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
CONTRIBUTIONS
Employer Groups M0 M1 M2 M3 M4 M5 PARENT
1 – 20 members 1 000 1 408 1 571 1 652 1 690 1 800 1 000
21 – 499 members 950 1 337 1 493 1 569 1 606 1 710 950
500+ members 900 1 267 1 414 1 487 1 522 1 620 900
Level 0 Principal member Adult dependant Child dependant (Max 3) Parent
Private members
<60 years 1 087 544 272 1 359
>=60 years 3 259 1 630 816 1 630
Students 485 n/a n/a n/a
Additional contributions for day-to-day cover
Level 0 0
Level 1 225
Level 2 337
Level 3 450
Level 4 898
Level 5 1 346
Medscheme Eswatini 2021 Flexible Plan

OVERALL ANNUAL LIMIT (OAL)

750 000 per beneficiary

OVERALL DAY-TO-DAY LIMIT (DTD)

Level 0: 0
Level 1: 2 500
Level 2: 3 750
Level 3: 5 000
Level 4: 10 000
Level 5: 15 000

NO / LOW CLAIM BONUS

Yes
20% of contributions minus all claims

TRAVEL BENEFIT TO SOUTH AFRICAN HOSPITALS

Pre-authorised travelling costs for referrals to South African acute care hospitals if residing more than 150km from hospital.
75% of Cost
Travelling expenses 900 per family per annum
Accommodation expenses 375 per night, limited to 2 nights per family per annum

LOYALTY PROGRAMME

Not applicable

FUNERAL POLICY

Member/Spouse
Dependant: 16+ years
Dependant: 6 – 15 years
Dependant: 0 – 5 years
20 000
20 000
10 00
5 000
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.

WELLNESS BENEFITS

Limited to 1 GP consultation per beneficiary per annum.
1 GP consultation per beneficiary per annum covering:
  • GP consultation fee
  • Blood pressure
  • Cholesterol
  • Blood glucose
  • Papsmear for female beneficiaries
  • Prostate test for male beneficiaries
  • BMI
  • Osteoporosis screening
  • Mammogram for female beneficiaries
  • Flu vaccine
  • Pneumococcal vaccine

ALCOHOLISM AND DRUG DEPENDENCY (Substance abuse)

Subject to available savings

ALTERNATIVE HEALTHCARE PRACTITIONERS & PARAMEDICAL SERVICES

(Audiology, Biokinetics, Chiropractors (including X-Rays), Dieticians, Genetic Councelling, Hearing Aid Acousticians, Homeopathy, Naturopathy (Including medicines), Occupational Therapy, Orthoptics, Physiotherapy, Podiatry & Speech Therapy) 100% NPL / NHRPL (SA)
Subject to available DTD

AMBULANCE SERVICES (Emergency only)

100% NPL / NHRPL (SA)
12 120 per family

APPLIANCES – MEDICAL AND SURGICAL

Wheelchairs
Hearing Aids
Subject to available DTD
Subject to available DTD

BLOOD AND BLOOD PRODUCTS

100% Cost

CONSULTATIONS AND VISITS (General Practitioners, Specialists & Nurse Practitioners)

Rooms or Home 100% NPL / NHRPL (SA)
Subject to available DTD
In Hospital 100% NPL / NHRPL (SA)

DENTISTRY

Advanced Dentistry/Oral Surgery
(Inlays, Crowns, Bridges, Study Models, Metal Base, Oral medicines by: Orthodontists, Periodontists, Prosthodontists and Dental Technicians)
100% NPL / NHRPL (SA)
Subject to available DTD
Basic/Ordinary & Restorative
(Including Plastic Dentures, Dental Technicians & Dental Therapist)
Joint limit with Advanced Dentistry
100% NPL / NHRPL (SA)
Subject to available DTD
Osseointegrated Implants
(Including hospitalisation, Dental Practitioner, Anaesthetist)
Joint limit with Advanced Dentistry
No Benefit
Maxillo Facial Surgery 100% NPL / NHRPL (SA)

