Primary Care Benefit

Modified on Tue, 27 May at 12:04 PM

Primary Care cover provides benefit for the difference between what the medical scheme pays and the provider charges for the consultation fee only. 

This includes:
* Dental Consultations
*Alternative therapist consultations: Chiropractors, Physiotherapists, Biokineticists, Occupational therapists (including ICD-10 Codes F80 - R89 - refer to the definition clause for the full description), Homeopathy and Audiologists recognised and paid for by the medical scheme chosen option
* GP Consultations






Options

Ultimate Gap



Benefit description:

This benefit provides cover for the difference between what a primary provider charges for a consultation and what your Scheme pays. 


Payment is dependent upon the medical scheme paying a portion towards the consultation fee. 


Important points to consider:

  • This benefit covers costs related to the consultation fee only and not any scans or tests done during the consultation.


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