Key Benefits
OAL per beneficiary per annum:
R174 000
In-Hospital Benefits
Gap Cover
Co-payments
Day Hospital/Clinic and/or In Room Surgical
PMB Cover
Hospital Account Shortfalls
A great start to your gap cover.
OAL per beneficiary per annum:
R174 000
Gap Cover
Co-payments
Day Hospital/Clinic and/or In Room Surgical
PMB Cover
Hospital Account Shortfalls
The excesses imposed by your medical scheme payable to a maximum rand limit for specified procedures or tests. Cover for co-payments imposed by medical schemes for hospital admissions, scans and surgical procedures. Co-payment benefits are subject to a sub-limit of R42 000 per policy per annum, limited to R11 000 per claim. Co-payments related to cancer are catered for in a separate benefit category.
Subject to a sub-limit of R3 600 per policy per annum with a claim limit of R1 200 for your Gap component as per the defined list: hearing aids, wheelchairs, CPAP machine, humidifiers, insulin
pump, glucometer, nebuliser and the Mirena device.
A R100 000 per policy applies once your medical scheme cancer benefit limit has been reached and a percentage co-payment is applied. Limited to R15 000 per claim for cancer co-payments. Cancer cover incorporates co-payment cover and biological drugs. In order to access this benefit you need to be on a registered treatment plan with your medical scheme.
The Cancer Boost benefit is limited to R50 000 per beneficiary per annum. This benefit is restricted to policyholders where their medical scheme option has a defined rand limit for cancer treatment. The Cancer Boost benefit can only be claimed once your rand limit on your medical scheme cancer benefit has been
reached and you require ongoing treatment. This benefit is dependent upon the insured having already been registered on the
medical scheme’s cancer programme. The Cancer Boost benefits are limited to those that were determined within the approved medical scheme treatment plan which must be submitted to Sirago upon application for this benefit. This benefit provides a subsidy
towards the cost of ongoing treatments and drugs. This applies when the medical scheme’s cancer benefit limit is reached and provides no further funding.
In event of death or total permanent disability of the policyholder of the Sirago policy. The Premium Waiver is directly linked to your policy premium per month as indicated in your schedule of insurance. This benefit is not paid in cash, but held as a credit against the policy for the applicable 6 month period. Should there be any premium adjustments within the 6 month period, the credit balance available for the rest of the waiver period, will be adjusted accordingly. This benefit cannot be transferred, ceded or converted to cash.
An instruction to add a new-born to the policy must be submitted within 31 days of the birth of the child. After confirmation of pregnancy, this benefit has a R2 000 sub-limit for claims for prenatal scans, childhood immunisations or pre- and post-birth tests (to limit) per child. In the event of twins, the benefit will be doubled, and in the event of triplets, the benefit will be tripled.
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