DTPs) with specific codes Bipolar mood disorder unexpected onset of a health condition
and treatment guidelines which
qualify for PMB. Bronchiectasis that requires immediate medical or
Cardiac failure surgical treatment. Failure to provide
Cardiomyopathy medical or surgical treatment would
Chronic obstructive pulmonary disease result in serious impairment to bodily
(COPD) functions or serious dysfunction of a
Chronic renal disease bodily organ or part or would place the
Coronary artery disease person’s life in serious jeopardy.
Crohn’s disease
Diabetes insipidus
What to do in an emergency
Diabetes mellitus type 1
If you have an emergency, you can go
Diabetes mellitus type 2 directly to hospital. Register
Dysrhythmia emergency hospital admissions on the
Epilepsy 1st working day after the emergency
Glaucoma admission – phone 086 0200 678.
Haemophilia A and B
Hyperlipidaemia If you need emergency transport,
Hypertension phone Netcare 911, the designated
Hypothyroidism service provider for emergency
Multiple sclerosis transport, on 082 911.
Parkinson’s disease
Rheumatoid arthritis
Schizophrenia
Systemic lupus erythematosus (SLE)
Ulcerative colitis
To access prescribed minimum benefits, certain conditions apply, such as pre-authorisation in line with the list of PMB conditions and codes
as described in the Regulations, the use of designated service providers and network providers, treatment protocols and medicine formularies.
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8
Benefits
The following provides a detailed comparison of the benefits provided by each benefit option.
Core benefits Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
CHRONIC ILLNESS AND PMB
Diagnosis, treatment and care costs of 270 PMB and 26 chronic 100% of the cost* 100% of the cost* 100% of the cost* 100% of the cost*
conditions on the CDL Unlimited Unlimited Unlimited Unlimited
Subject to protocols, pre-authorisation and DSPs
TRAUMA BENEFITS
Benefits for major trauma that necessitates hospitalisation in the
case of:
• Motor vehicle accidents
• Stab wounds
• Gunshot wounds 100% of the cost* 100% of the cost* 100% of the cost* 100% of the cost*
• Head trauma Unlimited Unlimited Unlimited Unlimited
• Burns
• Near drowning
Subject to authorisation, PMB protocols and case management
POST-EXPOSURE PROPHYLAXIS (for HIV/Aids)
EMERGENCY TRANSPORT SERVICES
Netcare 911 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation and protocols Unlimited Unlimited Unlimited Unlimited
In beneficiary’s country of residence
In the RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana
• Transport by road
• Transport by air
Outside beneficiary’s country of residence 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Transport by road R2 050 per case R2 050 per case R2 050 per case R2 050 per case
• Transport by air 100% of the MT 100% of the MT 100% of the MT 100% of the MT
R13 700 per case R13 700 per case R13 700 per case R13 700 per case
* Contracted tariffs may apply.Back to contents
Core benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
HOSPITALISATION
(State and private hospitals and day clinics)
Subject to pre-authorisation, protocols and case management 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Intensive and high-care wards Unlimited Unlimited Unlimited Unlimited
• Ward accommodation Any hospital Any hospital Any hospital Any hospital
• Theatre fees
• Treatment and ward medicine Prime 1 Network Prime 2 Network Prime 3 Network
• Consultations, surgery and anaesthesia 119 network hospitals 119 network hospitals 119 network hospitals
CONFINEMENT (childbirth) 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation, protocols and case management Unlimited Unlimited Unlimited Unlimited
HOME DELIVERY
Subject to pre-authorisation 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Professional nursing fees R13 000 per event R13 000 per event R13 000 per event R13 000 per event
• Equipment
• Material and medicine
STANDARD RADIOLOGY, PATHOLOGY AND MEDICAL
TECHNOLOGIST SERVICES
In hospital 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to clinical protocols Unlimited Unlimited Unlimited Unlimited
RADIOGRAPHY (services by radiographers)
In and out of hospital 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to clinical protocols and on request by a medical doctor R1 050 per family per year R1 050 per family per year R1 050 per family per year R1 050 per family per year
SPECIALISED RADIOLOGY
In and out of hospital 100% of the MT 100% of the MT 100% of the MT 100% of the MT
On request of a specialist and subject to clinical protocols Unlimited Unlimited Unlimited Unlimited
• MRI and CT imaging (subject to pre-authorisation) Member pays the first Member pays the first Member pays the first Member pays the first
R1 650 per examination R1 650 per examination R1 650 per examination R1 650 per examination
• Angiography 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Unlimited Unlimited Unlimited Unlimited
ORGAN TRANSPLANTS 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation and clinical protocols Unlimited Unlimited Unlimited Unlimited
• Cornea implants 100% of the MT 100% of the MT 100% of the MT 100% of the MT
R28 800 per implant per year R28 800 per implant per year R28 800 per implant per year R28 800 per implant per year
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Core benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
POST-HOSPITAL CARE
