SAMWUMED offers its members general and specialised radiology benefits.
OPTION A
Paid from Savings
General Radiology Benefits
- Limited to R3,390 per family per year if performed out-of-hospital.
- Unlimited if performed in-hospital.
Specialised Radiology
- Limited to R10,330 per family per year for both in and out-of-hospital services
- Virtual colonography and Coronary Angiography are limited to one per beneficiary per year.
- Oncology, organ and stem cell transplant, and renal dialysis radiology expenses are covered under their respective benefits and not from this limit.
Conditions:
- General Radiology is subject to Nominated GP referral, Scheme protocols, and the use of Designated Service Provider (DSP) Networks.
- Benefits are subject to authorisation.
- Specialised Radiology is subject to Nominated GP referral and Scheme protocols.
- Pre-authorisation is required for CT scans, MUGA scans, MRI scans Radio isotope studies and virtual colonography.
OPTION B
Paid from Risk
General Radiology Benefits
- R9,980 limit per family per year if performed out-of-hospital and unlimited if performed in-hospital.
General Radiology Benefits
- Limited to R15,040 per family per year for both in and out-of-hospital services, subject to authorisation.
- Virtual colonography and Coronary Angiography are limited to one per beneficiary per year.
- Oncology, organ and stem cell transplant, and renal dialysis radiology expenses are covered under their respective benefits and not from this limit.
Conditions:
- General Radiology is subject to Nominated GP referral, Scheme protocols, and the use of Designated Service Provider (DSP) Networks.
- Benefits are subject to authorisation.
- Specialised Radiology is subject to Nominated GP referral and Scheme protocols.
- Pre-authorisation is required for CT scans, MUGA scans, MRI scans Radio isotope studies and virtual colonography.