Selfmed

Latest

Selfmed: All the 2017 medical aid plans

"] All plans "]

Selfmed preventative benefits: 2017

All preventative benefits, compared, for Selfmed medical scheme 2017

Selfmed other benefits: 2017

All other benefits, compared, for Selfmed medical scheme 2017

Selfmed medicine benefits: 2017

All medicine benefits, compared, for Selfmed medical scheme 2017

Selfmed mental health benefits: 2017

All mental health benefits, compared, for Selfmed medical scheme 2017

Selfmed maternity benefits: 2017

All maternity benefits, compared, for Selfmed medical scheme 2017

Selfmed optometry benefits: 2017

All optometry benefits, compared, for Selfmed medical scheme 2017

Selfmed oncology benefits: 2017

All oncology benefits, compared, for Selfmed medical scheme 2017

Selfmed dentistry benefits: 2017

All dentistry benefits, compared, for Selfmed medical scheme 2017

Selfmed out-of-hospital benefits: 2017

All out-of-hospital benefits, compared, for Selfmed medical scheme 2017

Selfmed in-hospital benefits: 2017

All in-hospital benefits, compared, for Selfmed medical scheme 2017

12 Page 1 of 2

How do I change my medical aid plan?

Can I be refused membership of a Medical Aid Scheme?

From our news desk

CMS might dissolve small medical aid schemes

Pregnancy cover if you don’t have medical aid

Help us crowdsource information about the Late Joiner Penalty

Our complaint against Bestmed re late joiner penalty

Our complaint against Genesis re late joiner penalty

Jargon Explained

DSP: Designated Service Provider (DSP) is a healthcare provider (doctor, pharmacist, hospital, etc) that is a medical scheme’s first choice when its members need diagnosis, treatment or care for a PMB condition. Could be a State facility.

Formulary: List of approved medicines for each condition. Each scheme has its own formulary which determines how it pays for medication. Some schemes have different lists (formularies) for different plans. If the medication you need is not on the formulary, the scheme might not pay for it, or might ask you for a co-payment.

Network Provider: A healthcare service provider (doctor, pharmacy, hospital, optometrist etc) with whom the scheme has a payment or service arrangement. Your plan might limit you to only providers in the network, or might require you to make a co-payment if your provider is not part of the network. Often, if you use network providers, the scheme will cover the cost in full, but check your plan for details.

PMB: Prescribed Minimum Benefits, is a set of conditions and their treatments that every plan must cover, in and out of hospital, regardless of what plan you are on, how much money (if any) is in your medical savings account etc. There are 270 recognised PMBs, including all emergency (life threatening) conditions and 27 chronic conditions. We have a more detailed explanation on PMBs here.

Scheme Rate: 100% is pre-set amount that the Scheme will pay for a service. If they pay at 200%, it means they will pay double what they normally would. You or your gap cover must pay the difference, if any. strong>There is no public reference as to what each Scheme pays out for what service.

More Jargon explained here

About Us

Medical Aid Bible has a simple purpose: to help you choose the best healthcare cover for your needs and your budget. We do this by comparing apples to apples, explaining the jargon and generally adding transparency to the whole complicated process!

Although utmost care was taken to show accurate information, we take no responsibility for errors. Always consult your broker or scheme provider before making any decisions concerning your medical aid.

We work with MC De Villiers Brokers to offer you the XelusGap Cover. MC De Villiers Brokers is an authorised Financial Service Provider (FSP:7241)

Unfortunately we cannot answer individual queries about your cover or claims, but you can contact us on info@medicalaidbible.co.za to tell us how we can improve, or how we helped you find the best cover!