Professional services relating to a Medihelp authorised private 100% of the MT 100% of the MT 100% of the MT 100% of the MT
hospital admission, required for up to 30 days after discharge M = R1 800 per year M = R1 800 per year M = R1 800 per year M = R1 800 per year
• Speech therapy M+ = R2 500 per year M+ = R2 500 per year M+ = R2 500 per year M+ = R2 500 per year
• Occupational therapy
• Physiotherapy
SUPPLEMENTARY HEALTH SERVICES
In hospital
• Occupational and speech therapy, audiometry, podiatry,
massage, orthoptic, chiropractic, homeopathic, herbal and 100% of the MT 100% of the MT 100% of the MT 100% of the MT
naturopathic, osteopathic and biokinetic services Unlimited Unlimited Unlimited Unlimited
• Physiotherapy and dietician services on referral by the
attending medical doctor
OXYGEN 100% of the MT 100% of the MT 100% of the MT 100% of the MT
In hospital Unlimited Unlimited Unlimited Unlimited
NEUROSTIMULATORS 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation and clinical protocols R111 900 per beneficiary R111 900 per beneficiary R111 900 per beneficiary R111 900 per beneficiary
• Device and components per year per year per year per year
RENAL DIALYSIS
In and out of hospital 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation and clinical protocols Unlimited Unlimited Unlimited Unlimited
PMB only
APPLICABLE PRESCRIPTION MEDICINE DISPENSED AND
100% of the MT 100% of the MT 100% of the MT 100% of the MT
CHARGED BY THE HOSPITAL ON DISCHARGE FROM THE
R350 per admission Savings account Savings account R350 per admission
HOSPITAL (TTO) (excluding PMB chronic medicine)
PSYCHIATRIC TREATMENT OF A MENTAL HEALTH CONDITION
Subject to pre-authorisation, protocols and services rendered in 100% of the MT 100% of the MT 100% of the MT 100% of the MT
an approved/network hospital/facility and prescribed by a R19 300 per beneficiary R24 400 per beneficiary R24 400 per beneficiary R29 300 per beneficiary
medical doctor per year per year per year per year
• Professional services rendered in and out of hospital by (maximum R29 300 per (maximum R33 500 per (maximum R33 500 per (maximum R39 300 per
a psychiatrist family per year) family per year) family per year) family per year)
• General ward accommodation
• Medicine supplied during the period of the treatment in
the institution
• Outpatient consultationsBack to contents
Core benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
ONCOLOGY
Subject to pre-authorisation and registration on the Medihelp
Oncology Programme. Protocols, DSP and MORP apply
100% of the MT 100% of the MT 100% of the MT 100% of the MT
PMB cases
Unlimited Unlimited Unlimited Unlimited
• Hospital and related cancer treatments and services,
including bone marrow/stem cell transplants (subject to PMB
legislation)
Non-PMB cases
• Hospital and related cancer treatments, including 100% of the MT 100% of the MT 100% of the MT 100% of the MT
radiotherapy, brachytherapy, chemotherapy and associated R210 800 per family per year R231 800 per family per year R231 800 per family per year R263 500 per family per year
adjuvant medicine
HOSPICE SERVICES AND SUB-ACUTE CARE FACILITIES AS AN
ALTERNATIVE TO HOSPITALISATION
Subject to pre-authorisation 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Services rendered in an approved facility and prescribed by a Unlimited Unlimited Unlimited Unlimited
medical doctor
PRIVATE NURSING AS AN ALTERNATIVE TO HOSPITALISATION
Subject to pre-authorisation 100% of the MT 100% of the MT 100% of the MT 100% of the MT
(Excluding general day-to-day care)
APPENDECTOMY
Subject to pre-authorisation 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Conventional or laparoscopic procedure Unlimited Unlimited Unlimited Unlimited
PROSTATECTOMY
Subject to pre-authorisation 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Conventional or laparoscopic procedure Unlimited Unlimited Unlimited Unlimited
• Robotic assisted laparoscopic procedure 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Hospitalisation: Hospitalisation: Hospitalisation: Hospitalisation:
R111 000 per beneficiary R111 000 per beneficiary R111 000 per beneficiary R111 000 per beneficiary
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Core benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
INTERNALLY IMPLANTED PROSTHESES
All hospital admissions and prostheses are subject to 100% of the MT 100% of the MT 100% of the MT 100% of the MT
pre-authorisation, protocols and case management
• EVARS prosthesis R34 600 per beneficiary R130 600 per beneficiary R130 600 per beneficiary R130 600 per beneficiary
per year per year per year per year
• Vascular/cardiac prosthesis R34 600 per beneficiary R55 900 per beneficiary R55 900 per beneficiary R55 900 per beneficiary
per year per year per year per year
• Health-essential functional prosthesis R23 000 per beneficiary R61 900 per beneficiary R61 900 per beneficiary R61 900 per beneficiary
per year per year per year per year
• Hip, knee and shoulder replacements (non-PMB) Hospitalisation: Hospitalisation: Hospitalisation: Hospitalisation:
• In case of acute injury where replacement is the only 100% of the MT 100% of the MT 100% of the MT 100% of the MT
clinically appropriate treatment modality
Prosthesis: Prosthesis: Prosthesis: Prosthesis:
Health-essential functional Health-essential functional Health-essential functional Health-essential functional
prosthesis benefits apply prosthesis benefits apply prosthesis benefits apply prosthesis benefits apply
