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MedAdd


As you progress through life, MedAdd will provide the layers of benefits you seek. Add a 15% savings account to provide for flexibility and outof-hospital expenses, built on a solid foundation of private hospital and emergency cover and additional out-of-hospital benefits. Pay 24% less when opting for MedAdd Elect, the network alternative of this plan.

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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
MedAdd

Added insured benefits

Women’s & men’s health tests

Contraceptives

Maternity & baby benefits

Screenings & immunisations

MedAdd

Core benefits

Specialised radiology

Emergency transport services | Post-hospital | Trauma cover

Hospital benefits (no overall annual limit)

MedAdd Elect (network hospitals)

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

MedAdd

Day-to-day benefits

Insured benefits (paid from savings first)

M = R1 300 | M+ = R2 600

15% savings account

Dentistry | Optometry

Care extender benefit

 MedAdd ElectMedAdd
Principal memberPrincipal memberR2 148
(R324 savings contribution included per month and R3 888 per year)
R2 598
(R390 savings contribution included per month and R4 680 per year)
DependantDependantR1 602
(R240 savings contribution included per month and R2 880 per year)
R2 202
(R330 savings contribution included per month and R3 960 per year)
Child dependant < 26 yearsChild dependantR750
(R114 savings contribution included per month and R1 368 per year)
R882
(R132 savings contribution included per month and R1 584 per year)
Pay for only 2 children under the age of 18 and 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.

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
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
Contraceptives
  • Oral/ injectable/ implantable contraceptives – R145 per month, up to R1 690 per year
  • Intra-uterine device – R2 300 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
Babies <2 years

2 consultations at a paediatrician/ GP/ ear, nose and throat specialist

Child immunisation

Standard immunisation up to 7 years

 

*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

MedAdd: Any private hospital
MedAdd Elect: Network hospitals and day procedure 
network applies to certain day procedures 
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 
Trauma that necessitates hospitalisation
Unlimited
Specialised radiology
Angiography, MRI and CT imaging – unlimited
    Post-hospital care for speech therapy, occupational therapy and physiotherapy
    R2 000 per member and R2 800 per family
    Childbirth
    • In hospital – unlimited
    • Home delivery – R14 100 per event
    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 – R250 000 per family
    Mental health (psychiatric treatment)
    R26 300 per person to a maximum of R36 200 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 – non-PMB cases are limited to replacements caused by an acute injury

    Other prostheses
    • EVARS prosthesis – R141 200 per person
    • Vascular/ cardiac prosthesis – R60 400 per person
    • Prosthesis with reconstructive or restorative surgery – R10 300 per family
    Organ transplants
    PMB – unlimited
    Cornea implants – R31 100 per implant
    Palliative care
    R22 900 per family
    Other core benefits
    Including renal dialysis, oxygen, hospice, subacute care and private nursing services as an alternative to hospitalisation
     

    Savings account
    15% savings available at the beginning of the year (see monthly contributions)

    Example of available savings:

    MedAdd:
    Member = R4 680 per year
    Member +1 = R8 640 per year
    Member +2 = R10 224 per year

    MedAdd Elect:
    Member = R3 888 per year
    Member +1 = R6 768 per year
    Member +2 = R8 136 per year

    Unused savings are carried over to the next year and earn interest. Once your savings are depleted, insured day-to-day benefits become available.

    GP and specialist visits, virtual consultations, physiotherapy, acute medicine, self-medication and visits to emergency units
    Paid from savings first
    Member = R1 300 per year 
    Family = R2 600 per year 
    MedAdd Elect: GP network and specialist referrals by a network GP apply
    Radiography
    R1 150 per family
    Dentistry (DRC network)
    • Conservative dental benefits for children <18 years
    • Removal of impacted teeth in the dentist’s chair
    Optometry (PPN network)
    Per person per 24-month cycle
    • Eye test
    • R275 for a frame / lens enhancements
    • R650 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

    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.