If you or a dependant are 65 years of age or older your 2020 options are as follows:
1) Compact 200 – R434 per month
This option has been designed to reduce the monthly premium by limiting the Gap Benefit. Your policy will pay for Specialists in-hospital up to 200% or 2 times above the rate your medical aid will pay. It is incumbent on you, the policy holder, to negotiate with your specialist to limit the tariff he/she will charge to avoid a shortfall after Gap Cover has paid their portion.
Co-payment Cover is up to to R15,000 per policy per year.
Sub-limit Cover pays up to R15,000 per event, limited to R30,000 per person per year.
Cancer Treatment Cover as follows:
Cancer Treatment Shortfalls – For treatment related to oncology co-payments and biological drugs where sub-limits are imposed by the medical scheme.
Cancer Treatment Top-Up – If your medical scheme imposes a maximum threshold for oncology and this is breached, an additional R60 000 per person p.a. is available to extend treatment.
2) Co-Evolution – R493 per month
Gap Benefit for Specialists in-hospital up to an additional 500%.
Co-payment cover limited to R50,000 per year.
3 ) Elite – R699 per family per month or R575 per individual member per month
This covers all the shortfalls we have identified to date. Gap Benefit for Specialists in- hospital up to 500%
Co-Payment Cover up to R50,000 per year.
Oncology Benefit – where your medical aid will only cover your oncology treatment costs if you pay the oncology payment.
Sub-Limit Benefit – covers hospital sub-limit shortfalls up to R30,000 per event and a maximum of R60,000 per person per year.