Day-to-Day Plan
Provide your staff with affordable primary care and access to treatment at all private networks.
Lion Health is insurance based and is NOT a medical aid.
| DESCRIPTION | DETAIL | VISITS PER ANNUM | VALUE PER DEPENDENT | WAITING PERIOD |
|---|---|---|---|---|
| Basic Wellbeing | General Practitioners | UNLIMITED – pre-authorisation required after 3 visits | Unlimited visits to network GPs | NONE |
| Basic Wellbeing | Virtual Consultations | This benefit provides access to a Virtual Consultation | Unlimited Virtual Consultations | NONE |
| Advanced Wellbeing | All specialist | As per annual limits when referred by Network GP | R2000 per member; Max R4000 per policy per annum | 90 Days |
| Dental | Dentist | 2 checkups per annum Incl. scaling, polishing, extractions, fillings | Agreed network tariff | 90 days |
| Optometry | Optometrist | One eye test every 24 months | Agreed network tariff | 90 days |
| Optometry – Spectacles | Spectacles | 1 set per 24 month period | Agreed network tariff | 90 days |
| Pathology | Blood tests | UNLIMITED | As per formulary | NONE |
| Radiology | Basic black and white x-rays | UNLIMITED | As per formulary | NONE |
| Maternity | Pregnancy | 2 growth scans & UNLIMITED antenatal medication | As per formulary | 10 months |
| Medication – Chronic | Chronic CDL | UNLIMITED -Refer to conditions listed | As per medicinal formulary | 90 days |
| Medication – Acute | Acute medication | R1000 per annum scripts or R150 per month OTC up to R1000 per year | As per medicinal formulary | NONE |
| Trauma Room | Emergency | R5000 per annum | Stabilisation | NONE |
| Covid | Test and Vaccine | Referred to by a network GP | As per formulary | NONE |
Cost per month
The premiums effective from 1 January 2024 will be as follows for retail/individuals:
| Cost per month per Main Member | R573 |
|---|---|
| Add Spouse | R460 |
| Add Child | R432 |