2026
11
Out of Hospital
Benefit and Extent of Cover
Choice
The DSP for audiology consultations and obtaining Hearing Aids is HearConnect
for both Double Plus and Double Network. The benefit is subject to pre-
authorisation and reimbursed at DSP rates. Co-payments will apply if the DSP is
not used.
For Double Network - PPN is the DSP for optical benefits and nominated GPs for
GP consultations.
Preventative Wellness Cover
Preventative programme accessible to all beneficiaries.
One consultation per beneficiary per annum with a GP (nominated network
GP for Double Network), specified Specialists, dietician, dentist - for a general
checkup only and optometrist for an eye test (PPN optometrist for Double
network) - paid at CBT rate, and one health risk assessment (to be done at
network pharmacy). Additionally, screening benefits (melanoma, PSA, pap
smear, mammogram) and certain vaccines are covered under this benefit.
Post-Hospital Cover Post-hospital cover for a period of 90 days.
Other Benefits
Not subject to an annual overall benefit limit - paid at CBT* rate. Generous
external appliance benefit of R95 040 per beneficiary with specific sub-limits (on
referral from a nominated network GP or a specialist for Double Network).
MSA Used as a "top up" or to extend benefits - see "MEDICAL SAVINGS ACCOUNT"
