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  Medihelp Necesse

Medihelp

Scheme option info for a single person

Scheme dataMedihelp
Necesse 2011
Scheme membership size112678
Scheme solvency31.5%
Plan DataMedihelp
Necesse 2011
Plan typeCapitated
Membership size11360
Hospital BenefitsMedihelp
Necesse 2011
Hospital limitCapped
R800 000 per family per year
Account paid at100%
100% of the Prime Cure agreed tariff.
Choice of hospitalContracted Network Hospitals only
Contracted private hospital or government hospital.
Standard co-payment for hospital admissionsNo
Hospital Co-Payment / DeductableCo-pay on defined list
R1000 co-payment on unauthorised non-emergency admissions
Chronic Medicine BenefitsMedihelp
Necesse 2011
Number of conditions covered26
Does scheme pay for high cost specialist medicinesNo stated benefit
Day to day benefitsMedihelp
Necesse 2011
Benefits

This is a capitated product and day to day benefits are provided by a limited network of providers. Treatment protocols and medicine lists apply.

RATESMedihelp
Necesse 2011
Base rate
Member: R 684
Adult: R 540
Child: R 294

This comparison is a summarised overview of the scheme options. The rules of the scheme prevail. (C) Jenus Group