MedElect

MedElect

MedElect’s quality networks enable comprehensive care in and out of hospital at an affordable premium.

from
R2 820 per month
in 2024
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Children aged 18-25

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Looking for a new medical aid?

Choosing a new medical aid is made easier by speaking to an accredited adviser about the plan that will suit your healthcare needs and pocket best. Whether you’re studying, moving up the corporate ladder or planning a family, we will help you make an informed decision.

To request pre-authorisation, view your benefits, and for other member services please log in to the Member Zone.


MedElect

Added insured benefits

Women’s and men’s health tests

Contraceptive benefits

Maternity and baby benefits

Cover for health tests, vaccinations, and screenings

MedElect

Core benefits

Specialised radiology benefit

Full trauma and emergency medical cover

Hospital benefits (no overall annual limit)

Network hospitals

271 PMB conditions – diagnosis, treatment, and care | 26 chronic illnesses (CDL)
Post-hospital benefit

MedElect

Day-to-day benefits

Network GP consultations and virtual care
M = R2 200 | M+1 = R4 050
M+2 = R4 750 | M+3 = R5 100
M+4+ = R5 700
Physiotherapy and occupational therapy
Member = R2 400 | Family = R3 750

MedElect

Day-to-day benefits

Specialist visits, radiology, pathology, clinical psychology, and acute medicine
M = R3 300 | M+1 = R5 850
M+2 = R6 700 | M+3 = R7 100
M+4+ = R7 750
Dentistry | Optometry
Care extender benefit

 

 R0 - R800
(Student)
R801+
Main memberMain memberR894R2 820
DependantDependantR894R2 208
Child dependant <21 yearsChild dependantR894R912
Children pay child dependant rates until they turn 21

These benefits are provided in addition to your insured day-to-day benefits and are activated when you register on HealthPrint, Medihelp’s free wellness programme for members, on the Member Zone. Your health screening results from Dis-Chem or Clicks will automatically upload to your health record on HealthPrint.

Maternity benefits
  • Ten antenatal and postnatal consultations at a midwife/ GP/ gynaecologist
  • Two antenatal and postnatal consultations at a dietician/ lactation specialist/ antenatal classes
  • Two 2D ultrasound scans
Babies <2 years
Two consultations at a paediatrician/ GP/ ear, nose, and throat specialist
Child immunisation
Standard immunisations up to seven years
Health screenings
  • One combo health screening (blood glucose, cholesterol, BMI, and blood pressure measurement)*
    or
    an individual test (blood glucose or cholesterol)
  • HIV testing, counselling, and support
Preventive care benefits
  • A tetanus vaccine
  • A flu vaccine
  • A mammogram* every two years
  • A Pap smear* every three years
  • A prostate test*
  • A pneumococcal vaccine
  • An FOBT test* 
  • A bone mineral density test* every two years
  • Two HPV vaccinations for girls and boys between 10-14 years or three between 15-26 years
Contraceptives
  • Oral/ injectable/ implantable contraceptives – R150 per month, up to R2 000 per year
  • Intra-uterine device – R2 300 every 60 months
Supporting wellness
  • Back treatment at a Documentation Based Care facility (a prerequisite for spinal column surgery)
  • One dietician consultation if BMI is >30

*Making use of these benefits activate the care extender benefit.

In-hospital treatment and life-essential services (insured benefits)

Hospitalisation
No overall annual limit
Network hospitals
Day procedure network applies for certain day procedures
Trauma that necessitates hospitalisation
Unlimited
Childbirth
  • In hospital – unlimited
  • Home delivery – R15 600 per event
Standard radiology
Unlimited during hospitalisation
Specialised radiology
Angiography, MRI, and CT imaging – unlimited
Emergency transport (Netcare 911)
  • In country of residence
    Unlimited (RSA, Lesotho, Eswatini, Mozambique, Zimbabwe, Namibia, and Botswana)
  • Outside country of residence
    R2 400 for road transport and R16 100 for air transport
Treatment of life-threatening conditions
Unlimited
Includes 271 PMB and 26 Chronic Disease List (CDL) conditions
PMB medicine
Unlimited
Network pharmacy applies
Cancer treatment
  • PMB – unlimited
  • Non-PMB – R242 500 per family
Mental health (psychiatric treatment)
R22 900 per person to a maximum of R34 700 per family
Internally implanted prostheses
PMB only – unlimited
Organ transplants
PMB only – unlimited
Cornea implants – R34 200 per implant
Palliative care
R20 700 per family
Other core benefits
Including renal dialysis, prostatectomy, oxygen, subacute care, and private nursing services as an alternative to hospitalisation

 

Day-to-day benefit
Member = R3 300
Member + 1 = R5 850
Member + 2 = R6 700
Member + 3 = R7 100
Member + 4 + = R7 750
Specialist consultations and services, standard radiology, pathology (Ampath, Lancet, and PathCare Vermaak), acute medicine, and clinical psychology services
Subject to day-to-day benefit
Self-medication (non-prescribed medicine)
Member = R580
Family = R1 700
Subject to day-to-day benefit

Network GP consultations
Member = R2 200
Member + 1 = R4 050
Member + 2 = R4 750
Member + 3 = R5 100
Member + 4 + = R5 700

Non-network GP consultations
Member = R1 350
Family = R2 700
Medical appliances
R1 100 per family
Physiotherapy and occupational therapy (in an out of hospital)
Member = R2 400
Family = R3 750
Radiography
R1 250 per family
Dentistry (DRC network)
Routine check-ups, fillings, X-rays, oral hygiene, and removal of impacted wisdom teeth
Optometry (PPN network)
Per person per 24-month cycle
  • Eye test
  • R595 for a frame/ lens enhancements
  • R800 for contact lenses

 

One additional GP consultation
Activates for the family once the first claim for either a Pap smear, mammogram, prostate test, faecal occult blood test (FOBT) or bone mineral density test is paid from your added insured benefits

R490 for self-medication
Activates for the family once the first claim for a combo health screening (blood glucose, cholesterol, BMI, and blood pressure measurement) is paid from your added insured benefits
This is only a summary of the available benefits and co-payments may apply to certain benefits. Please consult the registered Rules of Medihelp and your plan’s brochure for more details. In case of a dispute, the Rules of Medihelp will apply (subject to approval by the Council for Medical Schemes). Certain added insured benefits are not available if the patient has registered the medical condition for PMB or chronic medicine benefits, as the treatment is no longer considered as preventive care.
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