Member Guide
CUSTOM OPTION
CUSTOM OPTION Targeted at young and healthy members. The Custom plan provides you and your dependants an opportunity to make health part of your journey with quality provider networks and a continuously enhanced benefit package. PRINT OR DOWNLOAD MONTHLY CONTRIBUTION SALARY BAND MEMBER ADULT CHILD R0 – R3 855 R1 324 R1 060 R339 R3…
ESSENTIAL OPTION
ESSENTIAL OPTION This entry level option is ideal for first time medical cover buyers – young and healthy individuals. It offers them peace of mind every stage of their health journey by using quality provider networks that offer simple day-to-day benefits and hospital cover. PRINT OR DOWNLOAD MONTHLY CONTRIBUTION SALARY BAND MEMBER ADULT CHILD R0…
Fight Against Fraud backup 2019
FIGHT AGAINST FRAUD! Anonymous, 24-hour, toll free fraud line: 0800 00 04 36 Fraud is a serious issue that affects your medical scheme benefits. Fraud is an unlawful and intentional misrepresentation that results in actual or potential wrong-doing to the Scheme. The Scheme’s fraud line is managed by an independent team that ensures that members reporting…
Exclusions per Option
Exclusions per Option OPTIMUM OPTION HOSPICARE OPTION HOSPICARE NETWORK CLASSIC OPTION CLASSIC NETWORK CUSTOM OPTION ESSENTIAL OPTION ANNEXURE D: General exclusions ANNEXURE F: Dental Exclusions
ANNEXURE F: Dental Exclusions
ANNEXURE F: Dental Exclusions (with due regard to the Prescribed Minimum Benefits) The cost of general dentistry performed in hospital The cost of gold, metal or other inlays in a denture or crown Fee for after-hours visits that the Scheme considers as convenience visits Bleaching of vital teeth Unregistered items and items listed as ‘by…
ANNEXURE D: General exclusions
ANNEXURE D: General exclusions (with due regard to the Prescribed Minimum Benefits) All medical schemes have a list of services and products that they will not pay for. The Scheme’s exclusions are split into general and dental exclusions to make it easy for you to determine what will not be covered by the Scheme. Search…
MHC’s Partners
MHC‘s PARTNERS We have contracted a network of service providers who provide various administrative and operational services to ensure that you get access to quality healthcare. They are as follows: Primary care service management Designated service provider network management Preferred provider network management Dental provider network management Dental risk management Dental pre-authorisation Formulary management Pharmacy…