PlatCap | Medical aid you can trust

The PlatCap option provides benefits similar to other low-cost medical scheme options but at a more affordable price. Members have unlimited GP visits, as long as they use Platinum Health facilities or the Scheme’s Designated Service providers (DSPs). Prescribed minimum benefits (PMBs), as required by the Medical Schemes Act, are covered both in-and-out of hospital at 100% of the cost/negotiated Tariff; subject to services rendered by a public hospital or the scheme’s DSPs at cost and no levy or co-payment shall apply.

PlatComprehensive | Value for money

PlatComprehensive is our premium plan option and is designed to meet even the most demanding healthcare needs. It offers extensive benefits, including unlimited hospitalisation at DSP hospitals and cover for both acute and chronic medication, according to the Scheme’s formulary. Members can access healthcare services through either a primary healthcare nurse or a general practitioner at any of our healthcare facilities or designated services providers. Statutory Prescribed Minimum Benefits (PMBs), as required by the Medical Schemes Act, are covered both in-and-out of hospital at 100% of cost/negotiated Tariff. Services rendered by a public hospital or the Scheme’s DSP at cost and no levy or co-payment shall apply. Subject to regulation 8(3) any services rendered by a non-DSP on a voluntary basis will be covered by the Scheme 100% of Scheme Tariff.

PlatFreedom | Your ticket to freedom

PlatFreedom gives members the flexibility to visit any healthcare provider of their choice. The PlatFreedom option has been improved – its benefits are no longer tied to the Overall Annual Limit (OAL). Only in-hospital benefits and certain benefits specified benefits (*) are now subject to an OAL of R1 221 241 per member family. Hospitalisation is subject to the OAL at 100% of the lower of cost or Scheme Rate and authorisation must be obtained from the Scheme in all instances. There is a limit on Acute medication inclusive of the over-the-counter (OTC) benefit. Prescribed Minimum Benefits (PMBs), as required by the Medical Schemes Act, are covered both in-and-out of hospital at 100% of cost/negotiated Tariff; subject to services rendered by a public hospital or the scheme’s DSPs at cost and no levy or co-payment shall apply.