Selfmed out-of-hospital benefits: 2017

By Staff Writer -

Click here to compare out-of-hospital benefits across all schemes, or use the menu bar above for more options. Selfmed home page.

All plans

Selfmed Selfnet Essential 2017: Out Of Hospital Benefits
In brief:
1. GP consultations:
  • No benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R850 R850 R300
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Specialists consultations:
  • No benefit, unless PMB
3. Pathology:
  • No benefit, unless PMB
4. General radiology:
  • No benefit, unless PMB
5. Specialised radiology:
  • No benefit, unless PMB
6. Supplementary Services: (Physio, etc)
  • No benefit, unless PMB

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Selfmed Selfnet 2017: Out Of Hospital Benefits
In brief:
1. GP consultations:
  • Network GP: Unlimited
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,185 R1,185 R418
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Specialists consultations:
  • R1,070 per person and R2,140 per family from network specialist, including radiology, pathology and medication
3. Pathology:
  • Unlimited subject to network protocol, formulary and referral ny network GP
4. General radiology:
  • Unlimited subject to network protocol, formulary and referral ny network GP
5. Specialised radiology:
  • No benefit, unless PMB
6. Supplementary Services: (Physio, etc)
  • No benefit, unless PMB

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Selfmed MexXXI 2017: Out Of Hospital Benefits
In brief:
1. GP consultations:
  • No benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,599 R1,592 R818
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Specialists consultations:
  • Some day procedures covered
3. Pathology:
  • No benefit, unless PMB
4. General radiology:
  • No benefit, unless PMB
5. Specialised radiology:
  • R1,600 co-payment. In and out of hospital
6. Supplementary Services: (Physio, etc)
  • No benefit, unless PMB

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Selfmed Selfsure 2017: Out Of Hospital Benefits
In brief:
1. GP consultations:
  • Paid from day-to-day benefit
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,456 R2,451 R836
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Specialists consultations:
  • Paid from day-to-day benefit
3. Pathology:
  • R4,900 per person or R6,900 per family
  • Shared with radiology, pathology, standard dentistry, physio and biokinetics
4. General radiology:
  • R4,900 per person or R6,900 per family
  • Shared with radiology, pathology, standard dentistry, physio and biokinetics
5. Specialised radiology:
  • R1,600 co-payment. In and out of hospital
6. Supplementary Services: (Physio, etc)
    Physio and biokinetics:
  • R4,900 per person or R6,900 per family. Shared with radiology, pathology, standard dentistry, physio and biokinetics
  • Otherwise, from day-to-day benefits

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Selfmed 80% 2017: Out Of Hospital Benefits
In brief:
1. GP consultations:
  • 20% co-payment and limited to M =consults, M1 = 30 consults and M2+ =45 consults
  • Shared with GP and Specialist consults>/li>
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R6,335 R5,485 R1,100
Children: Pay for maximum 3 children
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

Compare with these plans:

2. Specialists consultations:
  • 20% co-payment and limited to M =consults, M1 = 30 consults and M2+ =45 consults
  • Shared with GP and Specialist consults>/li>
3. Pathology:
  • 20% co-payment
4. General radiology:
  • 20% co-payment
5. Specialised radiology:
6. Supplementary Services: (Physio, etc)
  • Medical and clinical technology: 20% co-payment
  • Physio, speech therapy, occupational therapy, podiatry, orthotic treatment, hearing aid acoustics, dieticians, chiropractors, osteopaths, homeopaths, naturopaths, herbalists and biokinetics: 20% co-payment and limited to R4,800 per person and R13,600 per family

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