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Overall, the Sizwe Hosmed Titanium Executive Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and mental health benefits to up to 3 Family Members. The Sizwe Hosmed Titanium Executive Medical Aid Plan starts from R8,415 ZAR.
👤 Main Member Contribution | R8,415 |
👥 Adult Dependent Contribution | R7,446 |
🍼 Child Dependent Contribution | R1,719 |
🔁 Gap Cover | None |
🌎 International Cover | Covered up to 100% of the scheme rates |
📉 Annual Limit | Unlimited Hospital Cover |
🏥 Hospital Cover | Unlimited for PMBs |
➡️ Oncology Cover | R546,000 |
💙 Medical Savings Account | ☑️ Yes |
👶 Maternity Benefits | ☑️ Yes |
The Sizwe Hosmed Titanium Executive medical aid plan is one of 12, starting from R8,415 and includes an extensive list of chronic and non-PMB conditions, additional appliances and mental health benefits, access to chiropractors and other allied healthcare services, and more. Gap Cover is not available on the Sizwe Hosmed Titanium Executive Plan. However, Sizwe Hosmed offers 24/7 medical emergency assistance. According to the Trust Index, Sizwe Hosmed has a trust rating of 3.9.
Sizwe Hosmed offers 12 medical aid plans
👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R8,415 | R7,446 | R1,719 |
Poll: 5 Best Medical Aids under R1000
👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R21,004 | R18,585 | R4,291 |
👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
R4,785 | R3,965 | R1,813 |
Discover the 5 Best Medical Aid Co-Payment Cover in South Africa
Failing to pre-authorize or notify the scheme of admission within 48 hours will result in claim payments being withheld.
🔍 Hospital Admissions High Care Unit General Ward Theatre Recovery Room | Covered up to 100% of the Negotiated Tariff. |
📌 Medicines and consumables used in hospital and theatre | Covered up to 100% of the negotiated tariff. |
📍 Medicine to take home after discharge | Paid from the hospital benefit. Limited to 7 days’ medicine. |
☑️ Consultations and Procedures | Covered up to 100% of the negotiated tariff. |
✅ Basic Radiology and Pathology | Covered up to 100% of the scheme tariff. Paid from risk. |
1️⃣ Specialized Radiology | MRI, CAT scan, or angiograms are subject to an overall combined limit of R45,294 in and out-of-hospital per family per year. |
2️⃣ Oncology | Covered up to 100% of the DSP tariff. Enhanced oncology DSP protocols will apply. Unlimited Oncology treatment is available. Benefits over R682,500 are subject to a 20% co-payment on non-PMBs. |
3️⃣ Non-Cancer Specialised Drugs Benefits (including biological medicine) | Subject to PMBs and pre-authorization. Managed care and treatment guidelines will apply. |
4️⃣ Renal Dialysis | Covered up to 100% of the negotiated tariff. |
❤️ Organ Transplants | Covered up to 100% of the negotiated tariff. |
🦷 Dental Hospitalisation | Covered up to 100% of the scheme tariff. Children under seven can receive general anesthesia benefits once per year for intensive dental treatment. Symptomatic wisdom tooth removal is covered solely as Day Case. Subject to pre-approval. Treatment protocols will apply. |
🥰 Maxillo-facial and Oral Surgery | Covered up to 100% of the scheme tariff. The benefits of TMJ therapy are restricted to non-surgical interventions/treatments. Subject to managed care protocols. Only symptomatic wisdom teeth and surgical exposure are allowed. All other operations are subject to PMB approval. Only symptomatic impacted wisdom teeth are removed on a day-to-day basis. Claims for oral pathology procedures (cysts and biopsies, surgical treatment of jaw tumors, and soft tissue tumors) will be covered only if accompanied by a laboratory report confirming the diagnosis. |
💊 Drug and Alcohol Rehabilitation | Covered up to 100% of the scheme tariff. Limited to 3 days of withdrawal treatment + 21 days of rehabilitation at an approved facility |
🧠 Psychiatric Treatment (PMB) Consultations Ward Fees Medicines Psychiatry/psychology therapy sessions | Covered up to 100% of the scheme tariff. Twenty-one inpatient days per patient each year. Covers psychiatrist appointments and six in-hospital clinical psychologist consultations. Entitled to benefits of R50,715 per member for each admission, or R2,414 per day. |
💛 Non-PMB Psychiatric Treatment | Subject to managed care rules, four (4) additional out-of-hospital consultations in place of hospitalization are permitted. |
⬇️ Step-down Facilities | Covered up to 100% of the negotiated tariff. |
🏡 Home-Based Care | Covered up to 100% of the negotiated tariff. Paid from risk. Limited to R11,010 per family per year. |
🩹 Negative Pressure Wound Therapy | Covered up to 100% of the negotiated tariff. |
😮💨 Hyperbaric Oxygen Therapy | Covered up to 100% of the negotiated tariff. |
