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May 30, 2023
Major Medical Event Benefits
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Our options in partnership with
MME Benefits
Major medical event benefits can only be taken in conjunction with Health4Me day-to-day benefits.
Benefits
Accident and Emergency Cover*
Casualty benefit
Accident cover in-hospital benefit
Emergency cover (heart attack and stroke only) in-hospital benefit
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
Maternity lump sum benefit (waiting periods apply)
Funeral Benefits (natural death waiting periods apply)
Principal member, spouse and children > 14 years
Children 6 - 13 years
Children 1 - 5 years
Children < 1 year
Stillborn babies (past 28 weeks gestation)
Base
Accident and Emergency Cover*
Casualty benefit
Up to R30 000 per event
Accident cover in-hospital benefit
In-hospital benefit up to R500 000 per event
Emergency cover (heart attack and stroke only) in-hospital benefit.
Up to R250 000 per event at a private hospital
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
R500 per day in hospital for stays longer than 48 hours
Maternity lump sum benefit (waiting periods apply)
R10 000 payable to a member if hospitalisation is due to childbirth
Funeral Benefits (natural death waiting periods apply)
Natural Death
Accidental Death
Principal Member, Spouse and Children > 14 years
R10 000
R20 000
Children 6 - 13 years
R5 000
R10 000
Children 1 - 5 years
R2 500
R5 000
Children < 1 year
R1 250
R2 500
Stillborn babies (past 28 weeks gestation)
R750
R1 500
Premiums
Main Member
R147.50
Spouse
R147.50
Child
R78.80
Standard
Accident and Emergency Cover*
Casualty benefit
Up to R30 000 per event
Accident cover in-hospital benefit
In-hospital benefit up to R1 500 000 per event
Emergency cover (heart attack and stroke only) in-hospital benefit.
In-hospital benefit up to R500 000 per event
Hospital Cash and Maternity Lump Sum Benefit
Payment per day in hospital (waiting periods apply) **
R1 000 per day in hospital for stays longer than 48 hours
Maternity lump sum benefit (waiting periods apply)
R20 000 payable to a member if hospitalisation is due to childbirth
Funeral Benefits (natural death waiting periods apply)
Natural Death
Accidental Death
Principal Member, Spouse and Children > 14 years
R15 000
R30 000
Children 6 - 13 years
R7 500
R15 000
Children 1 - 5 years
R3 750
R7 500
Children < 1 year
R1 875
R3 750
Stillborn babies (past 28 weeks gestation)
R1 125
R2 250
Premiums
Main Member
R211.10
Spouse
R211.10
Child
R116.50
* Emergency transportation cover
Emergency transportation, stabilisation and treatment cost paid in case of an accident or an emergency (heart attack or stroke) that requires immediate medical treatment
If the benefit limit is exceeded, and further treatment is required, the member will be transported to a state facility for further care and treatment
Accident and emergency cover includes emergency transportation, stabilisation and treatment cost, as well as the cost of diagnostic scans (like MRI and CT scans), take-home medication, internal and external prosthetics, orthotics and assistive devices, rehabilitation services (like step-down services, wound care, physiotherapy and occupational therapy), subject to both clinical approval and the respective per event limits
** Payment per day in hospital
Base
Maximum of R20 000 payable per member per year.
Maximum of 40 days payable per member per year.
Standard
Maximum of R20 000 payable per member per year.
Maximum of 20 days payable per member per year.
