Medshield is one of the leading medical aid providers in South Africa with a long, proud history. And Medshield Medisaver is a flagship plan from Medshield.
Significantly, the Medisaver plan offers you top hospital cover with significant in-hospital benefits as well as a personal savings plan for day-to-day expenses.
Monthly contribution
Medshield Medisaver premiums are R 2 343 for the primary member, R 1 959 for an adult dependant and R 558 per child.
Major Medical Benefits of Medshield Medisaver
In hospital
Overall annual limit – Unlimited
Hospitalisation: Unlimited
Subject to the use of Medshield Hospital Network partners and pre-authorisation.
Clinical protocols will be followed.
Surgical procedures: Unlimited
Only if included in an authorised event.
Take home medication: That forms part of hospital benefit provided it is invoiced on the hospital account alternatively purchased on the day of discharge.
Subject to a limit of R600 per admission.
Hospital Alternatives:
R 50 000 limit per family for:
Hospice
Physical Rehabilitation
Home nursing
Sub-Acute facilities
Only applicable immediately after an event. Must be pre-authorised and part of the Medshield Hospital Network.
Appliances, Surgical, medical and general:
- R 7 500 per family per year
- Subject to pre-approval
- Nebulizers, Glucometers , Peak Flow Meters, and Blood Pressure Monitors (motivation required)
- Hearing Aids
- Wheelchairs
- Stoma Therapy related products
- CPAP Apparatus. Pre-authorisation needed. Service only from Preferred Provider.
- Clinical Protocols apply. Subject to appliance limit.
- Oxygen therapy equipment – Unlimited
- Home ventilators – Unlimited
- Blood, blood equivalents/products – Unlimited
- Pre-authorisation needed. Clinical Protocols apply
- Consultations with medical practitioners – Unlimited
- Provided included in authorised in-hospital event
- Refractive surgery: R 7000 per family per year. Pre-authorisation needed. Clinical Protocols apply
- Services must be from Medshield Hospital Network.
Included:
Phakic Lens Insertion
Lasik
Radial Keratotomy
Pathology and medical technology: Unlimited. Provided included in authorised in-hospital event
Clinical Protocols apply
Physiotherapy Unlimited. Provided included in authorised in-hospital event
General radiology: Unlimited. Provided included in authorised in-hospital event
Specialised radiology: R14 840 per family per year
Non PMBs will attract 10% co-payment
Specialised Radiology Limit applies. Pre-authorisation needed
Mental health: R35 000 per family per year. Pre-authorisation needed
Max 3 days when referred by a GP
Services must be from Medshield Hospital Network
Rehabilitation for Substance Abuse – 1 per member per year
HIV & AIDS: According to Managed Healthcare Protocols. Pre-authorisation needed
- Included:
- Anti-retroviral and related medicines
- HIV/AIDS related Pathology and Consultations
- HIV Counselling and Testing (HCT)
Infertility treatments and testing:
Pre-authorisation needed
Clinical Protocols apply
Maternity Benefits – R500 per family
- 12 Ante-Natal consultations per pregnancy.
- Scans and tests if pregnancy related
- Limited to: 2 x 2D Scans per pregnancy and 1 x Amniocentesis per pregnancy.
- Confinement and post-natal consultations
- Pre-authorisation needed
- Services must be from Medshield Hospital Network
Included
Confinement in hospital – Unlimited
Delivery by a General Practitioner or Medical Specialist – Unlimited
Confinement in a registered birthing unit or out of hospital – Unlimited
4 Post-Natal consultations per pregnancy.
Medshield Private Rates (up to 200%)
Oncology benefits
Oncology limit – R300 000 per family per year
Active Treatment: Including Brachytherapy, Stoma Therapy, Incontinence Therapy Oncology Limit applies. Subject to ICON Standard Protocols
Oncology Medicine R200 000 per family per year. Subject to ICON Standard Protocols
Radiology and Pathology: Oncology related Radiology and Pathology
Subject to Oncology Limit. Provided included in authorised in-hospital event
Chronic medicine Benefits
Services must be from Medshield Hospital Network
Medication supplied monthly
PMBs only and approved by Medshield Restrictive Formulary.
To get a hospital plan quote just complete and then send the form on this page