General Practitioners (GP) |
GP Network |
Funded at Non-Network tariff rate |
- Allows 2 out of network consultations per beneficiary per annum
|
Specialists |
Specialist Network |
Polmed rate applies, any shortfall will be for the account of the member. |
|
Hospital |
Hospital DSP |
- R15 000 co-payment for admission in a non-DSP Hospital
- R5 000 penalty for unauthorised admissions
|
- Polmed Hospital DSPs:
- Mediclinic
- Life Health
- NHN
- Clinix
- JMH
- Limited Netcare
|
Pharmacy |
Pharmacy Network |
- 20% of costs for using a non-Network Pharmacy
- 20% co-payment for voluntarily using a non-formulary product
|
- Open Pharmacy Network with 90% of Pharmacies
|
Renal Dialysis |
Renal Dialysis Network |
30% of cost when using a non-DSP |
- Renal Dialysis Network
- Refer to the website for more details
|
Oncology (Cancer) |
Oncology Network |
Funded at Network tariff rate |
Preferred Providers:
- Independent Clinical Oncology Network (ICON)
|
Emergency Medical Services |
Netcare 911 |
40% of cost for using unauthorised service provider |
|