• In case of wear and tear This option does not cover This option does not cover This option does not cover This option does not cover
this benefit this benefit this benefit this benefit
• Intra-ocular lenses Sub-limit subject to Sub-limit subject to Sub-limit subject to Sub-limit subject to
health-essential functional health-essential functional health-essential functional health-essential functional
prosthesis benefit prosthesis benefit prosthesis benefit prosthesis benefit
2 lenses per beneficiary per 2 lenses per beneficiary per 2 lenses per beneficiary per 2 lenses per beneficiary per
year, R4 150 per lens year, R4 150 per lens year, R4 150 per lens year, R4 150 per lens
• Implantable hearing devices (including devices and This option does not cover This option does not cover This option does not cover R105 100 per beneficiary
components) this benefit this benefit this benefit per year
• Prosthesis with reconstructive or restorative surgery
R9 600 per family per year R9 600 per family per year
In and out of hospital R4 250 per family per year R9 600 per family per year
• External breast prostheses in and out of hospital Savings account Savings accountBack to contents
Day-to-day benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
GPs AND SPECIALISTS
Consultations and follow-up consultations 100% of the MT
M = R1 200 per year
PHYSIOTHERAPY
M+ = R2 400 per year
Treatment and material
Pooled benefit for GP and
specialist consultations,
physiotherapy, acute medicine
and self-medication
CLINICAL PSYCHOLOGY AND PSYCHIATRIC NURSING
In and out of hospital 100% of the MT
SUPPLEMENTARY HEALTH SERVICES M = R9 450 per year
Occupational and speech therapy, dietician services, audiometry, M+1 = R15 000 per year
podiatry, massage, orthoptic, chiropractic, homeopathic, herbal and M+2 = R17 700 per year
naturopathic, osteopathic and biokinetic services 100% of the MT 100% of the MT M+3+ = R18 700 per year
This option does not cover Savings account Savings account
PATHOLOGY AND MEDICAL TECHNOLOGIST SERVICES
these benefits
Out of hospital CHILD CARE BENEFITS CHILD CARE BENEFITS
Subject to clinical protocols and requested by a medical doctor M+ = R2 000 per year M+ = R1 000 per year
STANDARD RADIOLOGY GP consultations for children GP consultations for children
Out of hospital ≥2 toBack to contents
14
Day-to-day benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
• Non-PMB generic chronic medicine This option does not cover 100% of the MT 100% of the MT This option does not cover
Subject to pre-authorisation and registration on Medihelp’s this benefit Savings account Savings account this benefit
chronic medicine management programme
• Original medicine when no generic equivalent is available
– 80% of the MT will apply
• Voluntary use of original medicine when a generic
equivalent is available – 70% of the MMAP will apply
• PMB chronic medicine 100% of the MHRP 100% of the MHRP 100% of the MHRP 100% of the MHRP
Subject to pre-authorisation and registration on Medihelp’s
Prime 1 Network Prime 2 Network Prime 3 Network
PMB medicine management programme
DSP & formulary apply DSP & formulary apply DSP & formulary apply
OXYGEN
Out of hospital 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation, clinical protocols and services Unlimited Unlimited Unlimited Unlimited
prescribed by a medical doctor
OPTOMETRY
Subject to pre-authorisation by PPN and services should be 100% of the MT
obtained from a PPN provider 1 composite examination
• Optometric examinations per beneficiary per
1 composite consultation, including refraction test, tonometry 24-month cycle
and visual field test
• Spectacles or contact lenses
Benefits are limited to either spectacles or contact lenses This option does not cover 100% of the MT 100% of the MT R800 per beneficiary per
• Spectacles these benefits Savings account Savings account 24-month cycle
• Frames and/or lens enhancements
• Lenses (one pair of standard clear Aquity lenses) Single vision or bifocal lenses
per beneficiary per 24-month
cycle (multifocal lenses paid
at the cost of bifocal lenses)
• Contact lenses R1 185 per beneficiary per
24-month cycleBack to contents
Day-to-day benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
EXTERNAL PROSTHESES AND MEDICAL APPLIANCES
In and out of hospital
• Artificial eyes 100% of the MT 100% of the MT
R4 700 per family per R4 700 per family per
3-year cycle 3-year cycle
100% of the MT 100% of the MT
• Speech and hearing aids 100% of the MT 100% of the MT
Savings account Savings account
R4 700 per family per R4 700 per family per
3-year cycle 3-year cycle
• Artificial limbs 100% of the MT 100% of the MT
R4 700 per family per R4 700 per family per
3-year cycle 3-year cycle
• Wheelchairs 100% of the MT 100% of the MT 100% of the MT 100% of the MT
R4 700 per family per Savings account Savings account R4 700 per family per
3-year cycle 3-year cycle
• Medical appliances 100% of the MT 100% of the MT
Savings account Savings account
• Hyperbaric oxygen treatment
This option does not cover 100% of the MT 100% of the MT
• In hospital
these benefits R630 per family per year R1 250 per family per year
100% of the MT
R630 per family per year
• Out of hospital 100% of the MT
Savings account
• Stoma components 100% of the MT 100% of the MT 100% of the MT 100% of the MT
• Incontinence products/supplies Unlimited Unlimited Unlimited Unlimited
• CPAP apparatus 100% of the MT 100% of the MT 100% of the MT 100% of the MT
Prescribed by a medical doctor R9 700 per beneficiary per Savings account Savings account R9 700 per beneficiary per
