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MedPlus


Medihelp’s top-of-the-range product offers the most extensive cover to ensure that your and your family’s healthcare needs are always well taken care of.

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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
MedPlus

Added insured benefits

Women’s & men’s health tests

Contraceptives

Maternity & baby benefits

Screenings & immunisations

MedPlus

Core benefits

Specialised radiology

Emergency transport services  | Post-hospital | Trauma cover

Hospital benefits (no overall annual limit)

Any hospitals

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

MedPlus

Day-to-day benefits

GPs, specialists & supplementary services

Pooled benefits

Acute medicine benefits

Chronic medicine benefits

Standard radiology benefits

Dentistry | Optometry

Pathology benefits

Care extender benefit

Principal memberPrincipal memberR10 122
DependantDependantR10 122
Child dependant < 26 yearsChild dependantR2 526
Children pay child dependant rates until they turn 26

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
  • 9 months’ antenatal iron supplements
  • 9 months’ antenatal folic acid supplements
Babies < 2 years
2 consultations at a paediatrician/ GP/ ear, nose and throat specialist
Child immunisation
Standard immunisation up to 7 years
Health screening tests
  • 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 blood 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 – R160 per month, up to R1 900 per year
  • Intra-uterine device – R2 500 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 make use of certain added insured benefits.

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

Hospitalisation
No overall annual limit
Any private hospital
Refractive surgery
Unlimited
Trauma that necessitates hospitalisation
Unlimited
Childbirth
  • In hospital – unlimited
  • Home delivery – R14 100 per event
Specialised radiology
  • Angiography, MRI and CT imaging – unlimited
  • PET scans – R24 000 per case
Post-hospital care for speech therapy, occupational therapy and physiotherapy
R2 000 per member and R2 800 per family
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
Unlimited
Mental health (psychiatric treatment)
R46 600 per person to a maximum of R63 500 per family
Health-essential functional prostheses
R67 000 per person
  • Intra-ocular lenses – R4 480 per lens, 2 lenses per person
  • Hip, knee and shoulder replacement – PMB and non-PMB
Other prostheses
  • EVARS prosthesis – R141 200 per person
  • Vascular/cardiac prosthesis – R60 400 per person
  • Prosthesis with reconstructive or restorative surgery and external breast prostheses – R10 300 per family
  • Implantable hearing devices (including device and components) – R291 000 per person
Organ transplants
PMB only – unlimited
Cornea implants – R31 100 per implant
Bone marrow/stem cell transplants – R342 000 per person
Palliative care
R29 200 per family
Other core benefits
Including renal dialysis, prostatectomy, oxygen, hospice, subacute care and private nursing services as an alternative to hospitalisation
GP and specialist visits, virtual consultations, physiotherapy, clinical psychology, psychiatric nursing and supplementary health services
R3 900 per person (pooled per family)
Acute medicine
R7 000 per person (pooled per family)
Non-PMB chronic medicine
R20 000 per person
External prostheses and medical appliances
Per person per 3-year cycle
  • Artificial eyes – R17 100
  • Speech and hearing aids – R17 100
  • Wheelchairs – R9 300
  • Artificial limbs – R9 300
  • Wigs – R2 000

CPAP apparatus – R10 400 per person per 2-year cycle

Medical appliances and hyperbaric oxygen treatment – R2 000 per person

Optometry (PPN netwerk)
Eye testPer person per 24-month cycle
  • R1 000 for a frame/l ens enhancements
  • R1 680 for contact lenses
  • Replacement of lost/ broken spectacles
Conservative dentistry (DRC network)
Routine check-ups, fillings, X-rays and oral hygiene
Specialised dentistry (DRC network)
Crowns, implants, bridges and orthodontic treatment
Standard radiology
Unlimited
Radiography
R1 150 per family
Pathology
Unlimited

 

One additional GP consultation
AActivates 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 deductibles 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.