Topmed Hospital Plans Have Great Wellness Benefits
TopMed hospital plans give a surprising range of extended benefits. Services such as Maxillo-Facial surgery, a great maternity program and disease management makes TopMed an excellent choice for people of all ages. Her we will be taking a closer look at the wide-spread savings and benefits supplied from this premier hospital plan.
Premium Service with Premium Contributions
TopMed has a fairly competitive pricing structure, although cheaper hospital plans can be found elsewhere. Few give as comprehensive coverage as TopMed, but for this superior service, you pay a higher than average rate. The monthly contributions are as follows:
- R1458 for the Principal Member
- R1174 per Adult Dependent
- R592 per Child Dependent
Topmed Hospital Plans – In-Hospital Benefits
You are covered for almost all in-hospital procedures at a 100% scheme tariff rate. All prescribed minimum benefits are covered, sorting out chronic medication for most. The oncology cover from TopMed is nothing short of outstanding. Your coverage limits to R282,216 per year, which is more than enough to chemotherapy, radiotherapy and all supportive treatments for even the most advanced stages of cancer. TopMed even allows you to procure medicine from non-network providers, covering 70% of the charge. Here is everything which TopMed covers at a 100% tariff rate:
- Hospitalisation Costs (Theatre, Medicine, Material & Apparatus Costs)
- Immunocompromise& Opportunistic Infections
- Psychiatric Hospitalization
- Medicine Prescribed Upon Discharge
- Outpatient Care with Trauma Benefits
- GP & Specialist Visits
- Radiology & Pathology
- Blood Transfusions (100% of the Cost)
- Speech Therapy
- Occupational Therapy
- Maxillo-Facial Surgery
TopMed Co-Payments & Cover Limits
Even though the unlimited cover is supplied at a 100% tariff rate for most procedures, certain operations do require a co-payment. Dental does not have coverage, and optical benefits are provided on a limited basis. Before choosing TopMed, keep in mind that these procedures come with co-payments:
- MRI & CT Scans – R2,500 Co-Payment per Scan
- Gastroscopies and Colonoscopies – R2,500 Co-Payment per Scan
Certain procedures from TopMed also come with limits. Most in-hospital support is unlimited, other than these specific treatments and operations:
- Treatment of Immunocompromised and Opportunistic Infections – R44,340 per family per year
- Cardiac Peripheral and Aortic Stents, Valves, Pace Makers and Defibrillators – R53,880 per beneficiary per year
- Hip, Knee, Shoulder & Elbow Prostheses – R47,400 per beneficiary per year
- Orthopaedic Prostheses and Appliances – R53,880 per beneficiary per year
- Neuro& Deep Brain Stimulators – R33,550 per beneficiary per year
- Internal Sphincters and Stimulators – R53,844 per beneficiary per year
Extensive Additional Benefits from TopMed Hospital Plans
Some of the most generous extra benefits around can be found from TopMed. Their major medical services include posting total hip replacement therapy, giving you eight sessions of three months with a physiotherapist. Post total knee replacement cover also gives eight physiotherapy sessions. Your coverage ensures that you are taken care of in the case of a heart attack, while you can rest assured of post-trauma counselling for six months if you are the victim of a crime. TopMed also provides Even stroke rehabilitation.
Annual flu vaccines make a part of your wellness benefits from TopMed, as does the immunisation of your baby. Tetanus injections are supplied as needed, and pneumococcal treatments are given to high-risk individuals and those older than 60. All adult beneficiaries get a BMI, blood sugar, blood pressure and cholesterol test once per year. You also get various early detection services such as pap smears, general examinations, prostate, HIV, glaucoma, bone density and glaucoma tests at preset intervals.
One of the Most Extensive Hospital Plans in the County
TopMed is undoubtedly one of the best hospital plans in South Africa, despite its shortfalls regarding dental. The maxilla-facial surgery more than makes up for this shortcoming, should your oral health hit a dire state. If you can afford the premium, then you should consider TopMed. So as a stand-alone hospital plan, it excels, giving among the most comprehensive in-hospital and wellness benefits around.
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