New External Prosthesis Benefit on the Value Care Plan
We're pleased to offer additional support for members who need an external prosthesis
Subject to PMB regulations and Prime Cure preauthorisation, a beneficiary can access cover of up to R6 000 per year for medically necessary external prostheses, whether provided in- or out-of-hospital.
This benefit is separate from the annual hospital limit. Cover includes approved items such as artificial limbs, breast prostheses and ocular prostheses, as well as clinically necessary repairs or replacements. Cosmetic enhancements, upgrades and other non-medically necessary items are not covered.
This benefit is designed to support members' mobility, function and quality of life when they need it most.