24-month cycle 24-month cycle
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16
Day-to-day benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
DENTAL SERVICES* 100% of the MT 100% of the MT 100% of the MT
Subject to DSP’s managed care protocols Savings account Savings account 2 per beneficiary per year
Conservative dental services 2 per beneficiary per year 2 per beneficiary per year (once every 6 months)
• Routine check-ups (once every 6 months) (once every 6 months)
• Oral hygiene 100% of the MT 100% of the MT 100% of the MT
• Scale and polish treatments Savings account Savings account 2 per beneficiary per year
2 per beneficiary per year 2 per beneficiary per year (once every 6 months)
(once every 6 months) (once every 6 months)
• Fluoride treatment for children >5 and 5 andBack to contents
Day-to-day benefits
Hospital plan Savings Savings Comprehensive
Description Benefit Benefit Benefit Benefit
Specialised dental services 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation and DSP’s managed care protocols Savings account Savings account 1 partial frame (upper or
• Partial metal frame dentures lower jaw) per beneficiary
in a 5-year period
• Maxillofacial surgery and oral pathology 100% of the MT 100% of the MT 100% of the MT
• Surgery in the dentist’s chair Savings account Savings account
Benefits for temporomandibular joint (TMJ) therapy are
limited to non-surgical interventions/treatment
• Crowns and bridges 100% of the MT 100% of the MT 100% of the MT
Subject to pre-authorisation Savings account Savings account 1 crown per family per year,
This option does not cover once per tooth in a
these benefits 5-year period
• Implants 100% of the MT 100% of the MT This option does not cover
Subject to pre-authorisation Savings account Savings account this benefit
• Orthodontic treatment (only one beneficiary per family may 100% of the MT 100% of the MT 100% of the MT
begin orthodontic treatment per calendar year) Savings account Savings account R9 000 once per lifetime
Subject to pre-authorisation and orthodontic needs analysis Once per lifetime for Once per lifetime for per beneficiaryBack to contents
18
Deductibles
Visiting network service providers, making use of DSPs, following the correct pre-authorisation process and negotiating tariffs with your doctor are just
some of the ways in which you can manage or reduce out-of-pocket medical expenses.
Procedure-specific deductibles
There are a limited number of low-incidence procedures that
require a procedure-specific payment.
Hospital plan Savings Savings Comprehensive
Description
SPINAL COLUMN SURGERY
Subject to protocols and pre-authorisation Member pays the first Member pays the first Member pays the first Member pays the first
R11 600 per admission R10 400 per admission R10 400 per admission R9 100 per admission
ENDOSCOPIC PROCEDURES
Subject to protocols and pre-authorisation Member pays the first Member pays the first Member pays the first Member pays the first
Gastroscopy, colonoscopy, arthroscopy and sigmoidoscopy R2 100 per admission R2 750 per admission R2 750 per admission R2 100 per admission
• In a day clinic
• In a hospital Member pays the first Member pays the first Member pays the first Member pays the first
R3 200 per admission R3 850 per admission R3 850 per admission R3 200 per admission
• In the doctor’s rooms No deductible No deductible No deductible No deductible
DENTAL PROCEDURES UNDER GENERAL ANAESTHESIA
In hospital
Subject to pre-authorisation and DSP’s managed care protocols Member pays the first Member pays the first Member pays the first Member pays the first
• Removal of impacted teeth (3rd molars)* R3 300 per admission R3 300 per admission R3 300 per admission R960 per admission
• Extensive treatment for children younger than 5 years –
once per lifetime*
SPECIALISED RADIOLOGY
In and out of hospital
Member pays the first Member pays the first Member pays the first Member pays the first
Subject to pre-authorisation, clinical protocols and services must
R1 650 per examination R1 650 per examination R1 650 per examination R1 650 per examination
be requested by a specialist
MRI and CT imaging
PRIME NETWORK OPTIONS
• Out-of-network hospital used by choice 65% of the benefit applies 65% of the benefit applies
Not applicable
• PMB chronic medicine outside the formulary and/or not 40% of the benefit applies 40% of the benefit applies
obtained from the DSP
* On all options, item codes may apply on the dentist’s account for removal of impacted teeth. For Prime 1, 2 and Unify, the dentist’s account for extensive dental treatment, is for the member’s account/payable from the savings account.Back to contents
Deductibles
Hospital plan Savings Savings Comprehensive
Description
NO PRE-AUTHORISATION OBTAINED
• All planned hospital admissions
• Oxygen for out-of-hospital use
80% of the benefit applies
• Dental procedures under conscious sedation (sedation cost)
in the dentist’s chair
• Specialised dental services
• Emergency transport services 50% of the benefit applies
Summary of exclusions
Please refer to Medihelp’s Rules for the medical conditions, procedures and services, appliances, • Appointments not kept.
medicines, consumables and other products that are excluded from benefits, with the exception of
• The treatment of infertility, other than that stipulated in the Regulations under the Medical
services which qualify for PMB and are authorised by Medihelp. The following is an extract from the
Schemes Act, 1998.
