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Summary of 2014 medihelp products

Medical aid companies all offer the same products, right? Wrong!

Medihelp knows people’s needs are different, which is why our 2014 range of medical aid products is designed to suit different lifestyles, ages and pockets – from a network medical aid package (an ideal option for low-income earners) all the way to premium medical aid plans for high-income earners.

We also understand that you and your family deserve the very best in healthcare – that’s why Medihelp is the South African medical aid company on which you can rely. Our medical aid products will not only provide you with peace of mind in the event of an unfortunate medical emergency, with medical cover for major medical procedures, but will also assist you in maintaining your good health – every day.


View all benefits

Take a look at a summary of our great products:


Major medical benefits

 
Necesse network Dimension Prime 1 Dimension Prime 2 Dimension Prime 3 Dimension Elite
HOSPITAL BENEFITS
Network applicable – no overall annual limit
Sub-limits apply for specific procedures
HOSPITAL BENEFITS
Choose between Prime 1 and Prime 1 Network
No overall annual limit
Co-payment on specified procedures may apply
Co-payment on non-network admissions may apply
HOSPITAL BENEFITS
Choose between Prime 2 and Prime 2 Network
No overall annual limit
Co-payment on specified procedures may apply
Co-payment on non-network admissions may apply
HOSPITAL BENEFITS
Choose between Prime 3 and Prime 3 Network
No overall annual limit
Co-payment on specified procedures may apply
Co-payment on non-network admissions may apply
HOSPITAL BENEFITS
No overall annual limit
Co-payment on specified procedures may apply
SPECIALISED RADIOLOGY
During and not during hospitalisation
R11 900 per family
SPECIALISED RADIOLOGY
During and not during hospitalisation
R15 500 per family
SPECIALISED RADIOLOGY
During and not during hospitalisation
R15 500 per family
SPECIALISED RADIOLOGY
During and not during hospitalisation
R15 500 per family
SPECIALISED RADIOLOGY
During and not during hospitalisation
R23 400 per family
CHRONIC DISEASE BENEFITS
26 CDL conditions – diagnosis, treatment and care
CHRONIC DISEASE BENEFITS
26 CDL conditions – diagnosis, treatment and care
Prime 1: Any provider
Prime 1 Network: Obtained from a restricted DSP to prevent a 60% co-payment
CHRONIC DISEASE BENEFITS
26 CDL conditions – diagnosis, treatment and care
Prime 2: Any provider
Prime 2 Network: Obtained from a restricted DSP to prevent a 60% co-payment
CHRONIC DISEASE BENEFITS
26 CDL conditions – diagnosis, treatment and care
Prime 3: Any provider
Prime 3 Network: Obtained from a restricted DSP to prevent a 60% co-payment
CHRONIC DISEASE BENEFITS
26 CDL conditions – diagnosis, treatment and care
PRESCRIBED MINIMUM BENEFITS (PMB)
270 PMB conditions – diagnosis, treatment and care
Specialist network
PRESCRIBED MINIMUM BENEFITS (PMB)
270 PMB conditions – diagnosis, treatment and care
Specialist network
PRESCRIBED MINIMUM BENEFITS (PMB)
270 PMB conditions – diagnosis, treatment and care
Specialist network
PRESCRIBED MINIMUM BENEFITS (PMB)
270 PMB conditions – diagnosis, treatment and care
Specialist network
PRESCRIBED MINIMUM BENEFITS (PMB)
270 PMB conditions – diagnosis, treatment and care
Specialist network
TRAUMA-RELATED BENEFITS
As well as post-exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
TRAUMA-RELATED BENEFITS
As well as post-exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
TRAUMA-RELATED BENEFITS
As well as post-exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
TRAUMA-RELATED BENEFITS
As well as post-exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
TRAUMA-RELATED BENEFITS
As well as post-exposure prophylaxis in the event of sexual assault or accidental exposure to HIV

Emergency medical services

 
Necesse network Dimension Prime 1 Dimension Prime 2 Dimension Prime 3 Dimension Elite
ROAD & AIR TRANSPORT (ER24)
Unlimited within RSA
24-hour helpline & trauma counselling
ROAD & AIR TRANSPORT (ER24)
Unlimited within RSA
24-hour helpline & trauma counselling
ROAD & AIR TRANSPORT (ER24)
Unlimited within RSA
24-hour helpline & trauma counselling
ROAD & AIR TRANSPORT (ER24)
Unlimited within RSA
24-hour helpline & trauma counselling
ROAD & AIR TRANSPORT (ER24)
Unlimited within RSA
24-hour helpline & trauma counselling

EMS – Emergency medical services
CDL – Chronic Diseases List

Day-to-day benefits

 
Necesse network Dimension Prime 1 Dimension Prime 2 Dimension Prime 3 Dimension Elite
MEDIHELP DSP NETWORK
An array of basic day-to-day healthcare services provided by various network providers with Necesse GPs as the primary point of care for access:
Consultations, medicine, dental, optical, physiotherapy, radiology and pathology
Protocols & sub-limits apply
OVERALL BENEFIT:
M = R1 180 M+ = R2 250

Sub-limits:
Consultations - GPs, specialists & physiotherapy
M = R820
M+ = R1 540

