Add-on Benefits
| Add-on Benefits* | DS Standard |
DH High |
||
| 3.1 Basic Dentistry Sub-limit (Consultation, radiology, filling, tooth extraction,cleaning and scaling, incision and drainage,root canal treatment) | 1,509 |
3,319 |
1,509 |
3,319 |
| 3.2 Specialized Dentistry‑˜ (includes crowns, bridges, dentures and diagnosis) | 3,240 |
4,860 |
3,240 |
4,860 |
| 3.3 Orthodontic/Maxillo-facial/Oral Surgery (subject to case management) treatment include implants | up to limit 3.0 |
up to limit 3.0 |
up to limit 3.0 |
up to limit 3.0 |
| ˜ Refers to treatment every two years. | - |
- |
- |
- |
| 4.1 BOMaid Designated Service Providers | Guaranteed eye care benefit which includes consultation(s), one pair of clear aquity single vision lenses or one pair of clear aquity bifocal lenses or one pair of clear aquity multifocal lenses to the value of bifocal lenses and a frame. |
|||
| 4.2 Non-BOMaid Designated Service Providers | ||||
|
60 |
- |
100 |
- |
|
150 |
- |
165 |
- |
|
350 |
- |
375 |
- |
|
To the value of bifocal lenses to the value of bifocal lenses |
|||
| 4.3 Frame and/or any lens enhancements | 550 |
- |
550 |
- |
| 4.4 Contact lenses (NB: Benefit ONLY available as an alternative to 4.1, 4.2 and 4.3) | 1,050 |
- |
1,050 |
- |
| 4.5 Laser refractive eye surgery (referrals from BOMaid approved opthalmologist/ optometrist with a prescription of - 5.00 dioptre and below) NB: Use of this benefit nullifies any optical benefit entitlement for the subsequent five years of membership. |
3,000 |
4,500 |
3,000 |
4,500 |
| 5.1 Surgical appliances {recommended by surgeon/orthopedic surgeon (for non permanent disability) e.g knee/collar/chest /foot braces, crutches and walking frames} Pre-authorization required | 200 |
250 |
200 |
250 |
| 5.2 Wheel chairs, crutches and walking frames (for permanently physically challenged) | up to limit 5.0 |
up to limit 5.0 |
up to limit 5.0 |
up to limit 5.0 |
| 5.3 Hearing aid (prescription is required) | up to limit 5.0 |
up to limit 5.0 |
up to limit 5.0 |
up to limit 5.0 |
| 5.4 Medical appliances e.g glucometer and nebuliser (recommended by Physician/ Pediatrician) | 700 |
875 |
700 |
875 |
| (excluding appliances) Medical referral is required for all as well as pre-assessment for cover of 6.2 to 6.5) | - |
- |
- |
- |
| 6.1 Physiotherapy Motivational report is needed for assessment of cases requiring more than 20 treatment sessions. |
3,253 |
4,973 |
3,253 |
4,973 |
| 6.2 Occupational Therapy | 3,253 |
4,973 |
3,253 |
4,973 |
| 6.3 Speech Therapy | 3,253 |
4,973 |
3,253 |
4,973 |
| 6.4 Clinical psychology | 3,253 |
4,973 |
3,253 |
4,973 |
| 6.5 Clinical Dietician (consultation only) maximum 5 session | 3,253 |
4,973 |
3,253 |
4,973 |
| 7.1 Homeopathic treatment | 1,000 |
2,000 |
1,000 |
2,000 |
| 7.2 Chiropractic treatment | 1,000 |
2,000 |
1,000 |
2,000 |
| 7.3 Naturopathic treatment | 1,000 |
2,000 |
1,000 |
2,000 |
| 7.4 Acupuncture treatment | 1,000 |
2,000 |
1,000 |
2,000 |
| 7.5 Traditional Healing - (cover strictly limited to for Ngope, Thobega and Mototwane) | 1,000 |
2,000 |
1,000 |
2,000 |
| 8.1 Funeral limit - Member |
- |
8,000 |
- |
8,000 |
| - Spouse/parent ˘ | - |
8,000 |
- |
8,000 |
| - Child Dependant 16-21 years | - |
7,000 |
- |
7,000 |
| - Child Dependant 16-21 years | - |
3,000 |
- |
3,000 |
| - Child Dependant 16-21 years | - |
2,000 |
- |
2,000 |
* For the amount of each ADD ON please refer to the subscription table
1. HIV/AIDS COVER IN ACCORDANCE WITH THE SBF PROGRAM
2. MEMBER'S ATTENTION IS SPECIFICALLY DRAWN TO RULE 15 (20): “In all benefit categories any one family member cannot claim in excess of the single member's limit”.
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