Rules:
• Treatment of alcoholism and drug abuse as well as services rendered by institutions which
• Services which are not mentioned in the Rules as well as services which in the opinion of the
are registered in terms of the Prevention of and Treatment for Substance Abuse Act 70 of
Board of Trustees, are not aimed at the generally accepted medical treatment of an actual or a
2008 or other institutions whose services are of a similar nature, other than stipulated in the
suspected medical condition or handicap, which is harmful or threatening to necessary bodily
Regulations published under the Medical Schemes Act, 1998.
functions (the process of ageing is not considered to be a suspected medical condition or
handicap). • The cost of transport with an ambulance/emergency vehicle from a hospital/other institution
to a residence/medical doctor’s rooms if the visit does not pertain to a hospital admission.
• Travelling and accommodation/lodging costs, including meals as well as administration costs of
a beneficiary and/or service provider. • Emergency room facility fees.
• Operations, treatments and procedures of own choice, for cosmetic purposes, and obesity • Physiotherapy services associated with the removal of impacted wisdom teeth.
related treatment, with the exception of services which qualify for PMB and are approved
beforehand by Medihelp. • Dietician and physiotherapy services rendered in hospital not referred by the attending
medical doctor.
• Costs exceeding the Medihelp tariff for a service or the maximum benefit to which a member is
entitled, subject to PMB. • Cochlear implants – all related procedures, services and devices (not applicable to Prime 3).
This is a summary of benefits. In the event of a dispute, the registered Rules of Medihelp will apply (which are subject to approval by the Council for Medical Schemes). If a beneficiary joins during the course of a financial year, the benefits are calculated pro rata
according to the remaining number of months per year.
19Back to contents
20
Prime hospital network
Members of the Prime network benefit options must be admitted to one of the network Our website lists all the network hospitals. Download our Medihelp member app, which is
hospitals or day clinics below when they need to undergo planned procedures. Visit www.medihelp.co.za. available on iOS and Android devices.
Gauteng KwaZulu-Natal Limpopo
Alberton Netcare Clinton Hospital Amanzimtoti Netcare Kingsway Hospital Bela-Bela St Vincent’s Hospital
Netcare Union Hospital Ballito Netcare Alberlito Hospital Lephalale Mediclinic Lephalale
Benoni Netcare Lakeview Hospital (maternity and Durban Busamed Hillcrest Private Hospital Makhado Zoutpansberg Private Hospital
neonatal only) Lenmed Shifa Private Hospital Polokwane Mediclinic Limpopo
Netcare Linmed Hospital Life Chatsmed Garden Hospital Mediclinic Limpopo Day Clinic
Johannesburg Netcare Garden City Hospital Netcare St Augustine’s Hospital Tzaneen Mediclinic Tzaneen
Netcare Mulbarton Hospital Howick Mediclinic Howick
Netcare Park Lane Hospital Ladysmith Lenmed La Verna Private Hospital North West
Netcare Rand Hospital Newcastle Mediclinic Newcastle
Kempton Park Birchmed Surgical Centre Mediclinic Newcastle Day Hospital Klerksdorp Sunningdale Hospital
Ekurhuleni Surgiklin Day Clinic Pietermaritzburg Mediclinic Pietermaritzburg Wilmed Park Private Hospital
Krugersdorp Netcare Bell Street Hospital Netcare St Anne’s Hospital Potchefstroom Mediclinic Potchefstroom
Netcare Krugersdorp Hospital Pinetown Life The Crompton Hospital Medicross Potchefstroom
Netcare Pinehaven Hospital Port Shepstone Hibiscus Private Hospital Rustenburg Netcare Ferncrest Hospital
Midrand Cure Day Hospital Midstream Richards Bay Netcare The Bay Hospital Vryburg Vryburg Private Hospital
Pretoria Cure Day Hospital Erasmuskloof Shelly Beach Shelly Beach Day Clinic
Cure Day Hospital Medkin Umhlanga KZN Day Clinic Northern Cape
Netcare Umhlanga Hospital
Intercare Hazeldean Day Hospital
Life Brooklyn Day Hospital Kimberley Mediclinic Kimberley
Western Cape Upington Mediclinic Upington
Louis Pasteur Private Hospital
Netcare Akasia Hospital Cape Town Life Vincent Pallotti Hospital
Netcare Jakaranda Hospital Mediclinic Cape Gate Eastern Cape
Netcare Montana Hospital Mediclinic Durbanville
Mediclinic Durbanville Day Hospital East London Life Beacon Bay Hospital
Netcare Pretoria East Hospital
Mediclinic Louis Leipoldt Life St Dominic’s Hospital
Netcare Unitas Hospital
Mediclinic Milnerton Life St James Hospital
Zuid-Afrikaans Hospital
Mediclinic Strand Grahamstown Netcare Settlers Hospital
Roodepoort Mayo Clinic
Medicross Foreshore Day Hospital Humansdorp Life Isivivana Private Hospital
