Even if you think that you cannot afford medical aid, you might just be surprised to find out that you could find good medical cover that you can afford with Thebe Med Medical Aid Scheme.
ThebeMed is a unique medical aid scheme providing affordable, quality healthcare to members earning between R 2,000 and R 6,000 per month.
Once you earn more than R5 000 the options are not so “affordable” anymore as all the options are income-based.
ThebeMed provides a variety of benefit options and a selection of service providers suited to meet the specific needs of their individual members.
- Comprehensive private hospital cover
- Extensive out of hospital benefits
- Affordable premiums
Simple Approach of ThebeMed Medical Aid Scheme
The scheme has adopted an approach that will enable the fund to be simple and easy-to-use when medically necessary.
On both the Energy and Universal options, there is extensive day-to-day medical cover, and to streamline the whole process, the General Practitioner (GP) is the Key Role Player.
The GP is seen as the gatekeeper and must determine whether further treatment is needed. Referalls to specialists and radiologists must be made by your GP, otherwise the costs will not be paid in full.
[tip title=”moneysmart tip”]When in doubt, always go back to your GP.[/tip]The Plans
There are 2 plans, namely the Energy Plan and the Universal Plan.
Both are very similar, providing private hospital cover as well as comprehensive day-to-day medical benefits through a network of providers.
On the Universal plan, the benefits are a little bit more restrictive and limited than on the Energy Plan.
With the Universal Plan, you don’t have any choice in the DSP (Designated Service Provider), but on the Energy plan members will be able to select a network option that will best suit their needs in terms of choice of provider and affordability.
You can choose between paying more (and having more choice in terms of the number of doctors you may visit) or paying less and staying with one doctor.
The member’s contribution would be charged according to Network selection.
- Core Members are only allowed to consult 1 Primary Care Provider in the Core Network. Failing to do so will result in no payment.
- Medium Members have a choice of up to 3 Primary Care Providers in the Medium Network. Failing to do so will result in a 25% co-payment.
- Open Members are allowed to consult any Primary Care Provider in or out of the Network.
Unique Benefits of ThebeMed Medical Aid Scheme
Some of the unique benefits offered by ThebeMed Medical Aid Scheme are listed below:
Member Support Services
A programme has been developed to help members improve their state of health, develop coping skills and for members to accept responsibility for their own wellness.
Some of the benefits include :
- Confidential counselling advice line
- Short-term counselling
- Marital and relationship difficulties
- Personal and work related stress
Maternity Benefits/BAMBINO Programme
This programme includes the following:
- 2 antenatal visits (Universal)
- 2 sonars (Universal) OR 3 sonars (Energy)
- Maternity hamper
Home Delivery
- By a registered midwife
- Limited to R6 000 per pregnancy
The Premiums
Please note: All benefits will be pro-rated for members admitted during the benefit year. All costs payable at 100% of negotiated rates.
UNIVERSAL PLAN
| COMBINED INCOME |
MAIN MEMBER |
ADULT DEPENDENT |
CHILD DEPENDENT |
| 0 – 2500 | R578 | R514 | R287 |
| 2501 – 5000 | R605 | R537 | R300 |
| 5001 – 7500 | R717 | R616 | R336 |
| 7501 + | R1008 | R952 | R392 |
ENERGY PLAN
|
INCOME |
NETWORK |
|||||
|
CORE |
MEDIUM |
OPEN |
||||
| SINGLE | M+1* | SINGLE | M+1* | SINGLE | M+1* | |
| 0 – 4000 | R945 | R1638 | R1181 | R2048 | R1330 | R2305 |
| 4001 – 7500 | R1464 | R2094 | R1626 | R2326 | R1912 | R2733 |
| 7501 – 10k | R2310 | R3118 | R2497 | R3371 | R2996 | R4045 |
| 10 001 + |
R2587 | R3358 | R2722 | R3533 | R3403 | R4417 |
* M+1 refers to principal member plus 1 dependent
[gravityform id=”31″ name=”Medical Aid Thebe”]For more information visit http://www.thebemed.co.za/ or call them on 0861 84 32 36.
For any medical aid queries or advice, please feel free to contact Nelda at nelda@medicalbenefits.co.za or call (021) 975-8324.
