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SERVICE ITEM

EXCEL PLAN (RTGS)

Member              $82

1st Beneficiary    $82

2nd & Sub. Ben.  $64

Adult Ben.          $82

LINK PLAN (RTGS)

Member               $52

1st Beneficiary     $52

2nd & Sub. Ben.  $ 52

Adult Ben.           $52

GUARDIAN PLAN (RTGS)

Member             $37

1st Beneficiary    $37  

2nd & Sub. Ben  $37

Adult Ben.         $37

GLOBAL LIMIT $32 000 per annum $20 000 per annum $10 000 per annum
General Practitioners Paid in full according to negotiated tariff Paid in full according to negotiated tariff Paid in full according to negotiated tariff
Medical Specialists Paid in full according to negotiated tariff Paid in full according to negotiated tariff Paid in full according to negotiated tariff
Hospitalisation $10 850 per annum $5 000 per annum $2 500 per annum
Rehabilitation Hospitalisation $3 000 per annum $1 800 per annum $1 000 per annum
Acute prescription drugs $ 400 per annum. $ 250 per annum  $ 200 per annum
Chronic disease drugs $650 per annum $350 per annum  $300 per annum
Haemodialysis/
Chemotherapy
Paid in full according to tariff Paid in full according to tariff Paid in full according to tariff
Dentistry $1 650 per annum

Dentures by pre-authorisation

$800 per annum

Dentures by pre-authorisation

$400 per annum
Refraction Paid in full according to tariff – once a year Paid in full according to tariff – once a year Paid in full according to tariff – once a year
Optical $ 650 per 3 years. Anything below 3 years requires Special recommendation and pre-authorisation $ 400 per 3 years.  Anything below 3 years requires Special recommendation and pre-authorisation $ 200 per 3 years. Anything below 3 years requires Special recommendation and pre-authorisation
Maternity $3 300 per annum $2 000 per annum $1 330 per annum
Family Planning $   400 per annum $   350 per annum $   200 per annum
Infertility $   800 per lifetime   $450 per lifetime            –
Hearing Aids $   900  per 2 years  $750 per 2 years            –
Pathology Paid in full according to tariff up to a limit of $900 Paid in full according to tariff up to a limit of $750 Government, Mission and Municipal hospitals up to a limit of $400
Radiology Paid in full according to tariff up to a limit of $2 500 Paid in full according to tariff up to a limit of $1 500 Government, Mission and Municipal hospitals up to a limit of $800
Blood Transfusion Paid in full according to tariff Paid in full according to tariff Government, Mission and Municipal hospitals
Psychiatric Services Paid in full according to tariff Paid in full according to tariff Paid in full in at Government, Mission and Municipal hospitals
Rehab Services $750 per annum $500 per annum $400 per annum
Prostheses $1 100 per 5 years Government, Mission and Municipal hospitals up to a limit of $800            –
Private Ambulances Paid in full according to tariff Paid in full according to tariff Paid in full according to tariff at Government, Mission and Municipal hospitals
Air Evacuation Paid in full for life threatening situations only and subject to pre-authorisation            –            –
Foreign Treatment Paid according to local tariffs based on benefit limits Paid according to local tariffs based on benefit limits Paid according to local tariffs based on benefit limits

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