Affordable medical aid cover JOIN NOW

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  1. Download the application form below.
  2. Complete both sides of this application form to avoid a delay in registration.
  3. Send the completed form to the following email: membership@medschemeswaziland.com

All quoted amounts are in Emalangeni
CONTRIBUTION TABLE
M0 M1 M2 M3 M4 M5 PARENT
657 1 123 1 160 1 217 1 291 1 347 657
Medscheme Eswatini 2021 Achiever Plan

OVERALL ANNUAL BENEFITS

100 000 Per Family

FUNERAL POLICY

Member/Spouse
Dependent: 16+ years
Dependent: 6-15 years
Dependent: 0-5 years
15 000
15 000
7 500
3 750
Please be advised that the maximum entry age for the funeral benefit is 60 and the benefit will terminate when you reach the age of 60.

OUT PATIENT (OHEB)

2 000 M0
2 500 M1
3 000 M2+

WELLNESS BENEFIT

1 GP Consultation per beneficiary per annum covering:
  • GP Consultation fee
  • Blood pressure
  • Cholesterol
  • Blood glucose
  • Pap smear for female beneficiaries
  • Prostate test for male beneficiaries
  • BMI

ALCOHOLISM AND DRUG DEPENDENCY

(Substance abuse)
100% NPL
1 290 Per Family

ALTERNATIVE HEALTHCARE PRACTITIONERS

(Chiropractors (including x-rays),Homeopathy and Naturopathy (including medicines))
100% NPL
2 430 Per Family

AMBULANCE SERVICES

(emergency only)
100% NPL
6 400 Per Family
Appliances 100% Cost
Medical and Surgical 3 180 Per Family
Wheelchairs – within above limit 1 760 Per Family
Hearing Aids – within above limit 2 020 Per Family

BLOOD AND BLOOD PRODUCTS

100% Cost

CONSULTATIONS AND VISITS

100% NPL
Rooms or Home (General Practitioner, Specialist & Nurse Practitioners Subject to OHEB
In Hospital for Specialist 100% NPL

DENTISTRY

100% NPL
Advanced Dentistry/Oral Surgery (inlays, crowns, bridges, study models, metal base, oral medicines by: orthodontists, periodontists, prosthodontists and dental technicians) Subject to OHEB
Basic/Ordinary & Restorative (including plastic dentures, dental technicians & dental therapist) Subject to OHEB
Osseo integrated Implants (including hospitalization, dental practitioner, anesthetist) 100% NPL
Maxillo Facial Surgery 100% NPL

HOSPITALIZATION

100% NPL
In-patient (accommodation – general ward, theatre fees, medicines, materials & equipment)
Take treatment out (TTO’s)/take home medicines 420 Per admission
Out-patient (facility fee, consultation & medicine) 100% NPL
In-patient General practitioner ward visits 100% NPL
590 M0
825 M1
1 060 M2+

ALTERNATIVE TO HOSPITALIZATION

100% NPL
(step down nursing facilities, private nursing, frail care, hospice & physical rehabilitation in hospital)
Private nursing – normal consultation is paid as long as the benefit is available even if there no authorization acquired. 8 970 Per Family

IMMUNE DEFICIENCY (related to HIV/AIDS)

(services, materials, medicines)
Limited to acute medicine & consultation benefit, 3 months exclusion
100% NPL

MEDICINES & INJECTION MATERIAL

100% Cost
Chronic Medicines
Only cover for: hypertension, diabetic, asthma, epileptic, ulcer, bipolar &
schizophrenia (3 months exclusion)
1 000 M0
2 000 M1
2 500 M2+
Acute Medicines Subject to OHEB
Pharmacy Advised Therapy (OTC)
Schedule 0, 1 & 2 only
Subject to OHEB
185 per script 185 per script
Contraceptive – (OHEB) 85 Per script

MENTAL HEALTH – (in and out of hospital)

100% NPL
1 990 Per Family

MOTOR VEHICLE ACCIDENTS (in hospital)

100% NPL

NON-SURGICAL PROCEDURES & TEST

100% NPL
In Hospital
Out of Hospital
(sleep studies is paid only when authorized) limited to 1 study per family
100% NPL

OPTOMETRY

Frames, Lenses, Readers
100% NPL
One in 2 year claiming period, aligned to benefit year Subject to OHEB
Eye Examination 100% NPL
One per beneficiary per annum
Refractive Surgery (radial keratotomy/excimer laser) 100% NPL
1 830 Per Family

ORGAN TRANSPLANT (for pathology & radiology – separate benefits limits apply)

100% NPL

ONCOLOGY

Radiotherapy and Chemotherapy (including medicine, radiology and pathology)
100% NPL
Brachytherapy (within oncology benefit) 100% NPL

PATHOLOGY AND MEDICAL TECHNOLOGY

100% NPL
In Hospital 295 Per Admission
Out of Hospital Subject to OHEB

PHYSIOTHERAPY & BIO KINETICS

100% NPL
In Hospital
(only applicable when there is a referring doctor)
330 M0
665 M1
1 340 M2+
Out of Hospital Subject to OHEB

PREGNANCY/CONFINEMENT

100% NPL
Hospitalization (accommodation, theatre fees, Labour ward fees, drugs, dressing, medicines & materials) Physio will only be applicable to post caesarean cases during hospital stay. Abnormal vaginal delivery will be considered for physiotherapy on application & authorization 11 000 Per Family
Global fee for Delivery (within maternity limit) 100% NPL
2 800 Per Family
Services (consultations, visits & scans) Ante-natal consults are from the consultation benefit and scans from the radiology benefit and scans are limited to two. 100% NPL
2 x post-natal mid wife consultations per pregnancy

PROSTHESIS

100% Cost
Internal (e.g. knee & hip replacement, etc) – surgically implanted 1 670 Per Family
External (includes external fixators) 2 020 Per Family

RENAL DIALYSIS

No Benefit

RADIOLOGY & RADIOGRAPHY

100% NPL
In Hospital – general and specialist (including CT Scans, MRI Scans, etc) 3 520 Per Family
PET Scan & PET CT Scan (within above limit) 1 per family per annum
Bone Densitometry (within above limit) 1 per family per annum
Out of Hospital Subject to OHEB

REMEDIAL, OTHER THERAPIES & PARAMEDICAL SERVICES

100% NPL
Occupational therapy, Orthoptics, Podiatry, Speech therapy, Audiology, Dieticians, Hearing Aid Acousticians, Genetic Counseling Subject to OHEB

SURGICAL PROCEDURES

100% NPL

This Plan is subject to underwriting as per the Scheme Rules. Underwriting will be done at application stage.

NPL: Medscheme Eswatini Price List
NHRPL (SA): National Health Reference Price List (inside South Africa)
SAOA: South African Optometrists Association

DOWNLOAD PDF JOIN NOW

JOIN US TODAY

  1. Download the application form below.
  2. Complete both sides of this application form to avoid a delay in registration.
  3. Send the comleted form to the following email: membership@medscheme-eswatini.com/medscheme

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