about prosecure & prosecure savvy 2021 · 2020. 10. 21. · prosecure savvy 2021 maternity...

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The ProSecure options provide an exceptional range of comprehensive day-to-day and hospital benefits at affordable rates, perfect for your young family. If you need cover for planned and emergency hospital admissions, rich maternity benefits, chronic medication as well as day-to-day benefits, consider one of the ProSecure options. The rich maternity benefits are offered exclusively on these options. ABOUT PROSECURE & PROSECURE SAVVY 2021 MATERNITY PROGRAMME OUT-OF-HOSPITAL, PAID FROM RISK: 13 Consultations at a medical practitioner, including midwives 2 Ultra-sound scans (ante-natal) 1 Lactation consultation 1 Nutrition consultation 1 Nuchal Translucency Non-Invasive (NIPT) test Expectant mothers have access to the Profmed Baby programme via the Profmed App. You can also register your baby on the Scheme via the App. We’ll support you with helpful information during this special time and you’ll receive a special gift from us for your baby. ENJOY THESE PROSECURE & PROSECURE SAVVY BENEFITS All benefits are subject to the availability of funds, Scheme rules and protocols. Doctors’ fees in- and out-of-hospital paid at 100% Specific Tariff 1 Dentists’ fees in- and out-of-hospital paid at 135% Profmed Tariff Unlimited private hospitalisation Rich oncology cover Transplants, donor costs and dialysis 2 MRI and CT scans in- or out-of-hospital. Out-of-hospital paid at 80%, subject to annual overall day-to-day limit Rehabilitation Internal surgical devices Preventative care for early detection of high-risk diseases ENHANCED Trauma and HIV assistance Contraceptives Child immunisations and pneumococcal vaccine Chronic medication for 40 conditions (including ADHD) Day-to-day cover, e.g. consultations, acute medication, pathology and radiology Day-to-day dentistry cover, not subject to the day-to-day limit International travel emergency medical assistance up to R5 million per beneficiary, per journey. Out-of-hospital limit of R10 000, co- payment of R2 000 Emergency ambulance services Profmed Baby programme Sabbatical benefit of no longer than 3 years with lenient underwriting on return to South Africa. Available after one year of membership Multiply Wellness and Rewards Programme PROSECURE MONTHLY CONTRIBUTIONS ADULT: R4 079 ADULT DEPENDANT: R3 777 CHILD: R1 594 PROSECURE SAVVY MONTHLY CONTRIBUTIONS ADULT: R3 672 ADULT DEPENDANT: R3 399 CHILD: R1 434 1 Specific Tariff - Procedures: 120% of Profmed Tariff; Consultations: R502 for GPs and R754 for specialists; or paid at code-specific Rand values Savvy hospitalisation at network hospitals. POST-NATAL HOMEBASED NURSE VISIT, SUBJECT TO DAY-TO-DAY LIMIT *NEW A post-birth visit at 6 weeks, incorporating wellness checks for baby and mom and administration of 6-week immunisations. Designated Service Provider is SA Home Care.

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Page 1: ABOUT PROSECURE & PROSECURE SAVVY 2021 · 2020. 10. 21. · PROSECURE SAVVY 2021 MATERNITY PROGRAMME OUT-OF-HOSPITAL, PAID FROM RISK: 13 Consultations at a medical practitioner, including

The ProSecure options provide an exceptional range of comprehensive day-to-day and hospital benefits at affordable rates, perfect for your young family.

If you need cover for planned and emergency hospital admissions, rich maternity benefits, chronic medication as well as day-to-day benefits, consider one of the ProSecure options.

The rich maternity benefits are offered exclusively on these options.

ABOUT PROSECURE & PROSECURE SAVVY2021

MATERNITY PROGRAMME OUT-OF-HOSPITAL, PAID FROM RISK: 13 Consultations at a medical practitioner, including midwives

2 Ultra-sound scans (ante-natal)

1 Lactation consultation

1 Nutrition consultation

1 Nuchal Translucency Non-Invasive (NIPT) test Expectant mothers have access to the Profmed Baby programme via the Profmed App. You can also register your baby on the Scheme via the App. We’ll support you with helpful information during this special time and you’ll receive a special gift from us for your baby.

