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This new generation plan provides members with the flexibility and independence to manage their own day to day expenses via generous
savings and a rich hospital cover. Members on the Classic Network option can enjoy significant savings on their monthly contributions and
still enjoy comprehensive benefits.


This is the portion of your monthly contribution that is allocated to a savings account that is held in the principal member’s name. The money in this account is used to pay for out-of-hospital medical expenses

ClassicR8 700R7 380R2 172


ClassicR4 304R3 653R1 078


MHC’s philosophy is to provide quality, comprehensive healthcare while maintaining affordable contributions. In order to strike the necessary balance to achieve our philosophy, it is necessary to introduce DSPs. In this way, MHC can contain spiralling healthcare costs but nevertheless ensure that members receive the most appropriate treatment.

Members may choose not to use the DSP but will be liable for any co-payment over and above what is charged by the DSP.


Not sure what we mean? Refer to glossary on pg 62 of the Member Guide.

General practitioners (GPs) and specialists Subject to ASL
Telehealth Subject to ASL Scheme rates and managed care protocols apply Please call 0861 000 300 for more information
Over the counter (OTC)
Preventative medicines
Subject to ASLR230 per event per day
Paid from ASL – refer to page 11 of the Member Guide
Chronic benefit
Benefits are subject to registration onto the
chronic management programme
Provider - Network pharmacy
26 conditions covered as per the
chronic disease list and prescribed
minimum benefits
Refer to page 18 of the Member Guide for more information on co-payments
Subject to ASL
Per beneficiary: 1 composite eye examination, a frame of up to R860 and 2 lenses every 24 months OR contact lenses of up to R1 530 instead of glasses per year

Members may utilise positive savings for claim values above the annual optometry limits. Please call 0861 000 300 for more info

Dentistry: Basic and specialised
Please note that, while dentures are covered, there is a limit of 1 set of dentures every 4 years per beneficiary. General anaesthetic is available for children under the age of 8 for extensive basic treatment and this is limited to once every 24 months per beneficiary. Cover is available for the removal of impacted wisdom teeth in theatre but must be pre-authorised by emailing a detailed quotation and clear panoramic radiograph to the dental department.
Subject to ASL
Auxiliary services Subject to ASL


Chronic medicines

Non-CDL chronic medicine

26 conditions – unlimited (refer to page 60 of the Member Guide),
plus 10 conditions, subject to sub-limits:

M0 – R5 180
M1 – R10 250
M2 – R12 790
M3 – R13 845
M4 – R15 745
M5+ – R18 180

Network provider Medipost Pharmacy
Co-payment for non-formulary medicine 20%
Co-payment for use of non-network provider 30%
Free Hello Doctor consults Telephonic consults via HELLO DOCTOR. Talk or text a doctor on your phone, anytime, anywhere, official language – for free. Refer to page 10 for detailed information
Medical and surgical appliances
General appliances per family per annum R14 690
Sub-limits to Appliance Benefit:
Glucometer per beneficiary every 2 years
Nebuliser per family every 3 years R865
External Prosthesis per family per annum R25 900
MRI, CT, PET and radio isotope scans R15 000 per scan Per family = 2 scans paid from risk benefits thereafter ASL Subject to pre-authorisation and managed care protocols
Hearing aids

Subject to medical and surgical appliance limit every 3 years

Hearing aid maintenance R1 160 per beneficiary per annum
Mental health Subject to ASL
Extra consultations and medicine (Only once ASL reaches R300) Single member = 2 visits
Family = 5 visits
Patient care programmes (Diabetes, HIV, oncology) Subject to registration and managed care protocols


Subject to pre-authorisation and
managed care protocols
IMPORTANT: Treatment performed in-hospital or falls within the Major Medical Benefits needs to be pre-authorised prior to commencement of treatment. Conditions such as cancer will require you to register onto the Patient Care Programme to access benefits. MHC will pay benefits in accordance with the Scheme Rules and clinical protocols per condition. The sub-limits specified below apply per year. If you join the Scheme after January your limits will be pro-rated.
In-hospital limits Network hospital - Life Healthcare
State and private hospital Unlimited
30% co-payment for using non-network provider
(This co-payment is only applicable to benefit below and not the entire benefit)
Gastroscopy, colonoscopy,
sigmoidoscopy, arthroscopy, joint
replacements, diagnostic laparoscopy,
urological scopes and facet joint
If performed in hospital
A co-payment of R1200 will apply per
admission which needs to be paid
directly by the member to the treating
If performed out of hospital
Procedure will be paid at scheme rate
subject to pre-authorisation and clinical
GPs and specialists At Scheme rate
Specialists subject to preferred provider rates
To-take-out medicine Up to 7 days
Organ transplant (non-PMB cases) Per family = R71 770 (limit includes harvesting and transportation costs)
National donor only
Internal Prostheses Per family per annum = R40 800
Refractive eye surgery

Per beneficiary per eye = R6 170; maximum of R12 340 for both eyes once per lifetime

Reconstructive surgery (as part of PMBs) Per family = R71 660
MRI, CT, PET and radio isotope scans R15 000 per scan Per family = 2 scans paid from risk thereafter from ASL subject to motivation Subject to clinical protocols and pre-authorisation
Alternate care instead of hospitalisation Per family = 30 days to a maximum of R38 580 per event subject to clinical protocols and pre-authorisation
Mental health (in- and out-of-hospital) 100% of Scheme rate subject to clinical protocols and pre-authorisation
Alcohol and drug rehabilitation 100% of negotiated rate, at a South African National Council on Alcoholism and Drug Dependence (SANCA)- approved facility
Dialysis Subject to use of preferred provider, clinical protocols and pre-authorization
Oncology in and out of hospital
Non-PMB cases

PMB cases

Per family = R500 000 per annum
20% co-payment after limit has been
Subject to clinical protocols and preauthorisationUnlimited
Pathology and basic radiology At Scheme rate
General dentistry Subject to ASL and dental protocols
Ambulance transport Emergency – road and air Subject to use of the designated service provider, clinical protocols and preauthorization


General exclusions as set out in the Annexure D of the Rules

Dental exclusions as set out in Annexure F of the Rules