Springs Netcare N17 Hospital
Melomed Bellville Port Alfred Netcare Port Alfred Hospital
Vanderbijlpark Cormed Clinic
Melomed Gatesville Port Elizabeth Life St George’s Hospital (maternity and neonatal only)
Mediclinic Emfuleni
Netcare Christiaan Barnard Memorial Hospital Medical Forum Theatre
PJ Schutte Theatre Unit (dental procedures only)
Netcare Kuilsriver Hospital Netcare Greenacres Hospital
Vereeniging Mediclinic Vereeniging
Netcare N1 City Hospital Queenstown Life Queenstown Private Hospital
Midvaal Private Hospital
George Mediclinic Geneva Uitenhage Netcare Cuyler Hospital
Mediclinic George
Mpumalanga Hermanus Mediclinic Hermanus Free State
Mossel Bay Life Bayview Private Hospital
eMalahleni Advanced De La Vie Day Hospital Oudtshoorn Mediclinic Klein Karoo Bethlehem Bethlehem Medical Centre
eMalahleni Private Hospital Paarl Cure Day Hospital Paarl Mediclinic Hoogland
Ermelo Mediclinic Ermelo Mediclinic Paarl Bloemfontein Citymed Day Hospital
Middelburg Life Midmed Hospital Plettenberg Bay Mediclinic Plettenberg Bay Mediclinic Bloemfontein
Nelspruit Busamed Lowveld Private Hospital Somerset West Mediclinic Vergelegen Pasteur Eye Hospital
Kiaat Private Hospital Stellenbosch Mediclinic Stellenbosch Universitas Private Hospital
Mediclinic Nelspruit Mediclinic Stellenbosch Day Clinic Kroonstad Netcare Kroon Hospital
Secunda Mediclinic Secunda Mediclinic Winelands Orthopaedic Hospital Welkom Mediclinic Welkom
Vredenburg Life West Coast Private Hospital Welkom Medical Centre
Medihelp may change the information contained in this list from time to Worcester Mediclinic Worcester
time and will publish any changes on our website at www.medihelp.co.za.Back to contents
Our healthcare partners
We partner with preferred providers and networks to give you access to affordable, quality care.
Dental Risk Company PPN (optometry network)
Dental Risk Company (DRC) specialises in offering effective dental managed care solutions The Preferred Provider Negotiators (PPN) provide Medihelp’s optical benefits (in options
and provides Medihelp’s dental benefits in partnership with more than 2 300 dentists across which cover optometry) in partnership with more than 2 300 optometrists across South
South Africa. Members may visit any dentist of their choice, but benefits are managed by Africa. Medihelp members may visit any optometrist and benefits are paid according to
DRC and granted in accordance with DRC protocols. PPN tariffs.
Medihelp Preferred Pharmacy Network DSPs for the Prime network range only
Medihelp’s Preferred Pharmacy Network consists of more than 2 000 pharmacies who DSP
offer Medihelp members the most cost-effective professional fee structure for prescribed
MobileMeds
medicine. This means that members who visit network pharmacies will not have to pay
Members must obtain their PMB chronic medicine from a designated service provider (DSP)
any excess amounts for higher professional fees which non-network pharmacies charge to
to avoid a 60% deductible. Order your authorised PMB chronic medicine from MobileMeds.
dispense medicine items.
LifeSense, Dis-Chem Direct and Medipost Dis-Chem Oncology and Medipost
LifeSense Disease Management is the managed healthcare partner for HIV/Aids-related Dis-Chem Oncology and Medipost are the DSPs for oncology medicine.
services and post-exposure prophylaxis, while Dis-Chem Direct and Medipost are the
designated service providers (DSPs) for HIV/Aids medicine.
Specialist networks
Two specialist networks (for Medihelp’s non-network range and the Prime network range)
effectively manage any PMB specialist care that our members may require, while reducing
their out-of-pocket expenses. For members of our network options, specific specialist
networks also ensure streamlined care between the specialist and the network hospital,
especially with regard to PMB services.
Netcare 911
Netcare 911 is our partner in providing emergency medical services.
ICON
ICON is the Independent Clinical Oncology Network to which more than 80% of the
country’s oncologists belong. They provide the highest quality cancer care through a
countrywide footprint of high-tech chemotherapy and radiotherapy facilities. ICON is
Medihelp’s designated service provider for oncology treatment.
DBC
Medihelp’s back treatment programme is offered in cooperation with Document Based Care
(DBC). Each programme is developed by an inter-disciplinary medical team according to the
individual’s clinical profile.
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22
Explanation of terms
BMI – Body mass index CPAP is an apparatus which provides continuous positive airway pressure to assist breathing.
