R 207 Per Family Per Month
Who’s covered · No underwriting requirements. · Guaranteed cover for all applicants. · No age limits imposed. · No restrictions on the number of children covered. · Cover provided for adult dependants at no extra cost, i.e., parents and siblings of the policyholder. · Spouses on different medical schemes can be covered under the same policy. Gap Benefits · 500% of Medical Scheme Tariff cover for in-hospital procedures and 50 out-patient procedures. · No annual policy limit. · Prescribed Minimum Benefit (PMB) conditions are covered. · Cover is extended above scheme limits and is calculated as the difference between the medical practitioner charges and scheme tariff. Co-payment Benefits · Hospital admission and procedure-specific co-payments are covered with no annual limit. · The 20% co-payment that medical scheme members are required to pay when exceeding their cancer sub-limit is covered up to a maximum of R250 000 per individual and R2.5 million per family, per calendar year. · Co-payments for using a non-Designated Service Provider (non-DSP) are covered. · Co-payments on out-patient MRI, CT and PET scans are covered. Additional Benefits · R25 000 cover, paid out on first time diagnosis of cancer for each policy beneficiary. This is in addition to the normal Gap Cover benefits as they apply to cancer. · Up to R30 000 internal prosthesis cover such as those used in joint replacement and spinal surgery. This benefit applies to the shortfall that arises when the scheme’s sub-limit is exceeded. · Breast reconstruction benefit of R20 000 payable in the event of a single mastectomy and payable towards the cost of cosmetic breast reconstruction of the non-affected breast. · Up to R25 000 personal accident cover for all policy beneficiaries where partial or total permanent disability results. · Text message access to Hello Doctor, which provides access to a team of doctors who will answer medical and health-related questions within 1 hour. This service is free, 24/7 to all policyholders. · R25 000 accidental death cover for all policy beneficiaries. · RAF claims preparation costs benefit of up to R20 000. · RAF medico-legal costs benefit of up to R10 000. · Emergency transportation/search and rescue benefit of up to R25 000. · Life support equipment benefit of up to R25 000. · Trauma counselling benefit of up to R750 per visit, with an annual limit of R25 000. · Mobility benefit of up to R25 000. · Rehabilitation from accident benefit of up to R25 000. · The choice to take out additional Extended Cancer Cover and Extended Dentistry Cover over and above the core Gap Cover product. ADD EXTRA CANCER cover for R 75000 at Just R 48 pfpm. This would mean that you will get a total of R 100000 paid out to you in the event of you getting Cancer for the first time. MEDICAL PREMIUM WAIVER BENEFIT can also be added At R 135 for 24 months and R 235 for 60 months. Maximum payable of R 5230 with a thirty day waiting period in the event of the principal dying or becoming disabled. This is a brilliant benefit since it pays for a long term and gives you peace of mind knowing that the medical aid will be paid for which is one of the biggest family expenses. Dentistry Cover For an extra R 238 pm, you can now get extra cover for DENTISTRY. Cover for emergency root canal, Tooth removal, crowns, bridges and more have a specified limit for each procedure. See the brochure below. NOTE: SUB-LIMIT for internal prosthesis is the only SUB LIMIT benefit covered under the liberty GAP option. The product is underwritten by Zest life, a subsidiary of Liberty and re-insured by Guardrisk insurance company. Notes 1. The Liberty Policy does not have a range of options and it is a single policy that covers all the essential shortfalls. The competitor products all have a range of options and in this comparison we have chosen the option that has similar benefits to the Liberty Policy; 2. In some instances, we did not have the 2014 premium and it can be expected that the 2013 premium will increase by about 6% to 10%; 3. This is a general comparison and the benefit detail may vary between the products in respect of benefit maximums and exclusions Source: www.libertyhealth.co.za |
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