Selfmed MedXXI Premier Hospital Plan Features Limited Outpatient Cover
February 23, 2017
The MedXXI premier hospital plan is from SelfMed Medical Scheme. The unlimited in-hospital benefits are great for those with specialised needs. However, MedXXI is slightly higher priced than competing plans. It also only gives you limited outpatient cover. MedXXI supplies a 100% scheme tariff for all procedures handled. Here we’ll take a look at exactly what you get for your high-end premiums.
The MedXXI rates are between R200 to R400 more expensive than similarly packaged hospital plans. Their contributions are as follows:
- R1599 for the Principal Members
- R1592 per Adult Dependent
- R818 per Child Dependent
SelfMed charges you for a maximum of three child dependents. Your fourth child and more have coverage free of charge, although this is a fairly standard practice among most South African hospital plans.
An Overview of MedXXI In-Hospital Benefits
The MedXXI Premier Hospital Plan gives very little out-of-hospital cover. The in-hospital coverage is, however, excellent, giving unlimited cover for almost all procedures. Here are a few important procedures with full coverage:
- GP & Specialist Visits
- Ante-Natal Classes
- Foetal Scans
Auxiliary Benefits Supplied by MedXXI
Families with specialised needs requiring auxiliary medical services will find great value in MedXXI. It should be noted that this cover is only provided when hospitalised. They are as follows:
- Medical Technology
- Clinical Technology
- Speech Therapy
- Occupational Therapy
Co-Payments Due when Subscribing to MedXXI
Despite the extensive in-hospital benefits, there are still many procedures which require a co-payment. It is quite strange for a medical scheme of this cost. However, the operations are more specific than normally found.
- Non-Elective Maxilla-Facial Surgery – R1,100
- MRI & CT Scans – R1,600 co-payment
- Radio-Isotope Studies – R1,600 co-payment
Procedural Limits and Factors to Keep in Mind
Before subscribing to MedXXI, you should be aware of the procedural limits and procedures without coverage. Chronic medication has coverage as per law when your condition is listed as a prescribed minimum benefit. All other chronic medication must be submitted for approval before benefits are paid. Acute, medication, immunisations and both oral and injectable contraceptives, you must pay for out of your pocket. Neither basic nor specialised dentistry is part of the cover, neither is implantology.
- Internal Prosthesis – various category limits
- External Prosthesis – R53,600 per family per year
- Orthopaedic Appliances – R8000 per family per year
- Cochlear Implants – R30,200 per implant
- Oncology – R176,600 per family per year
- Organ Transplants – R44,8000 per recipient
You get no support for alternative therapies and medicine. There are no optical benefits and no rehabilitation services. You also have no cover for hearing aids.
Look to the MedXXI Premier Hospital Plan if You Need Auxiliary Benefits
The standard in-hospital cover, giving unlimited support, is better than you find with most schemes. The in-hospital auxiliary benefits are also unlimited, therefore making this scheme a great option for this suffering debilitating conditions which could land them in a hospital. You have free choice of any private hospital, although other lower priced packages also provide this freedom. Elderly individuals and those afflicted by disease may find value in this hospital plan, albeit a bit on the pricey side.
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All info was correct at time of publishing