necesse full-time student - 2018

from R474 per month

Necesse is an affordable healthcare solution for students that provides quality private cover through an extensive network of private hospitals and healthcare providers for your medical expenses incurred in and out of hospital.

 Medihelp Medical Scheme Full time student option


What do you pay?

You pay only R474 if your monthly income does not exceed R400 and if you can provide us with a letter on an official letterhead from your tertiary institution confirming that you are registered as a full-time student.

What are your benefits?

Hospital and trauma cover medical aid

Hospital cover

Emergency cover medical aid

Emergency cover

Doctors visit medical aid

Doctors' visits

Specialist care and essential  medical aid

Specialist care

Back treatment and xrays programme medical aid

X-rays & blood tests

Prescribed medicine medical aid

Prescribed medicine

Dentistry

Dentistry

Eye care

Eye care


 

Preventive care benefits

Our preventive care benefits are designed to enable you to identify potential health problems.

Health tests medical aid

Health tests

One test per student per year requested by a Necesse network GP:

  • 1 blood glucose test
    (pathology: 4057)
  • 1 cholesterol test
    (pathology: 4027)

Immunisation medical aid

Immunisation

One immunisation per student per year requested by a Necesse network GP:

  • 1 flu vaccine
  • 1 tetanus vaccine

Back treatment and xrays programme medical aid

Back treatment programme

1 Document-Based Care (DBC) programme per student per year at a DBC facility (subject to protocols and pre-authorisation)

* Benefits are subject to day-to-day benefits. 

Core benefits

These include benefits for major medical expenses such as hospitalisation, emergency benefits and home care as an alternative to hospitalisation.


Hospital and trauma cover medical aid

Trauma cover

Unlimited cover for trauma that necessitates hospitalisation in the case of motor vehicle accidents, stab wounds, gunshot wounds, head trauma, burns and near drowning.

Emergency cover medical aid

Emergency cover

  • Unlimited emergency cover in South Africa for transport by road or air by Netcare 911
  • R1 000 per student for outpatient emergency unit services, non-network doctors’ visits, as well as medicine and services rendered by a non-network medical doctor.

Specialist care and essential  medical aid

Essential cover

We offer 100% cover for 270 conditions and 26 chronic diseases treated by designated service providers and networks according to treatment protocols. This includes oncology, HIV, prostheses and medical, surgical and orthopaedic appliances.

 

Hospitalisation

100% cover for hospitalisation in a network hospital (subject to pre-authorisation and protocols)

Physio- and occupational therapy

R8 950 per year in hospital

Clinical technologist services

R20 200 per year in hospital

Radiology & pathology

  • R27 700 per year for standard radiology, pathology and medical technologist services in hospital
  • R15 000 per year for specialised radiology in and out of hospital. Services must be requested by a specialist on referral by a network GP and benefits are subject to clinical protocols.
    • MRI, CT imaging (subject to pre-authorisation) and angiography

Alternative care to hospitalisation

R20 200 per year for sub-acute care and private nursing services as an alternative to hospitalisation

Appendectomy

  • Conventional procedure – unlimited
  • Laparoscopic procedure – R15 800 for hospital costs

Day-to-day benefits

Day-to-day benefits include GP visits, dental procedures and eye care.


Consultations

  • 9 network GP consultations per student per year
  • R2 950 per student per year for specialist care (subject to referral by a Necesse network GP and pre-authorisation)
 

Optometry
Available per student in a 24-month cycle:

  • 1 complete consultation
  • Spectacles or contact lenses 

Spectacles

  • R200 for the frame
  • 1 pair of standard clear Aquity single vision, bifocal or multifocal lenses

Contact lenses

  • R450 per student

Other medical services

  • R1 900 per student per year for physiotherapy and occupational therapy out of hospital, if requested by a network GP
  • 100% of the Medihelp tariff for black and white X-rays and soft-tissue ultrasound scans (subject to codes)
  • 100% for blood tests (subject to a list of pathology codes and tests), done by Lancet/ PathCare on request of a network GP 
 

Dental

  • Routine check-ups
  • 4 fillings per student, 1 filling per tooth in 365 days
  • Tooth extractions
  • Root canal treatment in the dentist’s chair for 2 teeth per student per year
  • Laughing gas (in the dentist’s chair)
  • Extensive dental treatment under conscious sedation in the dentist’s chair (sedation cost), subject to pre-authorisation
  • X-rays
    • 4 intra-oral X-rays per student per year
    • 1 extra-oral X-ray per student in a 3-year period

Medicine

  • Acute medicine dispensed by a dispensing network GP
  • A list of approved medicine obtained from a network pharmacy and prescribed by a network GP or network dentist
  • Self-medication obtained from a network pharmacy
    • R100 per event
    • R270 per student per year
 

Important notes:

  • If a beneficiary joins during the course of a financial year, the medical aid benefits are calculated pro rata according to the remaining number of months per year.
  • This is a summary of the available benefits. In the event of a dispute the registered Rules of Medihelp will apply, subject to approval by the Council of Medical Schemes. Phone Medihelp on 086 0100 678 if you have any enquiries about the Rules of Medihelp Medical Scheme.

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