Health Plans: Essential Option

Essential Option 2020

  • Annual limits are limited to PMB conditions only for in and out of hospital benefits and are subject to sub-limits not being exceeded

  • Prorated benefits are applicable if you join after the 1st of January of a benefit year

  • 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

  • The Essential Package does not cover emergencies when travelling abroad

Download shows Benefits across all Options

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2020 by Hosmed Medical Scheme. Proudly created by Veritech ICT Solutions (Pty) Ltd

3 Victoria Link, Route 21 Corporate Park, Irene, 0178

0861 hosmed (467 633)

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