Day clinics for SCP and MCP

The questions raised at the AGM suggest that we need to remind members to use day clinics wherever possible, to avoid co- payments. A day clinic offers outpatient or same-day procedures, usually less complicated than those requiring hospitalisation. It is a facility which allows for a patient to be discharged on the very same day as the procedure is done.

Your Benefit Guide will inform you as to which procedures you should use a day clinic or accredited facility for. For members on the Managed Care Plan these would be endoscopies, such as gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy; and cataract procedures. For Standard Care Plan members, the same procedures apply, as well as all dental hospitalisation. Co-payments would be R3 200 should you choose a hospital admission instead of a day clinic for these procedures. Standard Care members please also remember to use the facilities on your plan’s hospital network to avoid co-payments.

If you are calling the Call Centre for authorisation, the agents will guide you as to which facility to use. You can also use the Provider Search in the member log-in area of the Scheme website to search for day clinics and network hospitals, or find a list on the website.

In the case of medical emergencies (as per the Medical Scheme’s Act definition) please proceed to the closest facility – no co- payment will apply.