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This traditional and first-class option provides members with comprehensive cover, which includes extensive day-to-day benefits; unlimited private hospitalisation; 26 CDL plus 28 non-CDL conditions. The option to choose if you would like a choice of providers.


R8 469R7 209R2 121


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 page 77 of Member Guide.

Day-to-day limit

M – R31 020
M1 – R43 240
M2 – R50 290
M3+ – R59 040

General practitioners (GPs) and specialists Subject to day-to-day limit

Subject to day-to-day limit
Scheme rates and managed care protocols apply
Please call 0861 000 300 for more information


M – R14 040
M1 – R15 210
M2 – R17 910
M3 – R19 540
M4+ – R120 830

Over the counter (OTC) R1500 per female beneficiary up to the age of 45 years
per annum
Contraceptives: oral, and iinjectables
Devices subject to pre-authorisation
R255 per event per day
Chronic benefit
Benefits are subject to registration onto the chronic management programme
Provider - Any provider
26 conditions covered as per the chronic disease list and prescribed minimum benefits.
Refer to page 22 for more information on co-payments

Per beneficiary = 1 composite eye examination
Per beneficiary = a frame of up to R1 570 and 2 lenses every 24 months
Contact lenses of up to R2 280 instead of glasses per year


Single member = R2 849
Family = R5 742


Single member = R15 090
Family = R22 400

Auxiliary services


At a preferred provider, subject to auxiliary sub-limit and day-to-day limits

Single member = R5 975
Family = R18 030

ADDITIONAL BENEFITS (paid from risk benefits)
Chronic medicine
Non-CDL chronic medicine limit

26 conditions – unlimited – plus 28 conditions, subject to sub-limits:

M – R7 720
M1 – R15 450
M2 – R16 680
M3 – R19 270
M4 – R21 280
M5+ – R22 510

Co-payment for non-formulary medicine 20%

Free Hello Doctor consults

Telephonic consults via HELLO DOCTOR. Talk or text a doctor on your phone, anytime, anywhere, any official language – for free Refer to page 10 for detailed information.

Medical and surgical appliances General per family = R11 650
Sub-limits to Appliance Benefit:
Glucometer per beneficiary every 2 years R915
Nebuliser per family every 3 years R915
Hearing aids

Per beneficiary every 3 years

Hearing aid maintenance


Unilateral = R13 660
Bilateral = R27 440
R1 230 per beneficiary per annum

External Prosthesis Per family per annum = R32 480
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 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.
Public and private hospital Unlimited
(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 injections
If performed in hospital
A co-payment of R1 200 will apply per
admission, which needs to be paid directly by the member to the treating practitioner
If performed out of hospital
Procedure will be paid at Scheme rate subject to pre-authorisation and clinical protocols
GPs and specialists Unlimited
Specialist – subject to preferred provider rates
To-take-out medicine Up to 7 days
Organ transplant (non-PMB cases)

Per family = R76 070 limit includes harvesting and transportation costs
National donor only

Internal Prostheses Per family per annum = R52 650
Refractive eye surgery Per beneficiary per eye = R6 540; maximum of R R13 080 for both eyes once per lifetime
Reconstructive surgery Per family = R75 950
MRI, CT, PET and radio isotope scans R15 900 per scan
per family per annum = 2 scans from risk thereafter from the annual day-to-day limit subject to clinical protocols and pre-authorisation
Alternate care instead of hospitalisation Per family = 30 days to a maximum of R46 150 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-authorization
Alcohol and drug rehabilitation 100% of negotiated rate, at a South African National Council on Alcoholism and Drug Dependence (SANCA)-approved facility
Subject to clinical protocols
Dialysis Unlimited and subject to use of preferred provider, clinical protocols and preauthorization
Oncology Unlimited clinical protocols and pre-authorization
Pathology and radiology Unlimited subject to clinical protocols
General dentistry Subject to day-to-day limit and sublimits
Ambulance transport Emergency road and air transport subject to use of the designated service provider, clinical protocols and pre-authorization


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

Dental exclusions as set out in Annexure F of the Rules