Health Plans: Access Option

Access Option 2020

• Unlimited hospitalisation In Network subject to sub-limits not being exceeded. Annual Member Savings Account:

       Member = 5 880

       Adult = 5 064
       Child = 1 142
       Out of hospital subject to sub limits and MSA*

• Statutory Prescribed Minimum Benefits (PMBs).  Services rendered are payable at 100% of cost at designated service providers (DSPs) with no annual limit

• 3 Month General Waiting Periods (Subject to the rights of interchangeability)

• 12 Months condition specific waiting period for pre-existing conditions (Subject to the rights of interchangeability)

• Claims received later than the last day of the 4th month in which the service was rendered will not be covered

• 100% of Scheme rates are payable in RSA currency for emergencies when travelling abroad (subject to PMBs). This is also subject to completion of documentation prior to leaving RSA and requires approval by the Scheme

Download shows Benefits across all Options