🅰️ Male Sterilisation/Vasectomy | Covered up to 100% of the scheme tariff. |
🅱️ Female Sterilisation/Tubal Ligation | Covered up to 100% of the scheme tariff. |
🧬 Back and Neck Surgery | Spinal surgery authorization for treating chronic back or neck pain is subject to managed care guidelines. Before authorizing surgery, managed care may require adherence to conservative clinical treatment. |
🟥 Stereotactic Radiosurgery | Covered up to 100% of the scheme tariff. |
🟧 Age-related Muscular Degeneration Treatment | Covered up to 100% of the negotiated tariff. |
🟨 Laparoscopic Hospitalisation and Associated Costs | Covered up to 100% of the scheme tariff. |
🟩 Internal and External Prostheses | Covered up to 100% of the negotiated tariff. Surgical and non-surgical prostheses are covered by up to 100% of the cost. There is an annual limit of R68,305 per family within the hospital limit. |
🟦 Internal Prostheses | Hip and knee (partial and total), only one prosthesis, and one joint every year. Spine – two (2) levels per year performed in a single surgery. |
🟪 Cardiac Stents | Cardiac – pacemaker, internal defibrillators, grafts, valves Vascular Stents are limited to 2 stents per family per year. Cardiac stents include three stents per family per year. |
🩸 Blood Transfusions | Covered up to 100% of the scheme tariff. |
🏈 Physiotherapy and Biokinetics | Covered up to 100% of the scheme tariff. |
🍎 Dietician and Occupational Therapy | Covered up to 100% of the scheme tariff. |
☀️ Day Hospital Procedures using a DSP hospital Network | Covered up to 100% of the scheme tariff. Paid from the available MSA funds and Above-Threshold Benefits. |
💴 Co-payments on day procedures | This will apply depending on the treatment. |
👩⚕️ Out-of-Hospital Consultations General Practitioners Specialists Outpatient Facilities | Covered up to 100% of the scheme tariff. Paid from the available savings or Above Threshold Benefit when savings are depleted. |
💊 Acute Medicine | Covered up to 100% of the reference price. Paid from the MSA and above the threshold. The following limits apply in terms of the ATB: Main Member – R7,000 Adult Dependent – R7,000 Child Dependent – R2,000 |
💉 PMB Disease List Medicines | Covered up to 100% of the reference price. Unlimited cover provided. Paid from risk. |
🟨 Other Chronic (non-CDL) medicines | Covered up to 100% of the reference price. Paid from risk. Limited to R16,044 per beneficiary and R30,676 per family per year. Non-formulary products will face a 30% co-payment when obtained voluntarily. |
💛 Pharmacy Advised Treatment (PAT) | Covered up to 100% of the reference price. Paid from the MSA or ATB. |
🟡 Contraceptives | Subject to Managed Care Protocols and formulary. Limited to R3,172 per family. Paid from the available MSA and threshold benefit. |
🥸 Spectacle Lenses | Covered up to 100% of the DSP tariff. The following is covered: R212 per lens for clear single-vision lenses. R460 per lens for clear bifocal lenses. R844 per lens for multifocal lenses. |
👁️ Contact Lenses | Covered up to 100% of the DST tariff. Limited to R2,083 per beneficiary every 2 years. |
🤓 Frames/Lens Enhancements | Covered up to 100% of the DSP tariff. Limited to R2,083 per beneficiary. |
🅰️ Eye Tests | Covered up to 100% of the DSP tariff. Limited to one comprehensive consultation per beneficiary every 2 years. |
🪥 Basic/Conservative Dentistry | Covered up to 100% of the scheme tariff. Pre-authorization and managed care protocols apply |
👑 Crowns Bridgework Dentures Orthodontics Removal of Impacted Wisdom Teeth Non-Surgical Periodontics | Pre-authorization is required for crowns and bridges. Three crowns per family per year and once per tooth in 4 years. |
📍 Dental Implants | 2 Implants per beneficiary every year for a maximum of R16,380 over 5 years. Individuals between nine and twenty-one do not qualify for fixed comprehensive treatment benefits. |
📌 Orthodontics | Pre-approval is necessary. A 35% co-payment is required. Individuals between the ages of nine and twenty-one are eligible for fixed comprehensive therapy. |
➡️ Partial Metal Frame Dentures | Subject to Periodontal Programme registration Restricted to conservative, non-surgical therapy only (root planing). |
↪️ Acrylic (Plastic) Dentures for beneficiaries 16> | One set of plastic dentures, full or partial (an upper and a lower) per beneficiary in 4 years, subject to pre-authorization. |
🔩 Partial Chrome Cobalt Dentures | Two partial frames (upper and lower) per beneficiary every five years, with a maximum of two family members per year. |
🥰 Maxillo-Facial and Oral Dental Surgery | Covered up to 100% of the Scheme Tariff. Subject to managed care protocols The benefit of Temporomandibular Joint (TMJ) therapy is restricted to non-surgical interventions or treatments. Claims for oral pathology treatments (cysts and biopsies, surgical treatment of jaw and soft tissue tumors) will be covered only if accompanied by a laboratory report that verifies the diagnosis. |
