Displaying details for NETWORK CHOICE



 NETWORK CHOICE
IN HOSPITAL AND PRESCRIBED MINIMUM BENEFITS 
HOSPITAL ACCOMMODATION INCLUDING CONFINEMENTS, SUBJECT TO PRE-AUTHORISATION100% DSP tariff as per protocols.
The DSP hospital group is Netcare.
ATTENDING DOCTORS AND SPECIALISTS CONSULTATIONS MEDICAL AND SURGICAL PROCEDURES INCLUDING CONFINEMENTS SUBJECT TO PRE-AUTHORISATIONUp to 100% CBT
100% CBT
SUPPLEMENTARY HEALTHCARE IN HOSPITAL (EG. PHYSIOTHERAPY AND PSYCHOTHERAPY)100% CBT
BLOOD TRANSFUSIONS (IN AND OUT OF HOSPITAL)100% of cost
RADIOLOGY IN HOSPITAL ADVANCED SCANS (MRI/CT/PET) SUBJECT TO PRE-AUTHORISATION100% CBT
100% CBT limited to R38 000 per family
PATHOLOGY IN HOSPITAL100% CBT
INTERNAL PROSTHESIS SUBJECT TO PRE-AUTHORISATION100% of cost limited to R38 000 per family
Exclusions: cochlear implants
HOME NURSING UP TO 21 DAYS, SUBJECT TO PRE-AUTHORISATION100% CBT (in lieu of hospitalisation only)
STEP-DOWN/PHYSICAL REHABILITATION APPROVED FACILITIES ONLY, UP TO 90 DAYS (SUBJECT TO PRE-AUTHORISATION)100% DSP Tariff
MEDICATION IN HOSPITAL100% SEP plus dispensing fee
TTO MEDICATION UP TO ONE WEEK’S SUPPLY100% SEP plus dispensing fee
INFERTILITY TREATMENTNo benefit
SUBSTANCE ABUSEPMB applied to hospital based treatment and limited to one rehabilitation treatment per beneficiary per year, subject to pre-authorisation and limited to 21 days
CHRONIC PMB CDL MEDICATION AND TREATMENT – SUBJECT TO PRE-AUTHORISATION AND PROTOCOLS REFER TO CHRONIC DISEASE LIST100% SEP plus a dispensing fee, subject to RP and DSP. Consultations and procedures – as per PMB regulations
PMB DTP TREATMENT OUT OF HOSPITAL TREATMENT SUBJECT TO REGISTRATION OF CONDITION AND PRE-AUTHORISATIONMedication – 100% SEP plus a dispensing fee, subject to MMAP and DSP.
Consultations and procedures – as per PMB regulations
ONCOLOGY SUBJECT TO PREAUTHORISATION AND ICON PROTOCOLS#Medication – 100% SEP plus a dispensing fee, subject to RP and DSP. Consultations and procedures – 100% DSP Tariff
The DSP is the ICON network
The ICON Essential benefits apply
# Please refer to the website for ICON benefit structures


Facebook Iconfacebook like buttonTwitter Icontwitter follow buttonLinkedinLinkedin
Thanks!

Please note that our web chat operating hours

are Mondays to Thursdays 8:00am-4:00pm,

and Fridays 8:00am-3:00pm,

excluding public holidays.

Please feel free to also contact us on [email protected]

Register

If you are a member, please use the member website