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This is a plan designed to cater to lower-level employees offering affordable basic medical aid benefits with private hospital access limited to Grade B Hospitals.
Where usage is considered excessive the Society reserves the right to restrict usage or recommend cost effective treatment options.

Medical Benefits

The following benefits are paid at to tariff.
  • Access to Private healthcare facilities.
  • In-hospital drugs.
  • General practitioners.
  • Specialist Treatment is covered upon referral by a primary care service provider.
  • Pathology and Radiology Services at Private and Government facilities.
  • Blood Transfusion Services (BTS).

Drug Benefits

  • Prescription drugs paid at the Cimas tariff up to an annual family limit.

Optical Benefits

  • Optical benefit up to package sublimit once every two (2) year period.

Maternity Benefits

  • Maternity cover includes consultation, delivery as well as ante and post natal visits.
  • Awards are paid at 100% up to sub limit.
  • There are also 2 antenatal scans allowed per pregnancy.

Dental Benefits

This caters for general and preventive dentistry including inlays, root-treatment, fillings, crowns and bridges, implants and orthodontic work.
  • Claims are paid at Healthguard tariff up to sub limit.
  • Prior authorization is required for crowns, bridges, dentures and orthodontic treatment.

Emergency Evacuation Services

Covered for life threatening situations only
  • Road Ambulance service is paid to tariff.
  • Air evacuation is paid to tariff.

Waiting Periods

The following benefit waiting periods apply to those joining the Society for the first time or where there has been a lapse in the membership. The Society reserves the right to waive waiting periods for members transferring from AHFoZ affiliated medical aid societies. These waiting periods include:
Four months for:-
  • A mandatory four (4) months waiting period will apply to all new members
Six months for:
  • Specialist treatment
  • MRI, CT scans and Nuclear medicine
  • Admission or treatment at a hospital
  • Dental treatment
Nine months for:
  • Maternity benefits
One (1) year for:
  • Spectacles/Contact lenses
  • Foreign treatment
Two (2) years for:
  • All internal and external prosthetic devices
  • Oncology benefit
  • Haemodialysis
  • Pre-existing conditions
Four (4) years for:
  • Orthodontic Treatment
  • For orthodontic work, members seek prior-authorisation from the Society before accessing treatment.
  • The age limit for the benefit is 18 years

Prior-Authorisation

  • To access treatment for chronic conditions members need to register with the Society’s Managed Care department. The Society does not guarantee full cover where a member/service provider does not seek pre-authorisation before accessing services.