Displaying details for ALLIANCE
| ALLIANCE | |
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| OTHER BENEFITS (per Beneficiary) SUBJECT TO THE ANNUAL OVERALL DAY-TO-DAY BENEFIT LIMIT | |
| DAY TO DAY BENEFITS BENEFITS BELOW ARE SUBJECT TO THE OVERALL ANNUAL LIMIT | Annual Overall Limits Adult R34 100 Child R21 300 |
| GP’S AND DENTISTS DENTAL X-RAYS PERFORMED BY DENTISTS, CONSULTATIONS AND PROCEDURES PERFORMED BY THESE PRACTITIONERS; BASIC DENTISTRY | 80% CBT |
| SPECIALISTS CONSULTATIONS, PROCEDURES AND RADIOLOGY PERFORMED BY THESE PRACTITIONERS | 80% CBT |
| ACUTE MEDICATION INCLUDING INJECTIONS AND MATERIALS | 80% SEP plus dispensing fee, subject to MMAP, co-payment from MSA |
| NON-DSP VISITS TO DOCTORS ROOMS | Not applicable |
| CASUALTY AND OUT PATIENT TREATMENT AT A HOSPITAL ALL MEDICATIONS WILL BE PAID OUT OF ACUTE MEDICATION BENEFIT | 80% CBT |
| NURSE VISITS | 80% CBT up to 21 days |
| SUPPLEMENTARY HEALTH AUDIOLOGY, CHIROPRACTORS, DIETICIANS, HOMOEOPATHS, OCCUPATIONAL THERAPY, PHYSIOTHERAPISTS, BIOKINETICISTS, PODIATRY AND SPEECH THERAPY | 80% CBT |
| ADVANCED DENTISTRY CROWNS, BRIDGES, ORTHODONTICS, DENTURES | 80% CBT limited to: M0 R17 400 M1 R26 000 M2+ R31 300 |
| OVER THE COUNTER MEDICATION | 80% SEP plus a dispensing fee, subject to MMAP, co-payment from MSA, limited to R4 400 per beneficiary |
| LASER K/EXCIMER LASER NO APPROVAL FOR SURGERY WHERE SPECTACLES OBTAINED IN PREVIOUS 12 MONTHS | 80% CBT limited to R13 155 per beneficiary per eye |
| SPECTACLES AND LENSES FROM OPTOMETRIST ONLY ANNUAL BENEFIT, UNLESS OTHERWISE STATED | Consultation: See Preventative Wellness Benefit Add ons R1 710 Single vision R1 710 OR Bifocal R3 420 OR Varifocal R5 150 AND Frames R7 670 OR Contact lenses R7 460 Lenses, frames etc 80% Optical Assistant Rates |
