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MedElect


MedElect’s quality networks enable comprehensive cover at an affordable premium for those individuals and families requiring more care.

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Quick price overview: include dependants

Adult

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Child

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*You only pay for two children younger than 18 years, until they are 26 years old
MedElect

Added insured benefits

Women’s & men’s health tests

Contraceptives

Maternity & baby benefits

Screenings & immunisations

MedElect

Core benefits

Specialised radiology

Emergency transport services | Trauma cover

Hospital benefits (no overall annual limit)

Network hospitals

270 PMB conditions - Diagnosis, treatment & care | 26 chronic illnesses (CDL)

MedElect

Day-to-day benefits

Network GP consultations & virtual care
M = R2 100 | M+1 = R3 700
M+2 = R4 350 | M+3 = R4 650
M+4+ = R5 200
Physiotherapy & occupational therapy
M = R2 200 | M+ = R3 450

MedElect

Day-to-day benefits

Specialist visits, radiology, pathology, clinical psychology, acute medicine
M = R3 000 | M+1 = R5 300
M+2 = R6 100 | M+3 = R6 500
M+4+ = R7 000
Dentistry | Optometry
Care extender benefit

 

 R0 - R800
(Student)
R801+
Principal memberPrincipal memberR702R2 226
DependantDependantR702R1 740
Child dependant <21 yearsChild dependantR702R720
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
  • 10 antenatal and post-natal consultations at a midwife/ GP/ gynaecologist
  • 2 antenatal and post-natal consultations at a dietician/ lactation specialist/ antenatal classes
  • Two 2D ultrasound scans
Babies <2 years
2 consultations at a paediatrician/ GP/ ear, nose and throat specialist
Child immunisation
Standard immunisations up to 7 years
Health screenings
  • One combo health screening (blood glucose, cholesterol, BMI & blood pressure measurement)*
    or
    an individual test (blood glucose or cholesterol)
  • HIV testing, counselling & support
Preventive care benefits
  • A tetanus vaccine
  • A flu vaccine
  • A mammogram* every 2 years
  • A Pap smear* every 3 years
  • A prostate test*
  • A Pneumovax vaccine
  • A Faecal occult bood test (FOBT)* 
  • A bone mineral density test* every 2 years
  • 2 HPV vaccinations for girls and boys between 10-14 years or three between 15-26 years
Contraceptives
  • Oral/ injectable/ implantable contraceptives – R140 per month, up to R1 600 per year
  • Intra-uterine device – R2 100 every 60 months
Supporting wellness
  • Back treatment at a Document Based Care facility (a prerequisite for spinal column surgery)
  • Chronic Care programme
  • One dietician consultation if BMI is >30

*Care extender benefits are extra benefits activated when a beneficiary makes use of certain added insured benefits. 

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 – R14 100 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 & Botswana)
  • Outside country of residence
    R2 210 for road transport and R14 700 for air transport
Treatment of life-threatening conditions
Unlimited
Includes 270 PMB and 26 Chronic Diseases List (CDL) conditions
PMB medicine
Unlimited
Cancer treatment
  • PMB – unlimited
  • Non-PMB – R220 000 per family
Mental health (psychiatric treatment)
R20 800 per person to a maximum of R31 600 per family
Internally implanted prostheses
PMB only – unlimited
Organ transplants
PMB only – unlimited
Cornea implants – R31 100 per implant
Palliative care
R18 800 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 000
Member +1 = R5 300
Member +2 = R6 100
Member +3 = R6 500
Member +4+ = R7 000
Specialist consultations and services, standard radiology, pathology, acute medicine and clinical psychology services
Subject to day-to-day benefit
Self-medication (non-prescribed medicine)
Member = R530
Family = R1 570
Subject to day-to-day benefit
Network GP consultations
Member = R2 100
Member +1 = R3 700
Member +2 = R4 350
Member +3 = R4 650
Member +4+ = R5 200
Non-network GP consultations
Member = R1 200
Family = R2 450
Medical appliances
R1 000 per family
Physiotherapy and occupational therapy
Member = R2 200
Family = R3 450
Radiography
R1 150 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
  • R550 for a frame/ lens enhancements
  • R750 for contact lenses
  • Replacement of lost/ broken spectacles

 

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

R450 for self-medication
Activates for the family once the first claim for a combo health screening (blood glucose, cholesterol, BMI & 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.