DAY TO DAY BENEFITS Network COMPCARE NETWORK CARECROSS & PRIMECURE GP consultations Unlimited GP visits Unlimited GP visits Unlimited at network GP subject Unlimited at network GP subject to Prescribed medication to formulary formulary Network provider subject to Network provider subject to Pathology (Blood tests) specific list specific list Network provider subject to Network provider subject to Radiology (x-rays) specific list specific list Flexi Benefit R2 120 Basic dentistry at Network provider Dentistry Payable from Flexi Benefit and protocols 1 consultation per year subject to referral, pre-auth and 10% co-pay Specialist consultations Payable from Flexi Benefit maximum of R700. 1 visit per year, limited to R770 Casualty benefit Payable from Flexi Benefit with 20% co-pay Subject to network provider and Optometry (2 year cycle - including specific range of frames and eye test) Payable from Flexi Benefit lenses 2 consultations per year - pay 1 consultation per year - pay upfront and claim back to upfront and claim back to maximum of R800 per event - maximum of R730 per event - Out of network visits refunded at 80 % refunded at 80 % CONTRIBUTION R 318 per month R 329 per month
DAY TO DAY BENEFITS Network COMPCARE NETWORK CARECROSS & PRIMECURE GP consultations Unlimited GP visits Unlimited GP visits Prescribed medication Unlimited at network GP subject to formulary Unlimited at network GP subject to formulary Pathology (Blood tests) Network provider subject to specific list Network provider subject to specific list Radiology (x-rays) Network provider subject to specific list Network provider subject to specific list Flexi Benefit R2 120 Dentistry Payable from Flexi Benefit Basic dentistry at Network provider and protocols Specialist consultations Payable from Flexi Benefit 1 consultation per year subject to referral, pre-auth and 10% co-pay maximum of R700. Casualty benefit Payable from Flexi Benefit 1 visit per year, limited to R770 with 20% co-pay Optometry (2 year cycle - including eye test) Payable from Flexi Benefit Subject to network provider and specific range of frames and lenses Out of network visits 2 consultations per year - pay upfront and claim back to maximum of R800 per event - refunded at 80 % 1 consultation per year - pay upfront and claim back to maximum of R730 per event - refunded at 80 % CONTRIBUTION R 318 per month R 329 per month
ABSAMedicalAidCoverGuideFebruary2012.docx