Suremed Challenger medical aid plan: 2017 v 2018

View all plans in this scheme.
Please note that these benefits are still being updated as more information is made available to us. Always consult with your broker before making final decisions regarding your healthcare cover.

COSTS and OVERVIEW:
Challanger
2018 costs In brief:
What’s new in 2018?
Main: Adult: Child:
Cost 2018: R R R
Cost 2017: (R4,000) (R3,000) (R800)
Gap (optional): KaeloXelus: R350 per family
(R600 per family if anyone is 60yrs+)
Overal Limit: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
PMBs: Day-to-day expenses for PMBs (eg. cancer) are always paid for by the scheme, according to protocols. Find out more
Children:

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Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family


IN HOSPITAL PROCEDURES:
Challanger
2017 v 2018 benefits Gap benefits Notes
Payout Rate for Specialists: 2018 benefits coming soon. 2017 benefits:
  • Up to 500% of scheme rate
  • In case of admission related to accident:
    • R300 per day, for days 1-13
    • R600 per day for days 14-20
    • R1,200 per day for days 21-30

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Hospital Choice: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
Specialised Radiology: 2018 benefits coming soon. 2017 benefits:
  • R16,900 per family,in and out of hospital
Supplementary Services: (Physio, etc) 2018 benefits coming soon. 2017 benefits:
  • Physiotherapy: R5,000 per person
Transplants: 2018 benefits coming soon. 2017 benefits:
  • In and out of hospital: R170,000 per family
Co-payments: none
  • Gap covers co-payments for most scopes and a defined list of other procedures, incl MRIs etc See full list
Alternatives to hospitals: 2018 benefits coming soon. 2017 benefits:
  • Private nursing and step down facilities: R20,000 per family
  • Hospice: R20,000 per family
Casualty: 2018 benefits coming soon. 2017 benefits:
  • R4,500 per person and R12,300 per family
  • Shared with GPs and Specialist Benefit
Other: 2018 benefits coming soon. 2017 benefits:
  • Non-surgical procedures: unlimited if performed in doctor's rooms
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OUT OF HOSPITAL BENEFITS:
Challanger
2017 v 2018 benefits Gap benefits Notes
GP consultations: 2018 benefits coming soon. 2017 benefits:
  • R4,500 per person and R12,300 per family
  • Shared with Specialist and Casualty Benefit


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Childcare:
  • No benefit
Specialists consultations: 2018 benefits coming soon. 2017 benefits:
  • R4,500 per person and R12,300 per family
  • Shared with GP and Casualty Benefit
Pathology: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
General radiology: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
Specialised radiology: 2018 benefits coming soon. 2017 benefits:
  • R16,900 per family, in and out of hospital
Supplementary Services: (Physio, etc) 2018 benefits coming soon. 2017 benefits:
  • R2,100 per person and R5,300 per family
  • Includes mental health
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MATERNITY BENEFITS:
Challanger
2017 v 2018 benefits Gap benefits Notes
Hospital stay: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
  • Elective caesarean: Covered up to vaginal birth benefit

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Consultations: 2018 benefits coming soon. 2017 benefits:
  • 9 consults, and one post-natal consultation
  • Antenatal classes: R500
Scans: 2018 benefits coming soon. 2017 benefits:
  • 2 x 2D scans
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CANCER (ONCOLOGY):
Challanger
2017 v 2018 benefits Gap benefits Notes
Overall coverage (in and out of hospital): 2018 benefits coming soon. 2017 benefits:
    R150,000 per person and R300,000 per family
All oncology benefits are assessed on a case-by-case basis, and are subject to protocols, preferred providers and scheme rules. Benefit covers out-of-hospital treatment too, like chemotherapy.
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DENTISTRY:
Challanger
2017 v 2018 benefits Gap benefits Notes
Dentistry: 2018 benefits coming soon. 2017 benefits:
  • Standard dentistry: unlimited, subject to protocols
  • Specialised dentistry: R5,300 per person and R12,300 per family
  • In-hospital: R11,750 per family, for children under 12yrs old and impacted wisdom teeth

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Orthodontics: 2018 benefits are coming soon!
Maxillo Facial Surgery: 2018 benefits are coming soon!

Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family

MEDICATION:
Challanger
2017 v 2018 benefits Gap benefits Notes
Chronic: 2018 benefits coming soon. 2017 benefits:
  • PMBs chronic: paid by scheme
  • Some non-PMB conditions are also covered

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Acute (presrcibed) medication: 2018 benefits coming soon. 2017 benefits:
  • R5,500 per person and R19,550 per family
  • 20% co-payment once R3,100 per person is reached
Over-the-counter: 2018 benefits coming soon. 2017 benefits:
  • R140 per prescription per month, limited to R1,350 per family per year
  • Included in acute medicine benefit
Birth Control:
On Discharge: 2018 benefits coming soon. 2017 benefits:
  • R500 per person per admission
Biological:
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OPTOMETRY:
Challanger
2017 v 2018 benefits Gap benefits Notes
Optometry: 2018 benefits coming soon. 2017 benefits:
  • R2,000 per person and R5,600 per family for glasses every two years or contact lenses every year

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MENTAL HEALTH:
Challanger
2017 v 2018 benefits Gap benefits Notes
In-hospital: 2018 benefits coming soon. 2017 benefits:
  • R17,950 per family

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Out-of-hospital: 2018 benefits coming soon. 2017 benefits:
  • R2,100 per person and R5,300 per family
  • Shared with supplementary services benefit
Trauma:
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OTHER BENEFITS:
Challanger
2017 v 2018 benefits Gap benefits Notes
General Appliances: 2018 benefits coming soon. 2017 benefits:
  • R8,700 per family, in and out of hospital, with sub limits as below
  • 2018 benefits coming soon. 2017 benefits:
    • CPAP machine: R5,000 every 3 years
    • Nebulisers/Humidifiers: R500
    • Glucometers: R500 every 3 years
    • Back support: R2,500
    • Orthotics: R1,000
  • No benefit

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1.1. Hearing Aids: 2018 benefits coming soon. 2017 benefits:
  • Limited to R5,000 every 3 years, subject to appliance limit
  • No benefit
1.2. Wheelchairs: 2018 benefits are coming soon!
  • No benefit
Dialysis: 2018 benefits coming soon. 2017 benefits:
  • R165,000 per family
HIV: 2018 benefits coming soon. 2017 benefits:
  • Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols
  • No benefit
Emergency Transport:
  • No benefit
International Insurance: 2018 benefits are coming soon!
  • No benefit
Other: 2018 benefits are coming soon!
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WELLNESS/PREVENTATIVE BENEFITS:
Challanger
2017 v 2018 benefits Gap benefits Notes
Flu vaccination: See "Other"
  • No benefit

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Pneumonia vaccines: See "Other"
  • No benefit
Back Rehabilitation Programme: See "Other"
  • No benefit
Biometric Screening: See "Other"
  • No benefit
Child Immunisation: See "Other"
  • No benefit
Pap Smear: See "Other"
  • No benefit
Mammogram: See "Other"
  • No benefit
PAS Test: See "Other"
  • No benefit
HIV Test: See "Other"
  • No benefit
Other: 2018 benefits coming soon. 2017 benefits:
  • R1,200 per person for preventative care, including mammograms and pap smears, limited to R2,100 per family
  • No benefit

Avoid bills! Get up to: 800% scheme rate;  R12,800 per ER visit; unlimited cancer cover;  

co-payments paid and cash payout for hospital stay. R350pm per family

2017 v 2018 benefits Gap benefits Notes
Overal Limit:
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Sub-limits:

    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