ENJOY THESE PROSECURE & PROSECURE SAVVY BENEFITS

All benefits are subject to the availability of funds, Scheme rules and protocols.

Doctors’ fees in- and out-of-hospital paid at 100% Specific Tariff1

Dentists’ fees in- and out-of-hospital paid at 135% Profmed Tariff Unlimited private hospitalisation Rich oncology cover Transplants, donor costs and dialysis

2 MRI and CT scans in- or out-of-hospital. Out-of-hospital paid at 80%, subject to annual overall day-to-day limit Rehabilitation Internal surgical devices Preventative care for early detection of high-risk diseases ENHANCED Trauma and HIV assistance Contraceptives

Child immunisations and pneumococcal vaccine Chronic medication for 40 conditions (including ADHD) Day-to-day cover, e.g. consultations, acute medication, pathology and radiology Day-to-day dentistry cover, not subject to the day-to-day limit International travel emergency medical assistance up to R5 million per beneficiary, per journey. Out-of-hospital limit of R10 000, co-payment of R2 000 Emergency ambulance services Profmed Baby programme Sabbatical benefit of no longer than 3 years with lenient underwriting on return to South Africa. Available after one year of membership

Multiply Wellness and Rewards Programme

PROSECURE MONTHLY CONTRIBUTIONS ADULT: R4 079 ADULT DEPENDANT: R3 777 CHILD: R1 594

PROSECURE SAVVY MONTHLY CONTRIBUTIONS ADULT: R3 672 ADULT DEPENDANT: R3 399 CHILD: R1 434

1 Specific Tariff - Procedures: 120% of Profmed Tariff; Consultations: R502 for GPs and R754 for specialists; or paid at code-specific Rand values

Savvy hospitalisation at network hospitals.

POST-NATAL HOMEBASED NURSE VISIT, SUBJECT TO DAY-TO-DAY LIMIT *NEW

A post-birth visit at 6 weeks, incorporating wellness checks for baby and mom and administration of 6-week immunisations.

Designated Service Provider is SA Home Care.

Page 2: ABOUT PROSECURE & PROSECURE SAVVY 2021 · 2020. 10. 21. · PROSECURE SAVVY 2021 MATERNITY PROGRAMME OUT-OF-HOSPITAL, PAID FROM RISK: 13 Consultations at a medical practitioner, including

All benefits are subject to the availability of funds, Scheme rules and protocols.

JOIN PROFMEDCall: 0800 DEGREE (334 733)Email: [email protected]

ANNUAL OVERALL DAY-TO-DAY LIMITS MEMBER: R11 654 MEMBER +1: R17 174 MAXIMUM: R22 842 PER FAMILY

ACUTE MEDICATION BENEFIT Subject to annual overall day-to-day limit MEMBER: R3 787 MEMBER +1: R5 669 MEMBER +2: R6 258 MEMBER +3: R6 490 MAXIMUM: R6 992 PER FAMILY OTC: R1 565 PER FAMILY 80% of cost. Subject to acute medication and day-to-day limits

CHRONIC MEDICATION LIMITS MEMBER: R17 364 MEMBER +1: R28 434 MAXIMUM: R39 387 PER FAMILY

DAY-TO-DAY DENTISTRY LIMITS PER BENEFICIARY: R6 071 MAXIMUM: R12 237 PER FAMILY

Not subject to day-to-day limit

EXTERNAL PROSTHESES AND APPLIANCES LIMITS PER FAMILY: R14 567 ADDITIONAL FOR HEARING AIDS ONLY: R6 875

CLIENT SERVICES Call: 0860 679 200Email: [email protected]: [email protected] Private Bag X1031, Lyttelton, 0140

OPTION LIMITS