Medical aid rates and Medical aid schemes

We charge NHRPL rates which is the national government gazette rate. NHRPL rates are regulated by the board of healthcare funders.

A medical aid rate is the rate at which your medical aid reimburses a claim, which is not necessarily NHRPL rates. Medical schemes determine their own specified rate at which they will pay for a claim. This will reflect in the annual prospectus you receive from your medical scheme. You, as the member of the medical aid and our valued patient, have to familiarise yourself with these rates prior to your visit to our practice.  We therefore cannot guarantee that your claim will be covered in full by your medical scheme.

Below are all the medical aid schemes we contract out to: However, the onus is still on the patient to confirm with their medical scheme whether we are indeed allowed to treat them and if we are a preferred network provider.

AECI (Medscheme)

Afrox

Altron

Anglo

Bankmed (not Basic Opt)

Barloworld (Medscheme)

Bestmed

Bonitas (Denis)

BP

Building Industry

CAMAF

Cape Medical Plan

Clicks

CompCare

De Beers

De Caan Services

Denis

Discovery

Edcon

Engen

Fishing Industry

Foschini

Gems

Genesis

 

 

 

Golden Arrow

IBM

Imperial Med

Old Mutual

Keyhealth

L.A. Health (not Keycare)

Libcare

Liberty

MB Med

Medimed

Medipos

Medscheme

Medshield

Metropolitan

Momentum Health

Munimed

Nampak

Naspers

NBC Pure Health

Nedcor

Netcare

Nimas

Old Mutual (Oxygen)

Opmed

 

 

Parmed

Pharos (B.I. Solutions)

PicknPay

Polmed

Primecure

Prosano

Purehealth

Remedi

Renaissance

Resolution Health

SABC

SA Breweries

Samwumed

Sappi

Sasol

Selfmed

Sizwe

Sovereign Health

Spectramed

Transmed

Tsogo

Tigerbrands

Wooltru

Unfortunately, we DON’T contract out to patients belonging to Allcare and all the medical aids administered by DENTAL RISK COMPANY (012 741 5101 or e-mail  network@dentalrisk.com to confirm network providers).  These include patients belonging to the following medical schemes:  Affinity Health; GetSavvi; DRUM; Stratum; Medicall; Eminent; Profmed; MediHelp; Topmed; Wesmart; National Health Care & EEBS. Also Ingwe Health Plan; One Care;  Sigma; Medical Waste Bin;  Medicover;  Malcor;  Medcor;  Medicor; Medicross & Global Health. Patients belonging to DISCOVERY HEALTH, but who are on the following options all fall under DRC: All the Keycare options; Remedi; Bankmed Basic; Anglo Med Std Core; TFG; Primary Care; LA Health Focus.

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