Sizwe mental health benefits: 2017

By Staff Writer -

Click here to compare mental health benefits across all schemes, or use the menu bar above for more options. Sizwe home page.

Hospital Plan

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Gomomo Plan

Sizwe Gomomo A 2017: Mental Health Benefits
In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: maternity. Limits apply. All else paid from savings or from out of pocket, unless PMB.
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,666 R1,546 R410
Children: Pay for all children
Income limit: R0-R10,112 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:maternity. Limits apply. All else paid from savings or from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • Subject to pre-authorisation and managed care

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Sizwe Gomomo B 2017: Mental Health Benefits
In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,060 R1,623 R420
Children: Pay for all children
Income limit: R10,113+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • Subject to pre-authorisation and managed care

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Savings Plan

Sizwe Savings Care A 2017: Mental Health Benefits
In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: radiology, pathology, maternity. Limits apply. All else paid from out of pocket, unless PMB.
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,015 R1,742 R490
Children: Pay for all children
Income limit: R0-R15,052 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.
Main: Adult: Child:
(S) Savings: R3,627 R3,136 R882

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2. Out-of-hospital:
  • R7,190 per family, from day-to-day benefit

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Sizwe Savings Care B 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,800 R2,243 R555
Children: Pay for all children
Income limit: R15,053+ (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R5,040 R4,037 R999

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2. Out-of-hospital:
  • R7,190 per family, from day-to-day benefit

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Primary Plan

Sizwe Primary Care A 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R407 R407 R407
Children: Pay for all children
Income limit: R0-R530 (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R4,190 per family

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Sizwe Primary Care B 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R1,907 R1,488 R480
Children: Pay for all children
Income limit: R531-R8,766 (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R4,190 per family

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Sizwe Primary Care C 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,326 R1,519 R480
Children: Pay for all children
Income limit: R8,767+ (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R4,190 per family

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Affordable Plan

Sizwe Affordable Care A 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,733 R2,511 R630
Children: Pay for all children
Income limit: R0-R15,052 (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R8,140 per family

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Sizwe Affordable Care B 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R2,843 R2,610 R660
Children: Pay for all children
Income limit: R15,053-R18,444 (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R8,140 per family

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Sizwe Affordable Care C 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R3,657 R3,251 R730
Children: Pay for all children
Income limit: R18,445+ (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R8,140 per family

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Full Benefit Plan

Sizwe Full Benefit A 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,210 R3,825 R860
Children: Pay for all children
Income limit: R0-R18,879 (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R15,680 per family

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Sizwe Full Benefit B 2017: Mental Health Benefits
In brief:
1. In-hospital:
  • 21 days per person
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Main: Adult: Child:
Total Cost: R4,885 R4,441 R960
Children: Pay for all children
Income limit: R18,880+ (other limits)
Day-to-Day Benefit:
Main: Adult: Child:
(S) Savings: R0- R0- R0-

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2. Out-of-hospital:
  • R15,680 per family

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