Prime 2 - 15% savings plan in 2021
The combination of a savings account, an insured benefit activated after depletion of the savings account and a basket of preventive and insured benefits for every life stage takes care of your healthcare needs. Prime 2 provides extensive hospital cover either at any facility or through a quality network (pay 22% less for the network option).
View a summary of Prime 2’s monthly contributions and benefits
| Network | Non-network | ||
| Principal member |  | R2 286 (R342 savings contribution included per month and R4 104 per year) | R2 934 (R438 savings contribution included per month and R5 256 per year) |
| Dependant | | R1 884 (R282 savings contribution included per month and R3 384 per year) | R2 412 (R360 savings contribution included per month and R4 320 per year) |
| Child dependant < 26 years |  | R684 (R102 savings contribution included per month and R1 224 per year) | R882 (R132 savings contribution included per month and R1 584 per year) |
| You only pay for two children younger than 18 years, after which child dependant rates will apply from the beginning of the year following the year in which they turn 18, until they are 26 years old. The monthly contribution does not take any employer subsidy into account. | |||
These benefits are provided in addition to other insured benefits and are available annually, unless otherwise indicated. Protocols and specific item codes may apply. Network information is available on the provider search page. Register for HealthPrint, Medihelp’s free online health and wellness programme, to activate these benefits.
| Routine screening and immunisation Available at network pharmacy clinics per person:
| Women's health
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Supporting wellness
| Men's health
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| Enhanced maternity benefits Registration on HealthPrint’s Maternity and Baby programme will activate these additional benefits:
| Child benefits
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Over 50s
| HealthPrint
Medihelp members get free access to this online health and wellness programme designed to add value based on their health profile through programmes such as the Maternity and Baby programme. |
Hospitalisation Non-network: any hospital Day surgery network: 134 day surgeries for certain procedures | Emergency transport
Netcare 911 In country of residence RSA, Lesotho, Eswatini, Mozambique, Namibia & Botswana – unlimited Outside country of residence Transport by road R2 130 and by air R14 200 per case |
Chronic illness/ PMB
| Specialised radiology
In and out of hospital
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| Psychiatric treatment In and out of hospital R25 300 per beneficiary per year (maximum R34 800 per family per year) | Oncology In and out of hospital
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Confinement (childbirth)
| Organ transplants PMB only – 100% of the cost Cornea implants – R29 900 per implant per year |
| Other core benefits Renal dialysis, oxygen, hospice, sub-acute care and private nursing services as an alternative to hospitalisation | Post-hospital care R1 870 per member and R2 600 per family per year for speech therapy, occupational therapy and physiotherapy for up to 30 days after discharge |
Prostheses benefits
| Palliative care 100% of the MT R22 000 per family per year |
15% savings account
| Medicine
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| Insured day-to-day benefits Paid from savings first GP and specialist consultations, physiotherapy, acute medicine and self medication, including visits to emergency units Member = R1 250 per year Member+ = R2 500 per year Network option GP network and specialist referrals from a network GP apply
| Dentistry DRC network applies
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| Optometry Savings account | External prostheses and medical appliances In and out of hospital
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Important:
This is only a summary of the available benefits. Please consult the registered Medihelp Rules for more information and details of services that are excluded from benefits. In case of a dispute, the Rules of Medihelp will apply (subject to approval by the Council for Medical Schemes).
Procedure-specific deductibles
Abbreviations
This is only a summary of the available benefits. Please consult the registered Medihelp Rules for more information and details of services that are excluded from benefits. 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 you have been registered for a chronic/ PMB condition, as the treatment is no longer considered as preventive care.
Some benefits may be linked to a specific age/ gender/ item code. Benefits are paid at 100% of the MT. - Doctors' consultations are paid from the available savings/ day-to-day benefits.
- Benefits may be subject to pre-authorisation and/ or protocols.
Procedure-specific deductibles
- Spinal column surgery – R10 850 per admission
- All endoscopic procedures (in hospital/ day clinic) – R4 050 (services should be rendered in a day surgery network to avoid a further 35% deductible)
- Specialised radiology (in and out of hospital) – R2 500 per examination
- Dental procedures under general anaesthesia during hospitalisation
Removal of impacted teeth (3rd molars – only specific item codes are paid on the dentist's account) and extensive dental treatment for children <7 years – R3 430 per admission - Hysterectomy and endometrial ablation – R6 000 per admission
- Prostatectomy (conventional/ laparoscopic procedures only) – R6 000 per admission
Abbreviations
BMI-Body mass index | CDL-Chronic Diseases List | COPD-Chronic obstructive pulmonary disease | CT-Computerised tomography | DRC-Dental Risk Company |DSP-Designated service provider | EMS-Emergency medical services | EVARS-Endovascular aortic replacement surgery | FOBT-Faecal occult blood test | GP-General practitioner | HPV-Human papilloma virus | OAL-Overall annual limit |MHRP-Medihelp Reference Price | MRI-Magnetic resonance imaging | MT-Medihelp tariff paid by Medihelp for benefits which can include a contracted tariff or the single exit price | PMB-Prescribed minimum benefits
Prime hospital network
Day surgery network
Specialist network
Savings account explanation
