Medihelp Plus medical aid plan: 2019

View all plans in this scheme.
Always consult with your broker before making final decisions regarding your healthcare cover.

Plus
2019 Costs:
Total Cost pm:

Main member:

R

Adult:

R

Child:

R
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In brief (2018):
  • Diagnosis and treatment of the 270 PMBs is always paid by scheme, in and out of hospital, according to protocols.
See full benefits below

IN HOSPITAL PROCEDURES:
Plus
Scheme Benefits: Notes and Links:
Specialists: 2019 Benefits coming November 15, 2018 Gap Cover
  • Gap cover is available for this plan. Budget about R350 for a fully comprehensive gap cover that will increase the scheme rate to 500% and pay most co-payments and increase sublimits.
Hospital Choice: 2019 Benefits coming November 15, 2018
Specialised Radiology: 2018 benefits coming soon!
Supplementary Services: (Physio, etc) 2019 Benefits coming November 15, 2018
Transplants: 2019 Benefits coming November 15, 2018
Co-payments: 2019 Benefits coming November 15, 2018
Alternatives to hospitals: 2019 Benefits coming November 15, 2018
Casualty: 2019 Benefits coming November 15, 2018
Other: 2019 Benefits coming November 15, 2018
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R150,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R150,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

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OUT OF HOSPITAL BENEFITS (non-PMB):
Plus
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
General info: 2019 Benefits coming November 15, 2018
GP consultations: 2019 Benefits coming November 15, 2018
Childcare: 2019 Benefits coming November 15, 2018
Specialists consultations: 2019 Benefits coming November 15, 2018
Pathology: 2019 Benefits coming November 15, 2018
General radiology: 2019 Benefits coming November 15, 2018
Specialised radiology: 2019 Benefits coming November 15, 2018
Supplementary Services: (Physio, etc) 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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MATERNITY BENEFITS:
Plus
Scheme Benefits Notes and Links:
Hospital stay: 2019 Benefits coming November 15, 2018
Consultations: 2019 Benefits coming November 15, 2018
Scans: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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CANCER (ONCOLOGY):
Plus
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital): 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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DENTISTRY:
Plus
Scheme Benefits Notes and Links:
Standard Dentistry: 2019 Benefits coming November 15, 2018
Specialised Dentistry: 2019 Benefits coming November 15, 2018
In-Hospital Dentistry: 2019 Benefits coming November 15, 2018
Orthodontics: 2019 Benefits coming November 15, 2018
Maxillo Facial Surgery: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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MEDICATION:
Plus
Scheme Benefits: Notes and Links:
Chronic: 2019 Benefits coming November 15, 2018
Acute (presrcibed) medication: 2019 Benefits coming November 15, 2018
Over-the-counter: 2019 Benefits coming November 15, 2018
Birth Control: 2019 Benefits coming November 15, 2018
On Discharge: 2019 Benefits coming November 15, 2018
Biological: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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OPTOMETRY:
Plus
Scheme Benefits: Notes and Links:
Optometry: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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MENTAL HEALTH:
Plus
Scheme Benefits Notes and Links:
In-hospital: 2019 Benefits coming November 15, 2018
Out-of-hospital: 2019 Benefits coming November 15, 2018 /td>
Trauma: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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OTHER BENEFITS:
Plus
Scheme Benefits Notes and Links:
General Appliances: 2019 Benefits coming November 15, 2018
  • No benefit
1.1. Hearing Aids: 2019 Benefits coming November 15, 2018
1.2. Wheelchairs: 2019 Benefits coming November 15, 2018
Dialysis: 2019 Benefits coming November 15, 2018
HIV: 2019 Benefits coming November 15, 2018
Emergency Transport: 2019 Benefits coming November 15, 2018
International Insurance: 2019 Benefits coming November 15, 2018
Other: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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WELLNESS/PREVENTATIVE BENEFITS:
Plus
Scheme Benefits: Notes and Links:
Flu vaccination: 2019 Benefits coming November 15, 2018
Pneumonia vaccines: 2019 Benefits coming November 15, 2018
Back Rehabilitation Programme: 2019 Benefits coming November 15, 2018
Biometric Screening: 2019 Benefits coming November 15, 2018
Child Immunisation: 2019 Benefits coming November 15, 2018
Pap Smear: 2019 Benefits coming November 15, 2018
Mammogram: 2019 Benefits coming November 15, 2018
PAS Test: 2019 Benefits coming November 15, 2018
HIV Test: 2019 Benefits coming November 15, 2018
Other: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.

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PROSTHETICS:
Plus
Scheme Benefits: Notes and Links:
Overal Limit: 2019 Benefits coming November 15, 2018
Sub-limits: 2019 Benefits coming November 15, 2018
What next?
We will email you a quote for this and two other comparable plans. No phone calls.

Together with a financial advisor, we can help you with unpaid claims, findinging a gap cover, general advice, plan changes, cheaper options and more. FREE.


    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • “Unlimited” benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised