Liberty Hospital Select Hospital Plan

The Liberty Hospital Select Hospital Plan offers an affordable solution for emergency or planned hospitalisation by using one of the partner hospitals on the Select Hospital Network. Therefore, you can also select your hospital for an R 8 500 voluntary co-payment.

Liberty Hospital Select hospital plan monthly contribution

The plan will cost R 1246 for the main member, R 1050 for an additional adult and R 474 per child, up to a maximum of three children.

Fortunately, there is no OAL or Overall Annual Limit however certain sub-limits are applicable.

Liberty Hospital Select hospital plan – IN HOSPITAL PROCEDURES:

  1. Payout Rate for Specialists:

100%  of scheme rate (prescribed rate plan pays out for specific services. Any costs exceeding this rate will be for the patient’s account)

 

  1. Hospital Choice:

Select Hospital Network partners. Non-network hospitals can be used, but a voluntary co-payment of R8,500 will apply.

 

  1. Specialised Radiology:

Annual limit of R25,700 per family

Bone density scans: one per member each year, in or out of hospital

Liberty Hospital Select hospital plan

  1. Supplementary Services: The following are paid at 100% of scheme rate: Dietician, Physiotherapist, Occupational Therapist, Audiologist, Speech Therapist, Clinical Technologist

 

  1. Transplants:

Excluding PMBs: Organ donor procedure will only be covered provided the donor, sub acuteas well as recipient, are both Scheme members. Procedure paid at 200% scheme rate.

PMB bone marrow transplants or solid organ transplants: 100% scheme rate at DSP

Imported corneas: R30,000

 

  1. Co-payments:

Provided the procedures done in public hospitals, doctor’s rooms or day clinics there is no co-payment.

Diagnostic cystoscopy, sigmoidoscopy, colonoscopy, proctoscopy, gastroscopy R1,700

Wisdom teeth removal, conservative spinal treatment, needle aspiration of joint, bursa or ganglion: R1,700

Hysteroscopy, arthroscopy, laparoscopy, and endometrial ablation: R4,100

Hysterectomy (non-cancer related), functional nasal procedures: R4,100

Reflux surgery: R7,750

Spinal surgery: R7,750

 

  1. Hospital alternatives:

Private nursing, physical rehabilitation assub-acute: R19,100

From Overall Annual Limit (OAL)

 

Liberty Hospital Select hospital plan – OUT OF HOSPITAL BENEFITS:

 

The following have no benefit on this plan:

 

  1. GP consultations:
  2. Specialists consultations:
  3. Pathology:
  4. General radiology:
  5. Supplementary Services: (Physio, etc.)

 

  1. Specialised radiology:

If a CT or MRI scan is conducted out of hospital and leads to an admission, the cost is covered by the in-hospital benefit

Two CT/MRI scans and one radioisotope scan per family, if requested by a specialist

From Overall Annual Limit (OAL)

 

Liberty Hospital Select hospital plan – MATERNITY BENEFITS:

  1. Scans and consultations: No benefit
  2. Hospital stay: 100% scheme rate

Liberty Hospital Select hospital plan – CANCER (ONCOLOGY):

 

  1. Total coverage (in and out of hospital): R234 000 per person

Subject to approved treatment plan

From Overall Annual Limit (OAL)

 

Note: Preferred providers, scheme rules and protocols apply. Oncology benefits will be assessed on a case-by-case basis.

 

Out-of-hospital treatment such as chemotherapy will also be covered under the benefit.

 

Liberty Hospital Select hospital plan – DENTISTRY:

 

  1. Dentistry: No benefit
  2. Maxillo Facial Surgery: 100% Scheme Rate
  3. Orthodontics: Members under the age of 21 only. Pre-authorisation required.

 

Liberty Hospital Select hospital plan – MEDICATION:

 

  1. Chronic: Only PMBs from Overall Annual Limit (OAL)
  2. Prescribed and over-the counter medication: No benefit
  3. Birth Control: No benefit
  4. Hospital Discharge: Limited to R2100, 7 days supply

From Overall Annual Limit (OAL)

 

OPTOMETRY:

 

  1. Optometry: No benefit

 

MENTAL HEALTH:

 

  1. Out-of-hospital: No benefit
  2. In-hospital: Maximum R19,100 per family

100% scheme rate

For psychiatric admissions physiotherapy is excluded

Maximum 3 days per GP admission

 

OTHER BENEFITS:

  1. Dialysis: R154,500 per person
  2. General Appliances, hearing aids, wheelchairs: No benefit

WELLNESS/PREVENTATIVE BENEFITS:

  1. HIV Test: Covered
  2. Flu vaccination: Covered
  3. Pneumonia vaccines: Covered for 65years upwards as well as at-risk members
  4. Biometric Screening: Basic tests covered
  5. Child Immunisation: Up to age 6
  6. Pap Smear: Ages 18-60 years covered, alternatively a liquid-based pap smear every 3 years
  7. Mammogram: For ages 40 and upwards, every 2 years
  8. PAS Test: Men 45 years and upwards, every 3 years

 

PROSTHESIS:

  1. Overal Limit:

Internal: 100% Scheme Tariff.  Subject to sub-limits listed below as well as a limit of R29,900 for unlisted internal prostheses and per person limit of R50,000

PMB joint replacements subject to R7,750 co-payment

External: If not specified in sub-limits, costs paid from Day-to-Day limits to a maximum of R12,000 per family

 

  1. Sub-limits: Internal:

Elbow, Knee, Hip, Shoulder replacement: PMBs only

Stents: R40,300

Valves: R37,200

Pacemaker: R47,000

Aorta stent grafts: R47,000

Cartoid stents: R17,800

Detachable platinum coils: R44,600

Embolic protection devices: R20,100

Intracranial replacement: R22,200

Perpheral arterial stent grafts: R33,200

Spinal plates and screws: R39,500

Approved spinal implantable devices and inter-vertebral discs: R39,500

Intraocular lens: R2,410 (per eye)

Neuro-stimulation/ablation devices for Parkinson’s: R44,600

Vagal stimulator for intractable epilepsy: R37,200

 

Note:

All benefits are paid are paid at 100% scheme rate except where otherwise specified

Pre-authorise all benefits

Protocols authorisation and sub-limits still apply to “Unlimited” benefits

PMBs are not subjected to limits or co-payments however scheme rules and protocols do apply.

 

Get a FREE hospital plan quote on this page if you live in South Africa

 

All info was correct at time of publishing