Suremed Challenger medical aid plan: 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.

Challanger
2018 Costs:
Total Cost pm:

Main member:

R

Adult:

R

Child:

R
2019 Costs:
Total Cost pm:

Main member:

R
(%)

Adult:

R

Child:

R
In brief (2018): See full benefits below

IN HOSPITAL PROCEDURES:
Challanger
Scheme Benefits: Gap Benefits:
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
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
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)

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Our quote will include the right gap cover for this plan

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):
Challanger
Scheme Benefits Gap benefits
Main: Adult: Child:
General info:
GP consultations: 2018 benefits coming soon. 2017 benefits:
  • R4,500 per person and R12,300 per family
  • Shared with Specialist and Casualty Benefit
Childcare:
  • No extra benefit available
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

No phone calls!
Our quote will include the right gap cover for this plan

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MATERNITY BENEFITS:
Challanger
Scheme Benefits Gap benefits
Hospital stay: 2018 benefits coming soon. 2017 benefits:
  • Unlimited
  • Elective caesarean: Covered up to vaginal birth benefit
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

No phone calls!
Our quote will include the right gap cover for this plan

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CANCER (ONCOLOGY):
Challanger
Scheme Benefits Gap benefits
Overall coverage (in and out of hospital): 2018 benefits coming soon. 2017 benefits:
    R150,000 per person and R300,000 per family

No phone calls!
Our quote will include the right gap cover for this plan

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DENTISTRY:
Challanger
Scheme Benefits Gap benefits
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
Orthodontics: 2018 benefits are coming soon!
Maxillo Facial Surgery: 2018 benefits are coming soon!

No phone calls!
Our quote will include the right gap cover for this plan

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MEDICATION:
Challanger
Scheme Benefits Gap benefits
Chronic: 2018 benefits coming soon. 2017 benefits:
  • PMBs chronic: paid by scheme
  • Some non-PMB conditions are also covered
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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Our quote will include the right gap cover for this plan

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OPTOMETRY:
Challanger
Scheme Benefits Gap benefits
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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Our quote will include the right gap cover for this plan

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MENTAL HEALTH:
Challanger
Scheme Benefits Gap benefits
In-hospital: 2018 benefits coming soon. 2017 benefits:
  • R17,950 per family
Out-of-hospital: 2018 benefits coming soon. 2017 benefits:
  • R2,100 per person and R5,300 per family
  • Shared with supplementary services benefit
Trauma:

No phone calls!
Our quote will include the right gap cover for this plan

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OTHER BENEFITS:
Challanger
Scheme Benefits Gap benefits
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
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: ER24
  • No benefit
International Insurance: 2018 benefits are coming soon!
  • No benefit
Other: 2018 benefits are coming soon!

No phone calls!
Our quote will include the right gap cover for this plan

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WELLNESS/PREVENTATIVE BENEFITS:
Challanger
Scheme Benefits Gap benefits
Flu vaccination: See "Other"
  • No benefit
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

No phone calls!
Our quote will include the right gap cover for this plan

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PROSTHETICS:
Challanger
Scheme Benefits Gap benefits
Overal Limit:
Sub-limits:

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Our quote will include the right gap cover for this plan


    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