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Getting to know Topmed Hospital Plan
Topmed, initially established in 1972 and currently a household name in South Africa, is well-known for its comprehensive medical aid plans. However, they offer the affordable Topmed hospital plan too.
Also, this scheme utilises expertise and industry strengths and provides tailor-made products to meet the growing needs of prospective clients.
Recently they have innovatively partnered with other service providers to ensure that members receive value for money as well as service excellence.
TopMed Hospital Plan
NB! Effective 1 January 2017, TopMed Hospital is changing to TopMed Essential.
TopMed Hospital Plan is an introductory Hospital Only Plan (no Day-to-Day benefits apply).
That is an ideal plan, specially geared towards younger people who seek In-Hospital cover plus cover in the event of catastrophic occurrences that might require a stay in a hospital.
The plan is also for those who are content to cover their Out-of-Hospital expenses in conjunction with cover from an In-Hospital Plan.
Topmed Hospital / Topmed Essential Benefits
Significantly, benefits only apply provided that the mandatory pre-authorisation is obtained, especially before the commencement of any In-Hospital treatment or any related clinical procedure.
However, in the case of emergency admittance benefits are forfeited if authorisation is not obtained within two business days after that.
NB! Scheme Policies and Protocols then apply throughout.
Importantly, the Topmed hospital plan covers the following In-Hospital treatments:
|· Treatment of Immunocompromise & Opportunistic Infections irrespective of cause
· Psychiatric Hospitalisation
· 7 Days Take Home Medication
|Accommodation, Theatre, Material, Hospital Equipment & Medicine
|· General Practitioners
· Associated Clinical Procedures
|Radiology & Pathology||Radioisotope Studies, CT & MRI Scans|
|Secondary Facilities||Hospice, Rehabilitation & Step Down Nursing|
|Out-Patient Treatment at Hospital Facilities||Only for Trauma|
|Maternity Programme / Confinements
Qualification for this benefit:
Register between weeks 12 and 20 of pregnancy
|· 6 Antenatal Consultations, Antenatal Classes and Prenatal Vitamins
· 2 Scans per Beneficiary per Pregnancy
· Pediatric / Newborn Visits
· Home Births
|Ambulance Services||· Preferred Provider ER 24
· Non-Preferred Provider
|Disease Management / Case Management
Disease Management – Focuses on the patient’s disease or condition, utilising all the cost elements involved.
Case Management – Intervention involves patient counselling & education, behaviour modification, therapeutic guidelines & incentives
|· AIDS and HIV-Infections
· Organ Transplants & Kidney Dialysis
|Auxiliary Services||· Clinical and Medical Technologists
· Blood Transfusions
· Internal Medical & Surgical Accessories
· Physio, Speech & Occupational Therapy, Dieticians & Social Workers
|Scopes||Colonoscopies & Gastroscopies|
|International Business & Leisure Travel Insurance|
|Post Operative Medical Cover
|· Heart Attack
· Post-Crime Trauma
· Hip and Knee Replacements (only in the event of trauma)
Reflected below, is the Topmed Hospital / Topmed Essential monthly contribution table:
|Main Member||R1 458|
|Adult Dependant||R1 174|
For More Information
Importantly, to acquire the Topmed Hospital / Topmed Essential Hospital Plan or for any other Topmed Healthcare plan, we recommend that first you request a quote or more information
|Information / Queriesfirstname.lastname@example.org|
|Client Services, Pre-authorisation
Case Management and
Disease Management Programmes
|Tel: 0860 00 21 58|
|International||087 740 2899 (for calls outside SA)|
|Fax||086 762 4050|
|Postal Address||PO Box 1462, Durban, 4000|
NB! Although we took every care to source and reflect accurate information, we do not accept any accountability for possible inaccuracies. Therefore it is imperative then that you consult a Consultant or a Broker before making any healthcare decision.
To get a hospital plan quote, please complete and then submit the short form on this page