Medihelp Medical Scheme

Medihelp

medihelp – why you should join?

Experienced

Industry experience is invaluable in predicting trends, honing administrative skills and dealing with the many challenges of providing sustainable and affordable healthcare cover. Medihelp has 108 years’ experience in the medical schemes industry to rely on.

Big enough

Medihelp is one of the largest open medical schemes in South Africa – we proudly take responsibility for the healthcare needs of over 220 000 South Africans.

Competitive offering

We offer ten benefit options to suit your healthcare needs. Choose between a hospital plan or comprehensive cover, freedom of choice or pay 20% less for an alternative network option.

Product Offering 

Medihelp Dimension Prime 1

A hospital plan with extra benefits for  preventative care.

The Dimension Prime range of benefit options offers members a choice between non-network options, or a significantly reduced contribution when choosing the network version of the option.
Dimension Prime network options are ideal for the healthy and offer a national footprint of excellent hospitals and specialists.

The available benefits do not differ between the standard Dimension Prime benefit options and the network options: the only difference between these options is that members of the network options must use the network hospitals, that designated specialists have been identified for these options and that the state is the designated provider for chronic PMB medicine

Medihelp Dimension Prime 2

Enjoy basic medical aid cover linked to a savings account for extra expenses.
The Dimension Prime range of benefit options offers members a choice between non-network options, or a significantly reduced contribution when choosing the network version of the option.
Dimension Prime network options are ideal for the healthy and offer a national footprint of excellent hospitals and specialists.
The available benefits do not differ between the standard Dimension Prime benefit options and the network options: the only difference between these options is that members of the network options must use the network hospitals, that designated specialists have been identified for these options and that the state is the designated provider for chronic PMB medicine.

Unify

A high savings account (25%) to cover your day-to-day healthcare needs

Essential cover for chronic illnesses on the Chronic Diseases List and 270 listed prescribed minimum benefits

Comprehensive hospital cover in the hospital of your choice

Cover for medical emergencies

Specialised radiology benefits

Preventive care health assessment tests

 

Medihelp Dimension Prime 3

Medical cover for the whole family, with benefits for optometrists and dentists.
The Dimension Prime range of benefit options offers members a choice between non-network options, or a significantly reduced contribution when choosing the network version of the option.
Dimension Prime network options are ideal for the healthy and offer a national footprint of excellent hospitals and specialists.
The available benefits do not differ between the standard Dimension Prime benefit options and the network options: the only difference between these options is that members of the network options must use the network hospitals, that designated specialists have been identified for these options and that the state is the designated provider for chronic PMB medicine.

Medihelp Elite

Comprehensive medical cover, including chronic medicine and specialists.
The Dimension range offers you seven benefit options to suit your health needs and pocket.
If you are young and healthy, the Dimension Prime network options offer you the same benefits rendered by quality network providers for certain services such as hospitalisation at 20% less.

Medihelp Plus

Medihelp Plus is Medihelp’s most comprehensive benefit option and offers ample benefits to families and individuals with diverse day-to-day medical needs. This option also offers excellent coverage for medical emergencies and private hospitalisation. In addition, preventive care benefits offer further peace of mind that your family’s health is protected.

Medihelp Necesse Network 2014

Get medical aid cover at an affordable premium at a network of doctors. This affordable network option focuses on making private healthcare services accessible to more South Africans.

  • Most healthcare services are provided by specific network doctors or providers.
  • Formularies, protocols and a pre-authorisation or registration process apply to most services.
  • This option has no overall annual limit and focuses on making private healthcare services more accessible.
  • Contributions are based on income and a network of private healthcare professionals provides access to quality care.

Insured day-to-day benefits

  • Eight of our options offer  insured day-to-day benefits.
  • Dimension Prime 2 offers the  flexibility of a savings account with unused funds accumulating for future use.

Added care

Additional insured benefits are available as part of preventive care, which include health assessment tests and immunisations.

National footprint of network providers

Our networks of healthcare providers have been cross-mapped with Medihelp’s existing member base, to ensure reasonable access and the delivery of quality care whilst curbing costs. Find a network doctor, specialist or hospital near you by simply visiting our website at www.medihelp.co.za or by downloading our member app, or dial *120*634# on your cell phone and follow the instructions.

Just for moms and babies

In addition to the day-to-day insured benefits, the Dimension range of benefit options also provides additional pregnancy and baby benefits as part of insured preventive care, consisting of:

  • 12 pregnancy consultations
  • Two 2D scans
  • Two consultations in baby’s first year
  • Standard immunisation
  • Free membership of an online pregnancy support programme with partner discounts and a baby pack.

Secured sites

Our secured sites for members and corporate customers support you with a number of functionalities to do all your Medihelp business online.

Online services

We have a member app for smart phones, complete with an e-membership card and instant benefit verification.

Edu-videos

Do you prefer watching videos to reading? Visit our library of educational videos on our website for topics such as hospital admissions, generic medicine, our member app and summarised statements.

Financially sound

Medihelp enjoys an AA- rating for its claims-paying ability from the independent rating agency Global Credit Rating. This rating marks our financial soundness in terms of our solvency and claims-paying ability.

Sustainable

The average age of our member base is getting younger and confirms that Medihelp’s range of products is attracting younger, healthier members with bigger families. A healthy profile contributes to the affordability and sustainability of your benefit option.

Monthly contribution to suit families

Members only pay monthly contributions for maximum two children younger than 18 years on the Dimension Prime range and children can remain child dependants and pay child dependant rates until the age of 26.

Hospitalisation

There are no overall annual limits on hospitalisation on any of our benefit options, with access to any private hospital. Should members choose a Dimension Prime Network option, a quality network of private hospitals will provide the same benefits at a significantly reduced contribution.

Unlimited cover for PMB and CDL

Prescribed Minimum Benefits (PMB) and conditions on the Chronic Diseases List (CDL) are covered at 100% of the cost (subject to protocols and designated service providers).

Cover in emergencies

ER24 will support you with life-saving emergency services and is just a phone call away – phone 084 124.

Social interaction

Our Facebook page and Twitter handle are tools to facilitate information sharing and the active engagement on a variety of health-related topics with our stakeholders.

Health topics

Medihelp shares information about mental health and other health topics on our website. A series of DVDs and booklets are also available at a discounted rate to Medihelp members.

Customer engagement

We cater for all your communication preferences. 80 telephone consultants, secured web services, smart phone apps and a free health magazine – all available in English and Afrikaans. Our regional offices in Cape Town, Port Elizabeth, Durban and Bloemfontein ensure that customers in those areas have a walk-in client service desk. The same service is offered at Medihelp’s head office in Pretoria.

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