Acute medicine & self-medication
M = R710
M+ = R1 060
INSURED OPTICAL BENEFITS (PPN NETWORK)
Spectacles/contact lenses

ALL OTHER DAY-TO-DAY MEDICAL EXPENSES
(paid from savings account contribution)
Prime 2:
R9 288 for a family of three
Prime 2 Network:
R7 344 for a family of three
STANDARD RADIOLOGY AND PATHOLOGY
M = R2 160 M+ = R2 920

INSURED DENTISTRY BENEFITS (DENIS NETWORK)

INSURED OPTICAL BENEFITS (PPN NETWORK)
Spectacles/contact lenses

OTHER INSURED BENEFITS
M = R4 400
M+1 = R7 250
M+2 = R9 000
M+3+ = R9 750
  • GPs & specialists
  • Psychologists
  • Physiotherapy
  • Supplementary health services
  • Acute medicine & self-medication
CHRONIC MEDICINE
M = R3 050 M+ = R4 750

ACUTE MEDICINE
M = R3 130 M+ = R5 940

STANDARD RADIOLOGY
R2 130 per family

PATHOLOGY
R2 130 per family

INSURED DENTISTRY BENEFITS (DENIS NETWORK)

INSURED OPTICAL BENEFITS (PPN NETWORK)
Spectacles/contact lenses

OTHER INSURED BENEFITS
M = R2 070 M+ = R3 980
  • GPs & specialists
  • Psychologists
  • Physiotherapy

Preventive care

 
Necesse network Dimension Prime 1 Dimension Prime 2 Dimension Prime 3 Dimension Elite
HEALTH TESTS
  • Routine tests – mammograms, cholesterol, blood sugar tets, pap smears and prostate tests
IMMUNISATIONS
  • Flu vaccination
  • Tetanus vaccine
PREGNANCY AND BABY BENEFITS
Benefits subject to participation in mom-2-be programme:
  • 12 pregnancy consultations & two 2D sonars
  • Two consultations (< 1 year)
  • Standard kids immunisation (< 7 years)
HEALTH TESTS
  • Routine tests such as mammograms, cholesterol and blood sugar tests
  • HIV test
IMMUNISATIONS
  • Flu vaccination
  • Tetanus vaccine
  • HPV vaccine
    (females 10 to 26 years)
BACK TREATMENT PROGRAMME
PREGNANCY AND BABY BENEFITS
Benefits subject to participation in mom-2-be programme:
  • 12 pregnancy consultations & two 2D sonars
  • Two consultations (< 1 year)
  • Standard kids immunisation (< 7 years)
HEALTH TESTS
  • Routine tests such as mammograms, cholesterol and blood sugar tests
  • HIV test
IMMUNISATIONS
  • Flu vaccination
  • Tetanus vaccine
  • HPV vaccine
    (females 10 to 26 years)
BACK TREATMENT PROGRAMME
PREGNANCY AND BABY BENEFITS
Benefits subject to participation in mom-2-be programme:
  • 12 pregnancy consultations & two 2D sonars
  • Two consultations (< 1 year)
  • Standard kids immunisation (< 7 years)
HEALTH TESTS
  • Routine tests such as mammograms, cholesterol and blood sugar tests
  • HIV test
IMMUNISATIONS
  • Flu vaccination
  • Tetanus vaccine
  • HPV vaccine
    (females 10 to 26 years)
BACK TREATMENT PROGRAMME
PREGNANCY AND BABY BENEFITS
Benefits subject to participation in mom-2-be programme:
  • 12 pregnancy consultations & two 2D sonars
  • Two consultations (< 1 year)
  • Standard kids immunisation (< 7 years)
HEALTH TESTS
  • Routine tests such as mammograms, cholesterol and blood sugar tests
  • HIV test
IMMUNISATIONS
  • Flu vaccination
  • Tetanus vaccine
  • HPV vaccine
    (females 10 to 26 years)
BACK TREATMENT PROGRAMME

DSP - Designated service provider


How to choose a medical aid plan
Having good medical care is essential. But with so many options out there, how do you ensure that a specific medical aid plan will suit your unique needs?

First, work out what your budget is – a good rule of thumb is to opt for the best medical aid plan that you can afford. Then, identify your healthcare needs by asking yourself these questions:

  • Do you have any chronic medical conditions? If your answer is no, then a hospital plan will suffice, but if your answer is yes then a comprehensive medical plan with a savings or day-to-day benefit component that includes cover for chronic medicine would be a better bet.
  • How often do you visit the doctor? If you consult your doctor regularly, you need to consider a comprehensive plan which offers day-to-day benefits.
  • Do you use acute medicine? If you’re healthy and active but require medicine from time to time for short-term illnesses, then consider going for a hospital plan with a savings plan such as Dimension Prime 2.
  • Do you use specialist services? If so, opt for a comprehensive plan.
  • Are you aware of any medical treatment you might need in future? Then it’s best to get on to a premium medical plan now!

Remember…

  • Before you sign on the dotted line, ensure you’re familiar with the benefits associated with the product you choose. Ask a registered Medihelp broker to contact you to explain our products in detail.
  • To assess your medical aid plan yearly to determine if it’s still the correct choice for you.