LMS Medical Fund Details

    December 20, 2016

    The LMS Medical fund has 11 different option plans. So these range from most comprehensive and with the luxury of choice, to the most basic and stringent options.

    Different LMS Medical Fund Plans

    The highest plan regarding full benefits and premium paid is the Traditional Ultimate. On this scheme, a single principal member currently pays a dividend of R6416. There is no overall annual limit to all the benefits, though individual benefit limits may apply. Members can go to any private hospital. Specialist bills are safe up to 300% of the LMS scheme rate with no co-payments for in-hospital procedures. While General practitioner bills are paid at 200% of plan price. LMS Medical FundDental treatment is limited to R41000 per beneficiary per year. The lasting benefit recognises 69 conditions, 27 of in the Prescribed Minimum Benefits which are government regulation. These 27 are safe on any of the LMS option plans. This cover has no medical savings interest but day to day benefits apply.

    LMS Medical Fund Complete Plus Plan

    Next is the Complete Plus plan which has a premium of R4889 per single principal member. This plan has a threshold and savings portion of benefits from which pays for out, and in-hospital visits and procedures according to the schemes schedule. This option has threshold and savings benefits. Also, specialists are covered at 200% of LMS’s rate. All oncology treatment attracts a co-payment of 10%. The plan limits dental treatment to R13700 per beneficiary, while the cap per family is R19100.Medicine cover depends on savings and the above threshold benefit.

    Saver Plus

    The Saver Plus Option carries a premium of R2886 per key member. This plan has a savings benefit from which covers all day to day bills. Also, it includes all private hospitals, and no overall annual limits apply. It has particular co-payments of R9600 and 7750 for joint replacement and spinal surgery respectively. From this option down only cover 27 chronic conditions which the minimum requirement laid out in Prescribed Minimum Benefits. So the Saver plans pay for medicines according to the scheme rate for medication.

    Complete Standard

    The Complete Standard program follows at a premium of R2598, followed by the Hospital plus at R2343, then is the Complete Select, the Saver Standard, all on a sliding scale regarding premium. The Saver Select is, even more, cost effective at R1580 monthly contribution.

    Hospital Plus

    The Hospital Plus plan has the highest premium and most comprehensive cover of the hospital series. All medicines and day to day costs, like optical and dental treatments the member pays for. Some benefits such as the in-hospital dental benefit or chronic treatment like dialysis and safe at 200% of the LMS rate to 100% on the other hospital plan options. On this plan specialists and doctor, its covers fees at 200% to the 100% of scheme rate of the other programs in this series.

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    All info was correct at time of publishing