COPD – Chronic obstructive pulmonary disease
CT – Computerised tomography A cycle means the stated length of the benefit cycle, commencing on the date of the first service
EMS – Emergency medical services and thereafter calculated from the date of each subsequent service after the completion of a
GP – General practitioner previous cycle, regardless of a break in membership or registration, or change in benefit option.
HPV – Human papilloma virus
M – Member Deductibles are the difference between the cover provided by Medihelp and the cost/tariff charged
MORP – Medihelp Oncology Reference Price for the medical service, and are payable directly to the service provider. Deductibles are applicable in
MRI – Magnetic resonance imaging the following cases:
OAL – Overall annual limit • When doctors and other providers of medical services charge fees which exceed Medihelp’s
PPN – Preferred Provider Negotiators tariffs, the member is responsible for paying the difference between the amount charged and
the amount which Medihelp pays;
The back treatment programme provided by Document Based Care (DBC) is a non-surgical • When Medihelp’s benefit allocation is not 100% (e.g. for original acute medicine), or where the
intervention in lieu of surgery for the management of spinal column disease/conditions/ cost exceeds the limit available for the service (e.g. for medical appliances); and
abnormalities. This approach to the treatment of back and neck pain involves an inter-disciplinary • When the member chooses not to obtain services from a designated service provider (e.g. ICON
team handling the rehabilitation programme, which is individualised for each patient based on in the case of oncology) or when a pre-determined deductible is applicable to a specific benefit
the patient’s needs and clinical diagnosis. Patients are assessed to ascertain if they are eligible to as indicated per benefit option.
participate in the programme.
DSP – Designated service providers appointed by Medihelp to provide certain medical services.
CDL – Chronic Diseases List which is covered in terms of prescribed minimum benefits.
An emergency medical condition means any sudden and unexpected onset of a health condition
The Chronic Care programme provides members who suffer from a combination of high blood that requires immediate medical or surgical treatment, where failure to provide such treatment
pressure, diabetes and high cholesterol with the support they need to contribute to their optimum would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or
health. Participation in the programme entails support by a registered nurse who coordinates the part, or would place the person’s life in serious jeopardy. An emergency medical condition must be
member’s care to ensure optimal utilisation of medicine and consultations within available benefits, certified as such by a medical practitioner. Emergencies qualify for PMB and must therefore also be
with the objective of improving members’ lifestyle and well-being. registered for PMB (see also “PMB”).
Contraceptives refer to injectable, implantable, intra-uterine, trans- and subdermal as well as EVARS prosthesis means endovascular aortic replacement surgery and is considered when the
oral contraceptives. patient suffers from an aortic aneurysm with an accompanying risk for anaesthesia.
Cost means the cost of PMB services, payable in full by Medihelp if the services are registered Formulary means a list of preferred items (medicine, pathology, prosthetic or otherwise) based
with Medihelp as qualifying for PMB and rendered by DSPs according to accepted PMB on its safety, efficacy and cost-effectiveness, used in the diagnosis and/or treatment of a medical
treatment protocols. condition (Prime network options only).Back to contents
Explanation of terms
Hospital benefits refer to benefits for services rendered by a hospital during a patient’s stay in Period refers to the specific duration described per benefit, e.g. dentistry, or the date of enrolment
hospital. Services include ward accommodation and ward medicine, standard radiology, pathology as a beneficiary.
and consultations during hospitalisation. Hospital benefits are subject to pre-authorisation and
Medihelp pays 80% of the hospital account if the admission is not pre-authorised. 65% benefits PMB – Prescribed minimum benefits are paid for 26 chronic conditions on the CDL and 270
are paid on the Prime network options in case of a voluntary admission to a non-network hospital. diagnoses with their treatments as published in the Regulations under the Medical Schemes Act
Procedure-specific deductibles may apply. Emergency admissions must be registered on the first 131 of 1998. In terms of these Regulations, medical schemes are compelled to grant benefits for
workday following the admission (see also “emergency medical condition”). the diagnosis, treatment and care costs of any of these conditions as well as emergency medical
conditions (that meet the published definition) without imposing any limits. PMB are subject to
MHRP – The Medihelp Reference Price is applicable to all pre-authorised PMB medicine. The price is pre-authorisation, protocols, and the utilisation of designated service providers, where applicable,
determined according to the most cost-effective treatment based on evidence-based principles. The e.g. ICON for cancer treatment. Benefits for PMB services are first funded from the related
MHRP will differ for the different benefit options and is subject to change (e.g. when new generic day-to-day benefits.
equivalents are introduced to the market). Please visit Medihelp’s website at www.medihelp.co.za
(the secured site for members) for the latest MHRP. Members are advised to consult their doctor Protocol means a set of clinical guidelines in relation to the optimal sequence of diagnostic testing
when using PMB medicine to make sure they use medicine on the MHRP where possible and so and treatments for specific conditions and includes, but is not limited to, clinical practice guidelines,
prevent or reduce deductibles. standard treatment guidelines, disease management guidelines, treatment algorithms, clinical
pathways and formularies.
