Synergy

Synergy 2018-08-09T08:56:59+00:00

Monthly premium:

R196.71 per family for under 65yrs

Monthly premium:

R265.31 per family for 65yrs+

This is the ideal benefit offering to choose if your medical aid has additional co-payments and out-of-pocket deductibles.

Benefits
In-hospital benefits Medical Expense Shortfall Cover Increases the medical aid rate up to 500%. (e.g. Specialists, GP’s, Anaesthetists, Radiology, Pathology, etc). Subject to the Overall Annual LimitIncreases the medical aid rate up to 500%. (e.g. Specialists, GP’s,
Anaesthetists, Radiology, Pathology, etc). Subject to the Overall Annual
Limit
Co-payment Cover R50 000 per admission per insured. Subject to the Overall Annual Limit
Non-DSP Hospital Penalty Cover R5 000 per admission. Limited to 1 claim per family per annum. Subject to
the Overall Annual Limit
Sub-limit Cover R15 000 per admission per insured. Limited to R50 000 per family per
annum, subject to the Overall Annual Limit
Out-of hospital benefits Co-payments for MRI, CT and PET scans R50 000 per admission per insured. Subject to the Overall Annual Limit
Casualty Benefit (Accidents only) R6 500 per event per insured. Subject to the Overall Annual Limit
Added benefits Medical Scheme Contribution Waiver Up to R5 500 per month for 6 months; in the event of death or permanent
and total disability as a result of an accident, of the medical scheme
contribution payer
Gap Premium Waiver Pays the premium for your Synergy policy for 6 months; in the event of
death or permanent and total disability as a result of an accident, of the
contribution payer
International Travel Cover R5 000 000 per insured

Overall Annual Limit (OAL) – R150 000 per insured per annum

Waiting Periods

  • A 3-month general waiting period applies to all benefits, with exception of benefits providing cover up to 500% should the commencement of the policy be in line with the commencement date of the medical scheme
  • A 9-month waiting period on pregnancy/childbirth
  • A 12-month waiting period on: hysterectomy (except where malignancy can be proven), hysteroscopies and endometrial ablations; joint replacements and spinal investigations, treatment or surgery (except in the event of an accident); tonsillectomy, myringotomy, grommets, adenoids, wisdom teeth and treatment or surgery for a hernia (except as a result of emergency surgery), treatment and/or surgery for cataracts, gastroscopies, colonoscopies; treatment and surgery for rotator cuff repair; treatment and surgery for nasal and sinus surgery; knee surgery and pre-diagnosed cancer
  • Please note that this is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership.