Emergency Room Cover
A sub-limit of R6 000 is applicable. This benefit covers an emergency at any registered emergency facility when you require immediate medical treatment due to an accident or illness. The following benefits collectively accumulate to the sub-limit. Accident benefit: all costs related to the accidental event will be covered and paid to a maximum value of the sub-limit available, whether you are liable to pay the costs related to the emergency event out of your own pocket or if your medical scheme pays from your savings account. Illness benefit: when you visit an emergency room in a medical emergency as a result of illness, we will cover the Gap portion only. We will cover a GP’s emergency facility where no hospital emergency is available within a 30km radius within the above stated benefit limits.
Appliance Benefit
Subject to a sub-limit of R3 600 per policy per annum with a claim limit of R1 200 for your Gap component as per the defined list: hearing aids, wheelchairs, CPAP machine, humidifiers, insulin
pump, glucometer, nebuliser and the Mirena device.