Necesse Student in 2021
Necesse is the ideal healthcare solution for full-time students and provides quality cover through an extensive network of private hospitals and healthcare providers for medical expenses incurred in and out of hospital.
From R636 per month
View a summary of Necesse’s monthly contributions and benefits
These benefits are provided in addition to other insured benefits and are available annually, unless otherwise indicated. Benefits for certain services may be limited to specific item codes and protocols may apply. A GP network and referrals to a specialist also apply. Network information is available on the provider search page. Register for HealthPrint, Medihelp’s free online health and wellness programme, to activate benefits as indicated.
| Routine screening and immunisation Available at network pharmacy clinics per person:
| Women's health
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Supporting wellness
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Hospitalisation 100% of the MT for hospitalisation in a network hospital(subject to pre-authorisation and protocols) | Emergency cover Unlimited emergency cover in South Africa for transport by road or air, pre-authorised and provided by Netcare 911 |
| Day procedures 100% of the MT Day procedure network applies Ophthalmological, endoscopic, dental procedures and ear, nose and throat procedures, as well as skin lesion removal and circumcisions | Emergency unit services and out-of-network visits
Outpatient emergency unit services, non-network doctors' visits, including medicine, services and radiology |
Chronic illness/ PMB & trauma
| Radiology & pathology
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| Alternative care to hospitalisation R23 100 per year for sub-acute care and private nursing services as an alternative to hospitalisation | Physiotherapy and occupational therapy In hospital, R10 250 per year (services rendered in hospital must be requested by the attending medical doctor) |
| Appendectomy Conventional or laparoscopic procedure – 100% of the MT | Organ transplant PMB – 100% of the cost
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| Clinical technologist services R23 100 per year (in hospital) |
Consultations
| Other medical services
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| Optometry
PPN network of optometrists Available per student in a 24-month cycle:
| Dentistry
DRC network of dentists
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Medicine
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Service provider networks
You must use your option's network hospitals and day procedure facilities, pharmacies, doctors and specialists when you require medical treatment. By using network providers, you will avoid additional expenses and ensure that the treatment is considered for benefits. To find a network provider, use the provider search function on this website.
- Spinal column surgery – R15 000 per admission (non-surgical back treatment at a DBC clinic is a prerequisite)
- All endoscopic procedures (in hospital/ day clinic) – R4 500 (services should be rendered in a day procedurenetwork to avoid a further 35% deductible)
- Hospital network: Use network hospitals for all planned hospital admissions
- Day surgery network: Use the day surgery network when you need to undergo ophthalmological, endoscopic and ear, nose and throat procedures, as well as skin lesion removal, dental procedures and circumcisions
- Medihelp Preferred Pharmacy Network: Have your prescribed medicine dispensed at a network pharmacy to qualify for benefits
- GP network: Use a network GP for day-to-day treatment and for referrals to specialists, including for radiology and pathology
- Specialist network: Use network specialists, as they have been matched to our network hospitals
Explanation of terms
An emergency medical condition means any sudden and unexpected onset of a health condition that requires immediate medical or surgical treatment, where failure to provide such treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place the person's life in serious jeopardy. An emergency medical condition must be certified as such by a medical practitioner. Emergencies qualify for PMB and must therefore also be registered for PMB (see also "PMB").
Hospital benefits refer to benefits for services rendered by a network hospital during a patient's stay in hospital. Services include ward accommodation and ward medicine, standard radiology, pathology and consultations during hospitalisation. Hospital benefits are subject to pre-authorisation and an 80% benefit will apply to the hospital account if the admission is not pre-authorised. Emergency admissions must be registered on the first workday following the admission. A 65% benefit applies for voluntary admission to a non-network hospital.
PMB – Prescribed minimum benefits are paid for 26 chronic conditions on the Chronic Diseases List (CDL) and 270 diagnoses with their treatments as published in the regulations under the Medical Schemes Act
131 of 1998. In terms of these Regulations, medical schemes are compelled to grant benefits for the diagnosis, treatment and care costs of any of these conditions as well as emergency medical conditions
(that meet the published definition) without imposing any limits, PMB are subject to pre-authorisation, protocols and the utilisation of designated service providers where applicable, e.g. Lancet/ PathCare for pathology tests and a specialist in the Necesse specialist network. PMB services are first funded from the related day-to-day benefits.