HOSPITALISATION

In-patient
(Accommodation – General Ward, Theatre Fees, Medicines, Materials & Equipment)
100% NPL / NHRPL (SA)
TTO’s 500 per admission
Out-patient
(Facility fee, consultation and medicine)
100% NPL / NHRPL (SA)
Subject to available DTD
Inpatient General Practitioner Consultations 100% NPL / NHRPL (SA)
1 360 M0
1 730 M1
2 040 M2+
Alternatives to Hospitalisation
(Step down nursing Facilities, Private Nursing, Frail Care, Hospice & Physical rehabilitation in hospital)
100% NPL / NHRPL (SA)
17 480 per family

IMMUNE DEFICIENCY (related to HIV/AIDS)

(Services, Materials, Medicines)
Limited to acute medicine and consultation benefit
100% NPL / NHRPL (SA)

MEDICINES & INJECTION MATERIAL

Chronic Medicines
Only cover for: asthma, allergic rhinitis, epilepsy, GORD, hypertension, diabetes (Type 1&2), hyperlipidaemia.
100% Cost
1 150 M0
2 360 M1
2 940 M2+
Acute Medicines 100% Cost
Subject to available DTD
Pharmacy Advised Therapy (OTC)
Within acute medicine limit
Schedule 0, 1 and 2 only
100% Cost
Subject to available DTD
220 per script
Contraceptives (oral)
Within acute medicine limit
100% Cost
Subject to available DTD
100 per script

MENTAL HEALTH (In and out of hospital)

100% NPL / NHRPL (SA)
9 290 per family

NON-SURGICAL PROCEDURES AND TESTS

In Hospital 100% NPL / NHRPL (SA)
Out of Hospital
(Sleep Studies is paid only when authorised by the Fund)
100% NPL / NHRPL (SA)
Subject to available DTD

OPTOMETRY

Frames, Lenses, Readers
One in 2 year claiming period
100% NPL / SAOA
Subject to available DTD
Eye Examinations 100% NPL / NHRPL (SA)
Subject to available DTD
Refractive Surgery
(Radial Keratotomy/ Excimer Laser)
No Benefit

ORGAN TRANSPLANTS

100% NPL / NHRPL (SA)
For pathology & radiology the separate benefit limits apply 152 000 per family

ONCOLOGY

Radiotherapy and Chemotherapy
(Including medicine, radiology and pathology.)
100% NPL / NHRPL (SA)
207 000 per family
Bracytherapy
(Within oncology limit above)
100% NPL / NHRPL (SA)
44 600 per family

PATHOLOGY AND MEDICAL TECHNOLOGY

In Hospital 100% NPL / NHRPL (SA)
20 700 per family
Out of Hospital 100% NPL / NHRPL (SA)
Subject to available DTD

PHYSIOTHERAPY AND BIOKINETICS

In Hospital
(Only applicable when there is a referring doctor)
100% NPL / NHRPL (SA)
780 M0
1 520 M1
2 410 M2+
Out of Hospital Subject to Paramedical Services Benefit limit

PREGNANCY/CONFINEMENT

Hospitalisation
(Accomodation, Theatre Fees, Labouir Ward Fees, Drugs, Dressings, Medicines and Materials.)
Physio will only be applicable to post caesarean cases during hospital stay.
Abnormal vaginal delivery will be considered for physiotherapy on application and authorisation.
100% NPL / NHRPL (SA)
31 300 per family
Global fee for delivery
Within Maternity limit above
100% NPL / NHRPL (SA)
6 140 per family
Services (Consultations, Visits & Scans)
Ante-natal consults are from the Consultation benefit and
Scans from Radiology benefit and scans are limited to two.
100% NPL / NHRPL (SA)
4 x post natal midwife consultations per pregnancy
Subject to available DTD

PROSTHESIS

100% Cost
Internal (e.g. Knee & Hip Replacements, etc.) – surgically implanted
External (Includes External Fixators)
26 800 per family
No Benefit

RENAL DIALYSIS

Acute & Chronic – for Pathology & Radiology the separate benefit limits apply. 100% NPL / NHRPL (SA)
69 000 per family

RADIOLOGY & RADIOGRAPHY

In Hospital
General and Specialised (including CT Scans, MRI Scans, etc)
100% NPL / NHRPL (SA)
16 200 per family
Out of Hospital
Within Radiology limit above
100% NPL / NHRPL (SA)
Subject to available DTD
PET Scan and PET-CT Scans
Bone Densitometry
Within Radiology limit above

1 per family per annum
1 per family per annum

SURGICAL PROCEDURES

100% NPL / NHRPL (SA)

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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