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Medihelp · Medihelp Medical Aid Scheme Plans

Medihelp MedElite Medical Aid Plan

standard tier

Consultations Treatment

Covered up to 100% of the MT.Unlimited cover provided.

GP ConsultationsSpecialistsTelemedicine and Virtual ConsultsNurse Visits at Network PharmaciesPharmacists who offer primary care and emergency units

Claims are paid from the savings account first.Once savings have been depleted, claims are covered up to 100% of the MT, up to the following amounts (subject to the OAL day-to-day benefit):– Main Member – R3,850 per year.– Main Member +1 Dependent – R5,000 per year.– Main Member +2 Dependents – R6,300 per year.– Main Member +3 Dependents> – R7,550 per year.

Care Extender Additional GP Consultation

When a beneficiary claims for a Pap smear, mammography, prostate exam, fecal occult blood test (FOBT), or bone mineral density test, one additional consultation benefit is activated for the family.

Non-PMB Chronic MedicineGeneric Medicine 100% of MMAPOriginal Medicine if no generic 80% of the MT.Original medicine is voluntarily used even if generic is available 70% of MMAP

Paid up to 100% of the MMAP.The following limits apply:– Main Member – R5,700 per year.– Main Member +1 Dependent – R8550 per year.– Main Member +2 Dependents – R11,400 per year.– Main Member +3 Dependents> – R12,200 per year.Subject to pre-authorisation, andregistration on Medihelp’s chronicmedicine managementprogramme.

Monthly Premiums

Principal Member
R3,850
family
R1,000
family
R3,600
family
R46,400
family
R1,000

Effective from January 2026

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