MedPrime

Apart from private hospitalisation, you get excellent cover for out-of-hospital services through a savings account and insured pooled benefits, as well as comprehensive separate dental and optometry benefits. Pay less for MedPrime Elect, the network alternative of this plan.

from

R3 918 per month

in 2024

Contribution calculator for {{small.SelectedProductName}}
Add your dependants

Main member

1 ({{small.model.MainMemberTotal}} a month)

{{small.StudentProducts.indexOf(small.SelectedProductCode) !== -1 ? 'Adults aged 21 and older' : 'Adults aged 26 and older'}}

Children aged 18-25

Children up to age 25 Children up to age 20 Children up to age 17*

{{small.model.DiscountOption ? '*You only pay for two children younger than 18 years, until they are 26 years old' : ' '}}

Total monthly contribution is:
{{small.model.Total}} a month

Apply here

Speak to an adviser

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.

I am not a member

I am a member

Added insured benefits

Women’s and men’s health tests

Contraceptive benefits

Maternity and baby benefits

Cover for health tests, vaccinations, and screenings

Core benefits

Specialised radiology benefit

Emergency transport services | Post-hospital benefit | Trauma cover

Hospital benefits (no overall annual limit)

MedPrime Elect (network hospitals)

271 PMB conditions - diagnosis, treatment, and care and 26 chronic illnesses (CDL)

Day-to-day benefits

10% savings account
Insured pooled benefits after depletion of savings account funds
GPs, specialists, medicine, and other day-to-day services
Member = R6 900 | Family = R12 700
10% savings account
Dentistry | Optometry
Care extender benefit

Product Summary (PDF)

Network facilities (PDF)

Monthly contributions

	MedPrime Elect	MedPrime
Main member	R3 918 (R390 savings contribution included per month and R4 680 per year)	R4 782 (R480 savings contribution included per month and R5 760 per year)
Dependant	R3 306 (R330 savings contribution included per month and R3 960 per year)	R4 044 (R402 savings contribution included per month and R4 824 per year)
Child dependant <26 years	R1 140 (R114 savings contribution included per month and R1 368 per year)	R1 398 (R138 savings contribution included per month and R1 656 per year)
Pay for only two children under the age of 18 and pay child dependant rates until they turn 26

Added insured benefits

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 Nine months’ antenatal iron supplements Nine months’ antenatal folic acid supplements	Babies < 2 years Two consultations at a paediatrician/ GP/ ear, nose, and throat specialist
	Child immunisation Standard immunisation up to seven years
Health screening tests 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 – R170 per month, up to R2 250 per year Intra-uterine device – R2 600 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.

Core benefits

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

Hospitalisation No overall annual limit MedPrime: Any private hospital. Day procedure facilities apply for certain day procedures MedPrime Elect: Network hospitals. Network day procedure facilities apply for certain day procedures	Refractive surgery R13 700 per family per event (beneficiaries 18 to 50 years)
Trauma that necessitates hospitalisation Unlimited	Childbirth In hospital – unlimited Home delivery – R15 600 per event
Specialised radiology Angiography, MRI, and CT imaging – unlimited	Post-hospital care for speech therapy, occupational therapy, and physiotherapy R2 200 per member and R3 150 per family
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 MedPrime Elect: Formulary and DSPs may apply	Cancer treatment PMB – unlimited Non-PMB – R313 900 per family
Mental health (psychiatric treatment) R34 700 per person to a maximum of R46 800 per family	Health-essential functional prostheses R73 800 per person Intra-ocular lenses – R4 900 per lens, two lenses per person Hip, knee, and shoulder replacements – non-PMB cases are limited to replacements caused by an acute injury
Other prostheses EVARS prosthesis – R155 600 per person Vascular/ cardiac prosthesis – R66 500 per person Prosthesis with reconstructive or restorative surgery and external breast prostheses – R11 300 per family Implantable hearing devices (including device and components) – R286 600 per person	Organ transplants PMB – unlimited Cornea implants – R34 200 per implant
Palliative care R27 500 per family	Other core benefits Including renal dialysis, prostatectomy, oxygen, hospice, subacute care, and private nursing services as an alternative to hospitalisation

Day-to-day benefits

Savings account 10% savings available at the beginning of the year (see monthly contributions) Example of savings: MedPrime Elect: Member = R4 680 per year Member + dependant = R8 640 per year Member + dependant + child = R10 008 per year MedPrime: Member = R5 760 per year Member + dependant = R10 584 per year Member + dependant + child = R12 240 per year Unused savings are carried over to the next year and accumulate interest. Once your savings are depleted, insured day-to-day benefits become available	GPs and specialists, clinical psychology, physiotherapy, supplementary health services, acute medicine, non-PMB chronic medicine, standard radiology, and pathology (Ampath, Lancet, and PathCare Vermaak) Available after depletion of savings account Member = R6 900 Family = R12 700
	Optometry (PPN network) Per person per 24-month cycle Eye test R865 for a frame/ lens enhancements R1 270 for contact lenses
Conservative dentistry (DRC network) Routine check-ups, fillings, X-rays, and oral hygiene	Specialised dentistry (DRC network) Crowns, bridges, and orthodontic treatment
External prostheses and medical appliances Per family per three-year cycle Artificial eyes – R5 450 Speech and hearing aids – R5 450 Wheelchairs – R5 450 Artificial limbs – R5 450 CPAP apparatus – R11 400 per person per two-year cycle Medical appliances and hyperbaric oxygen treatment – R1 550 per family	Radiography R1 250 per family

Care extender (activate additional day-to-day beneftis)

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.

MedPrime

{{small.model.NumOfAdultDependants}}

{{small.model.NumOfYoungAdultDependants}}

{{small.model.NumOfChildDependants}}

Looking for a new medical aid?

Help

Members

Join

Connect