MMAP – The Maximum Medical Aid Price is the reference price used by Medihelp to determine
benefits for acute and chronic medicine. The MMAP is the average price of all the available generic Savings account means an account which is held by Medihelp as part of the funds of Medihelp.
equivalents for an ethical patented medicine item. Funds in the savings account are used to pay for qualifying medical expenses and funds not used,
accumulate.
MT – Medihelp tariff refers to the tariff paid by Medihelp for different medical services, and can
include the contracted tariff for services agreed with certain groups of service providers such as TTO – To take out; medicine dispensed and charged by the hospital at discharge.
hospitals, the Medihelp Dental Tariff for dental services, and the single exit price for acute medicine.
The various tariffs are defined in the Rules of Medihelp. Vascular/cardiac prostheses include artificial aortic valves, pacemakers and related or connected
functional prostheses.
Network benefit options offer benefits to members in collaboration with a medical provider
network. Members on these options must make use of the network to qualify for benefits and
prevent deductibles. Please visit www.medihelp.co.za for details of the network providers for your
benefit option.
Oncology: The majority of oncology cases qualify for prescribed minimum benefits (PMB),
which Medihelp will cover at 100% of the cost in accordance with the protocols as set out in
the Regulations published under the Act, while non-PMB oncology is covered at specific benefit
amounts per option, provided that oncology is rendered by oncologists within the Independent
Clinical Oncology Network (ICON). All oncology treatments will be evaluated on an individual
basis according to ICON’s protocols and must adhere to ICON’s oncology treatment programmes.
Medihelp covers PMB bone marrow/stem cell transplants subject to the applicable PMB legislation.
Oncology received outside ICON or that deviates from the protocols is subject to deductibles.
23Back to contents
24
Contact us
Medihelp Partners
Medihelp Customer Care centre MRI and CT imaging Netcare 911 (emergency medical transport)
Tel: 086 0100 678 Tel: 086 0200 678 Tel: 082 911
Fax: 012 336 9540 mySOS app
Oncology
enquiries@medihelp.co.za
Disease management programme DRC (dental services)
www.medihelp.co.za
Tel: 086 0100 678 Tel: 087 943 9618
Application forms (new business) Fax: 086 0064 762 Fax: 086 687 1285
newbusiness@medihelp.co.za oncology@medihelp.co.za medihelp@dentalrisk.com
claims@dentalrisk.com
Membership enquiries Oncology medicine (Prime network options only)
auth@dentalrisk.com
Fax: 012 336 9532 Dis-Chem Oncology
www.dentalrisk.com
membership@medihelp.co.za Tel: 010 003 8948
Fax: 086 597 0573 HIV/Aids programme & post-exposure prophylaxis (PEP)
Subscriptions enquiries oncology@dischem.co.za Disease management programme
Fax: 012 336 9537 or LifeSense
subscriptions@medihelp.co.za Medipost Tel: 0860 50 60 80
Tel: 012 404 4430 SMS: 31271 for a call back
E-services Fax: 086 680 3319 Fax: 0860 80 49 60
Access the secured site for members (Member Zone) oncology@medipost.co.za Enquiries: enquiry@lifesense.co.za
via www.medihelp.co.za Scripts & pathology: results@lifesense.co.za
Download the member app from iStore/Google Play Private nursing, hospice and sub-acute care facilities
www.lifesensedm.co.za
Tel: 086 0100 678
Medicine
Submission of claims Fax: 012 336 9523
Dis-Chem Direct
Fax: 012 336 9556 hmanagement@medihelp.co.za
Tel: 011 589 2788
claims@medihelp.co.za
Chronic renal dialysis & oxygen administered at home Fax: 086 641 8311
Hospital admissions (all hospital admissions must be pre-authorised) Tel: 086 0100 678 direct.medihelp@dischem.co.za
Member Zone Fax: 012 336 9540 or
Member app preauth@medihelp.co.za Medipost
Tel: 086 0200 678 Tel: 012 426 4000
Fax: 012 336 9535 Medihelp fraudline Fax: 086 688 9867
hospitalauth@medihelp.co.za Tel: 012 334 2428 life@medipost.co.za
Fax: 012 336 9538
PMB chronic medicine and more than 30 days’ medicine supply fraud@medihelp.co.za PPN (optometry)
Tel: 086 0100 678 Tel: 086 1103 529 or 086 1101 477
Fax: 012 334 2466 MobileMeds (Prime network options only) info@ppn.co.za
medicineapp@medihelp.co.za PMB chronic medicine www.ppn.co.za
Tel: 086 0100 678
Prescribed minimum benefits (PMB) Fax: 012 336 9544 Council for Medical Schemes
Tel: 086 0100 678 mobilemeds@medihelp.co.za Tel: 086 1123 267
Fax: 086 0064 762 complaints@medicalschemes.com
enquiries@medihelp.co.za www.medicalschemes.comBack to contents
uppe marketing A20754
September 2019
086 0100 678 b
Medihelp is an authorised financial services
www.medihelp.co.za provider (FSP No 15738)You can also read
