Issue link: https://www.hub.camaf.co.za/i/1541114
MEMBER GUIDE - DOUBLE PLUS & DOUBLE NETWORK 12 Day-to-day Benefits Day-to-day benefits limited to an overall collective limit - paid at 80% CBT rate. The difference can be paid from Medical Savings Account. Benefits below are subject to the overall annual limit Annual Overall Limits Adult R17 985 Child R12 480 GPs and Dentists Dental x-rays performed by dentists, consultations and procedures performed by these practitioners; basic dentistry 80% CBT Nominated Network GP for Double Network Specialists Consultations, procedures and radiology performed by these practitioners 80% CBT (on referral from a nominated network GP for Double Network) Acute Medication Including injections and materials 80% SEP plus dispensing fee, subject to MMAP, co-payment from MSA (on referral from a nominated network GP for Double Network) Non-DSP Visits to Doctor's Rooms One visit per beneficiary 80% CBT for Double Network for non-network or non-nominated GP Casualty and Out Patient Treatment at a Hospital 80% CBT Nurse Visits 80% CBT up to 21 days Supplementary Health Audiology, Chiropractors, Dieticians, Homeopaths, Occupational Therapy, Physiotherapists, Biokineticists, Podiatry and Speech Therapy 80% CBT (on referral from a nominated network GP or a specialist for Double Network) Advanced Dentistry Crowns, Bridges, Orthodontics, Dentures 80% CBT limited to: M0 R17 530 M1 R25 245 M2+ R33 995 Dental Implants R57 750 per beneficiary for the case as a whole (facility fee and provider accounts) Health Check Boost Day-to-day top up benefit (allocated once all 3 required screenings are completed in the same benefit year). The benefit is non-transferable, does not roll over, and is applied per beneficiary per benefit year R500 per beneficiary Not available for pharmacy benefits. Over the Counter Medication 80% SEP plus a dispensing fee, subject to MMAP, co-payment from MSA, limited to R2 575 per beneficiary Laser K/Excimer Laser Benefit not available if spectacles or contact lenses claimed in the previous 12 months. If Laser K benefit is utilised, no spectacle and contact lense benefit for 24 months 80% CBT limited to R6 580 per beneficiary per eye