Standard Plus Option

Hospitalisation

Subject to Overall Annual Benefit - M1,000,000.00 per beneficiary

Hospital Alternatives

M29,616.00 per beneficiary

Paramedical Services

100% of scheme rates

Blood Transfusion

M57,999.00 per beneficiary

Maternity

Subject to Overall Annual Benefit

Maxillofacial Surgery

Subject to Overall Annual Benefit

Mental Health
(In Hospital)

M37,500 per beneficiary, 3 days maximum if admitted by GP

Mental Health
(Out Of Hospital)

M3,200.00 per beneficiary

Oncology

M200,000.00 per beneficiary

Organ Transplant

M200,000.00 per beneficiary for tissue and organ transplant, M30,000.00 for specialized radiology (MRI & CAT scans)

Immune Deficiency

M11,106.00 per beneficiary

Renal Dialysis

M200,000.00 per beneficiary

Prosthetic Appliances

M54,000.00 per beneficiary for internal devices surgically implanted.

M14,000.00 per beneficiary for external devices

Chronic Benefit

M8,000.00 per beneficiary

Dentistry

M2,506.00 per beneficiary

Optometry (Biannual benefit)

M3,089.00 per beneficiary, 100% of optometry benefit for prescribed lenses, M1,704.00 for frames

Pathology, Physical Therapy & Radiology

M7,000.00 per beneficiary

Consultation

M4,071.00 for Member. M2,850.00 for Spouse. M1,221.00 for Child. M1,832.00 for Student 21-26. M2,443.00 for Adult. 150 per script pbpd. OTC = 900 pbpa.