| Supplementary Benefits |
| Maternity Care | 12 ante-natal consultations, 2 x 2D scans, 4 post-natal consultations with midwife. Ante-natal classes R950 and post confinement in a private ward | 6 ante-natal consultations, 2 x 2D scans, 4 post-natal consultations with midwife. Ante-natal classes R900 | 6 ante-natal consultations, 2 x 2D scans, 4 post-natal consultations with midwife. |
| Refractive Surgery | R15 000 per family | No Benefit | No Benefit |
| HIV | Unlimited subject to Aid for AIDS registration | R23 500 per beneficiary subject to Aid for AIDS registration | R23 500 per beneficiary subject to Aid for AIDS registration |
| Mental Health | R36 000 per family, sub-limit of R12 000 in and out of hospital consultations | R23 500 per family, sub-limit of R11 500 in and out of hospital consultations | R23 500 per family subject to pre-authorisation. In hospital only. |
| Specialised Radiology | R23 000 per family, subject to pre-authorisation. (out of hospital only). | R17 000 per family , subject to pre -authorisation. (out of hospital only). | No Benefit |
| Ambulance - Emergency | ER24 | ER24 | ER24 |
| Endoscopies in Dr's Rooms* | Unlimited | Unlimited | No Benefit |
| Prostheses Internal | R 40 000 per family | PMB's only | PMB's only |
| Prostheses External | R 40 000 per family | PMB's only | PMB's only |
| Cochlear Implants | R150 000 | No Benefit | No Benefit |
| Internal Nerve Stimulators | R120 000 | No Benefit | No Benefit |
| HIV Test & Flu Vaccine | 1 each per beneficiary, per annum | 1 each per beneficiary, per annum | 1 each per beneficiary, per annum |
| Infant Paediatric benefit | 3 consultations before the age of 1 year. 2 consultations between the ages of 1 and 2 years | 2 consultations before the age of 1 year. 1 consultation between the ages of 1 and 2 years | 2 consultations before the age of 1 year. 1 consultation between the ages of 1 and 2 years |
| Childhood Illness Benefit | 2 GP consultations between the ages of 2 and 12 years | 1 GP consultation between the ages of 2 and 12 years | 1 GP consultation between the ages of 2 and 12 years |
| Preventative Care Benefit |
| Women's Health | • 1 mammogram every 3 years for females age 50 - 70
• 1 pap smear every 3 years for females aged 21 to 65 years | No Benefit | No Benefit |
| Cardiac Health | • 1 full lipogram every 5 years for beneficiaries over the age of 20 years | No Benefit | No Benefit |
| Elderly Health | • 1 Pneumoccocal vaccination above age 65 years
• 1 Faecal Occult blood test p.b.p.a between the age of 50 to 75 years
• 1 Bone Density Screening test for females above the age of 65 years | No Benefit | No Benefit |
| Children's Health | • 1 TSH test for infants below 1 month
• Immunisation for children up to age 12, as specified in the Extended Programme on Immunisation (EPI) | No Benefit | No Benefit |
| Appliances |
| General Appliances | R 6 800 per family | R 5 300 per family | No Benefit, except PMB's |
| Wheelchairs & Large Orthapaedic appliances | Included in General Appliances benefit | Included in General Appliances benefit | No Benefit, except PMB's |
| Stoma Products and CPAP* Subject to pre-authorisation | May exceed General appliances by R4 750 | May exceed General appliances by R4 750 | No Benefit, except PMB's |
| Hearing Aids | R20 000 Biennial per family | No Benefit | No Benefit |
| Oxygen : Home Ventilation | Unlimited subject to pre-authorisation by HBM | Unlimited subject to pre-authorisation by HBM | No Benefit, except PMB's |