Exact Cover

The EXACT COVER benefit covers necessary medical procedures that your medical scheme excludes because it is listed as a specific policy exclusion. This benefit covers the hospital and service providers accounts up the cover limit as specified. Subject to your Overall Annual limit (OAL) of R157 000.

INDIVIDUAL, UNDER 65
R222 / mon
FAMILY, UNDER 65
R255/ mon
FAMILY, 65+
R333/ mon

Medical Procedures not covered by your Medical Scheme & Cover Limit

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Arthroscopic Surgery
R85 000
Back And Neck Surgery
R85 000
Bunion Surgery
R16 000
Cochlear Implant, Auditory Brain Implant and Internal Nerve Stimulator Surgery including the Device and Processor
R80 000
Dental Procedures for Reconstructive Plastic Surgery due to an Accident
R80 000
Functional Nasal Surgery
R25 000
Joint Replacement Surgery
R50 000
Oesophageal Reflux And Hiatus Hernia Surgery
R58 000
Varicose Veins Surgery
R22 000

Waiting Periods

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A 12 month waiting period on pre-existing condition specific disease and or illness applies to this policy. In the event that there is no pre-existing conditions related to the Stated Conditions within this policy.
A 10 month waiting period applies where no claims can be submitted for a procedure or surgery related to the following conditions, unless due to an injury resulting from an accident: Dental Procedures for Reconstructive Plastic Surgery, Functional Nasal Surgery, Oesophageal Reflux and Hiatus Hernia Surgery, Back and Neck Surgery, Joint Replacement Surgery, Cochlear Implant, Auditory Brain Implant and Internal Nerve Stimulator Surgery including the device and processor, Bunion Surgery, Arthroscopic Surgery and Varicose Veins surgery. When a new beneficiary joins the policy, they are subject to normal underwriting terms and conditions and waiting periods as denoted above will apply.

WHAT THIS BENEFIT DOES NOT COVER:
Medical procedures listed as specific exclusions by your medical scheme that do not form part of our list of medical procedures covered. Service providers accounts where your medical scheme paid a portion towards the account, where your medical scheme applied an Overall AnnualLimit (OAL) as a cover limit to in-hospital medical procedures, If your medical scheme Sub-Limit benefit is exhausted at the time of the event or your chosen service providers charge a rate that exceeds the cover limit we provide.
NB: Exact cover can be enhanced by purchasing additional benefits, related co-payments and Gap Cover, not applicable to Exact benefits, only to the medical scheme cover.
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Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP:4710).
Underwriting Agency for GENRIC Insurance Company Limited (FSP:43638).
GENRIC is an Authorised Financial Services Provider and Registered Short-term Insurer.

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Contact

Tel: 010 599 1163

Fax: 086 508 2292

Email: info@sirago.co.za

Address: Midrand Business Park, Building 3, 563 Old Pretoria Main Road, Midrand, 1685

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