DHMS Basic Plan Comparison 2018 - afhealth.co.za

1 Alexander Forbes Health is a licensed financial services provider (FSP 33471).CMS registration number (ORG 3064)HEALTH12974-Health-YendCompa-2017-1 0 DHMS Basic plan Comparison 2018 KeyCare Series (Access, Core, Plus)SeriesBenefit DescriptionAccessCorePlusHospitalisation Cover while you re admitted into a general ward in hospital, including theatre and ward fees, specialists and radiology for an authorised for specialists on a payment arrangement, up to the Discovery Health negotiated rate. In addition to the general exclusions, additional exclusions apply to all KeyCare plans such as in-hospital dentistry, functional nasal surgery, joint replacements and of Cover for Specialists100% of Discovery Health rate for emergencies and trauma in the KeyCare network of private hospitals. Childbirth and care for your newborn covered in the KeyCare Access network. Other admissions are covered in a contracted network of state of Cover for Specialists100% of Discovery Health rate cover in the KeyCare Full Cover Hospital Network and 70% cover in the Partial Cover Hospital NetworkHospital and related accounts if member is admitted to a non-network hospital for a planned is a list of procedures that are covered in the KeyCare day surgery / Cancer coverIf you re diagnosed with cancer and once Discovery Health Medical Scheme have approved your cancer treatment, you are covered by the OncologyCare treatment is covered according to the Prescribed Minimum Benefits in a network of contracted state treatment is covered according to the Prescribed Minimum Benefits and if member goes to a cancer specialist in the Recovery Extender BenefitCovers certain out-of-hospital claims related to a defined list of traumatic events.

2 Claims are paid from the Trauma Recovery Extender Benefit for the rest of the year in which the trauma occurred, as well as the year after the event , subject to scheme benefitCovered, subject to scheme Gastroscopy, Colonoscopy, Sigmoidoscopy, ProctoscopyCovers scopes at the contracted state facilities and in the KeyCare Access Hospital Network if related to emergencies, trauma, childbirth and care for a scopes at the Discovery day-surgery purpose of this plan Comparison is to assist with the main differences between specific plans. For full details of each plan , please refer to the DHMS member guide and scheme rules will always Forbes Health is a licensed financial services provider (FSP 33471).CMS registration number (ORG 3064)HEALTH12974-Health-YendCompa-2017-1 0 DHMS Basic plan Comparison 2018 KeyCare Series (Access, Core, Plus) continuedSeriesBenefit DescriptionAccessCorePlusMaternity coverMaternity and post-birth benefitsSpecialist cover is subject to the baby born onto the Scheme and up to 12 months after is covered for two years after birth for up to two visits at a GP, paediatrician or an ENT within the KeyCare doctor network; member is covered for one six-week (post-birth) consultation at midwife, GP or gynaecologist; one nutritional assessment at a dietician.

3 Two mental health consultations with a counsellor or psychologist and one lactation consultation with a registered nurse or lactation gynaecologist consultations don t affect the KeyCare Specialist gynaecologist consultations do require a GP-to-specialist that aren t on the KeyCare specialist network won t be funded from the Maternity BenefitOffered though network providers; GP consultations, Basic dentistry, specialist visits, pathology, radiology, casualty, and so primary care through chosen GP and day to day medicine from medicine list, Basic radiology and pathology at network providerCasualty R325 co-payment fee payable by required per benefitCovers primary care through chosen GP and day-to-day medicine from medicine list, Basic radiology and pathology at network provider R325 co-payment fee payable by member. Pre-Authorisation required per : Whilst all reasonable care has been taken in compiling this plan specific Comparison , we have relied on information provided to us by the Discovery Health Medical Scheme (DHMS).

4 Consequently, we cannot accept any liability for errors or omissions that may arise as a result of reliance on such information.