MedAdd

MedAdd

The flexibility of a 15% savings account, additional insured cover once you’ve depleted your savings, cover for dental and eye care, as well as pregnancy benefits make this a popular choice for young families. Pay less for MedAdd Elect, the network alternative of this plan.

from
R2 676 per month
in 2024
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Main member
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Children aged 18-25

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

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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.


MedAdd

Added insured benefits

Women’s and men’s health tests

Contraceptive benefits

Maternity and baby benefits

Cover for health tests, vaccinations, and screenings

MedAdd

Core benefits

Specialised radiology

Emergency transport services | Post-hospital | Trauma cover

Hospital benefits (no overall annual limit)

MedAdd Elect (network hospitals)

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

MedAdd

Day-to-day benefits

15% savings account

Insured benefits (paid from savings first)

Member = R1 450 | Family = R2 800

Dentistry | Optometry

Care extender benefit

 MedAdd ElectMedAdd
Main memberMain member

R2 676
(R402 savings contribution included per month and R4 824 per year)

R3 354
(R504 savings contribution included per month and R6 048 per year)

DependantDependant

R2 100
(R312 savings contribution included per month and R3 744 per year)

R2 832
(R426 savings contribution included per month and R5 112 per year)

Child dependant < 26 yearsChild dependant

R930
(R138 savings contribution included per month and R1 656 per year)

R1 134
(R168 savings contribution included per month and R2 016 per year)

Pay for only two 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, 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
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
Contraceptives
  • Oral/ injectable/ implantable contraceptives – R160 per month, up to R2 100 per year
  • Intra-uterine device – R2 500 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
Babies <2 years

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

Child immunisation

Standard immunisation up to seven years

 

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

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

Hospitalisation
No overall annual limit

MedAdd: Any private hospital. Day procedure facilities apply for certain day procedures
MedAdd Elect: Network hospitals. Day procedure network applies to certain day procedures 
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 
Trauma that necessitates hospitalisation
Unlimited
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
    Childbirth
    • In hospital – unlimited
    • Home delivery – R15 600 per event
    Treatment of life-threatening conditions
    Unlimited
    Includes 271 PMB and 26 Chronic Disease List (CDL) conditions
    PMB medicine
    Unlimited 
    MedAdd Elect: Formulary and DSPs may apply
    Cancer treatment
    • PMB – unlimited
    • Non-PMB – R275 100 per family
    Mental health (psychiatric treatment)
    R28 900 per person to a maximum of R39 900 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 replacement – 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 – R11 300 per family
    Organ transplants
    PMB – unlimited
    Cornea implants – R34 200 per implant
    Palliative care
    R25 200 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 = R6 048 per year
    Member + dependant = R11 160 per year
    Member + dependant + child = R13 176 per year

    MedAdd Elect:
    Member = R4 824 per year
    Member + dependant = R8 568 per year
    Member + dependant + child = R10 224 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.

    GP and specialist visits, virtual consultations, physiotherapy, acute medicine, self-medication, and visits to emergency units
    Paid from savings first
    Member = R1 450 per year 
    Family = R2 800 per year 
    MedAdd Elect: GP network and specialist referrals by a network GP apply
    Radiography
    R1 250 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
    • R300 for a frame/ lens enhancements
    • R690 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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