Sizwe medicine benefits: 2017

By Staff Writer -

Click here to compare medicine 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: Medicine 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. Chronic:
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. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • R280 per family
4. On Discharge:
5. Birth Control:
  • No benefit
6. Notes:

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Sizwe Gomomo B 2017: Medicine 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. Chronic:
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. Acute (presrcibed) medication:
  • No benefit
3. Over-the-counter:
  • R280 per family
4. On Discharge:
5. Birth Control:
  • No benefit
6. Notes:

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Savings Plan

Sizwe Savings Care A 2017: Medicine 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. Chronic:
  • non-PMB: 11 additional conditions covered
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. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Sizwe Savings Care B 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 11 additional conditions covered
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. Acute (presrcibed) medication:
  • Paid from day-to-day benefit
3. Over-the-counter:
  • Paid from day-to-day benefit
4. On Discharge:
5. Birth Control:
  • Paid from day-to-day benefit
6. Notes:

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Primary Plan

Sizwe Primary Care A 2017: Medicine Benefits
In brief:
1. Chronic:
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-

Compare with these plans:

Day-to-day limit: M =R5,390 M1 =R7,980 M2 =R9,330 M3 =R10,670 M4 =R12,020 M5 =R13,370 M6+ =R14,720
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R1,680 M1 =R3,030 M2 =R3,370 M3 =R3,820 M4 =R3,930 M5 =R4,150 M6+ =R4,490
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Sizwe Primary Care B 2017: Medicine Benefits
In brief:
1. Chronic:
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-

Compare with these plans:

Day-to-day limit: M =R5,390 M1 =R7,980 M2 =R9,330 M3 =R10,670 M4 =R12,020 M5 =R13,370 M6+ =R14,720
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R1,680 M1 =R3,030 M2 =R3,370 M3 =R3,820 M4 =R3,930 M5 =R4,150 M6+ =R4,490
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Sizwe Primary Care C 2017: Medicine Benefits
In brief:
1. Chronic:
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-

Compare with these plans:

Day-to-day limit: M =R5,390 M1 =R7,980 M2 =R9,330 M3 =R10,670 M4 =R12,020 M5 =R13,370 M6+ =R14,720
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R1,680 M1 =R3,030 M2 =R3,370 M3 =R3,820 M4 =R3,930 M5 =R4,150 M6+ =R4,490
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Affordable Plan

Sizwe Affordable Care A 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 13 additional conditions covered
  • R4,940 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-

Compare with these plans:

Day-to-day limit: M =R9,330 M1 =R13,370 M2 =R15,390 M3 =R16,740 M4 =R18,760 M5 =R20,790 M6+ =R22,690
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R3,250 M1 =R4,940 M2 =R5,840 M3 =R6,290 M4 =R7,190 M5 =R7,420 M6+ =R7,640
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Sizwe Affordable Care B 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 13 additional conditions covered
  • R4,940 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-

Compare with these plans:

Day-to-day limit: M =R9,330 M1 =R13,370 M2 =R15,390 M3 =R16,740 M4 =R18,760 M5 =R20,790 M6+ =R22,690
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R3,250 M1 =R4,940 M2 =R5,840 M3 =R6,290 M4 =R7,190 M5 =R7,420 M6+ =R7,640
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

View this plan

Sizwe Affordable Care C 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 13 additional conditions covered
  • R4,940 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-

Compare with these plans:

Day-to-day limit: M =R9,330 M1 =R13,370 M2 =R15,390 M3 =R16,740 M4 =R18,760 M5 =R20,790 M6+ =R22,690
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R3,250 M1 =R4,940 M2 =R5,840 M3 =R6,290 M4 =R7,190 M5 =R7,420 M6+ =R7,640
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Full Benefit Plan

Sizwe Full Benefit A 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 33 additional conditions covered
  • R10,400 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-

Compare with these plans:

Day-to-day limit: M =R15,390 M1 =R20,790 M2 =R23,370 M3 =R26,060 M4 =R28,770 M5 =R31,460 M6+ =R34,150
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R4,380 M1 =R7,750 M2 =R8,990 M3 =R10,230 M4 =R10,890 M5 =R11,460 M6+ =R12,020
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

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Sizwe Full Benefit B 2017: Medicine Benefits
In brief:
1. Chronic:
  • non-PMB: 33 additional conditions covered
  • R10,400 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-

Compare with these plans:

Day-to-day limit: M =R15,390 M1 =R20,790 M2 =R23,370 M3 =R26,060 M4 =R28,770 M5 =R31,460 M6+ =R34,150
2. Acute (presrcibed) medication:
  • Paid from day-to-day benefit, with following sub limits:
M =R4,380 M1 =R7,750 M2 =R8,990 M3 =R10,230 M4 =R10,890 M5 =R11,460 M6+ =R12,020
3. Over-the-counter:
4. On Discharge:
5. Birth Control:
  • Paid from R2,490 per family
6. Notes:

View this plan


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