🔴 Alternative Services Speech therapy Podiatry Occupational therapy Social worker Dietetics and more! | Covered up to 100% of the scheme tariff. Paid from available savings and the ATB, limited to: Main Member – R3,356 Main Member and Dependents – R5,654 |
🟠 Chiropractors | Covered up to 100% of the scheme tariff. Limited to R2,426 per beneficiary per year. |
🟡 Chiropractic and Homeopathy Treatment | Covered up to 100% of the scheme tariff. Paid from available savings or benefits above the threshold Maximum annual benefit of R2,425 per beneficiary. |
🟢 Remedial and Other Therapies | Covered up to 100% of the scheme tariff. Collectively limited to R5,375 per family per year. |
🔵 Clinical and Medical Technologists | Covered up to 100% of the scheme tariff. Paid from available MSA or ATB. |
🟣 Physiotherapy Out-of-Hospital and Biokinetics | Covered up to 100% of the scheme tariff. Paid from available savings or above threshold benefit. The above threshold benefit is limited to R15,000 per family per year. Subject to pre-approval, clinical protocols, and managed care rules. |
1️⃣ Appliances Procurement of Nebulizer Glucometer Insulin pump Morphine pump C-PAP machine | Covered up to 100% of the negotiated tariff. Paid from available savings or ATB. Appliances are payable once per year and are subject to limits. Limited to the following: Main Member R3,201 Main Member and Dependents – R5,333 |
2️⃣ C-PAP Machine | The cost of C-PAP machines is covered by this benefit, subject to clinical requirements and procurement regulations being met. |
3️⃣ Hearing Aids | Risk pays for 100% of the negotiated tariff. Subject to an R43,650 yearly limit per household. Every three (3) years from the date of acquisition, one (1) pair of hearing units (one per ear) is provided to each beneficiary. |
4️⃣ Non-motorized Wheelchair | Limited to one per family every four years. Paid from risk and limited to R5,321 per family. |
✈️ Air/Road Ambulance and Emergency Services | Covered up to 100% of Negotiated Tariff 24-hour Contact Center Access, including Telephonic Nurse Advice Line. Emergency: Subject to pre-approval within 72 hours of the emergency. Only a preferred provider can perform inter-hospital transfers. Emergency response by road or air to the scene of the occurrence, as well as transfer from the scene to the nearest, most appropriate facility Escort repatriation of stranded children is possible. Non-emergency: Subject to pre-authorization. Medically justifiable inter-facility transfers. Medical repatriation. |
💭 Psychology and Psychiatry Treatment | Covered up to 100% of the scheme tariff. Limited to R20,056 per family. Limited to Psychiatrists, Clinical and Counselling Psychologists – mental health disorders. |
☑️ Infertility | Covered according to the relevant code of the PMB regulations. Investigations for infertility conditions are covered in a DSP hospital according to the policies of relevant Public Authorities. |
🥰 Hospice and Private Nursing | 100% of the Negotiated Rate for all services performed in certified step-down and nursing facilities. The Hospital Benefit Management Programme and the Disease Management Programme apply. Annual limit per family – R11,010d PMB applicable |
Sizwe Hosmed is concerned about its maternity mothers. This program offers information and advantages to help them during their pregnancy. In addition, pregnant women enrolled in the Bambino Programme are eligible for a complimentary maternity bag filled with baby goods at 24 weeks of pregnancy.
❤️ Sizwe Hosmed Bambino Program | Covered up to 100% of the scheme tariff. Subject to registration on the Maternity Program. |
🧡 Hospital Confinement | Covered up to 100% of the cost for accommodation in general ward rates, theatre fees, labor ward fees, medications, dressings, medicines, and materials in a private or provincial hospital. Covers up to 100% of the cost of drugs, dressings, medicines, and materials delivered by a midwife. |
💛 Home Delivery | Covered up to 100% of the cost of delivery by a general practitioner, medical expert, or midwife, as well as any materials supplied. |
💚 Maternity Ultrasounds | Two 2D scans are performed per pregnancy, excluding the diagnostic sonogram. Scans are compensated at 2D rates as arranged with the provider. Nine additional prenatal consultations are provided. Six are for a general practitioner, a midwife, or a specialist. Obstetrician visits per pregnancy upon referral by a general practitioner or midwife, in addition to the standard specialized benefits. |
💙 Maternity Visits/Consultations | Covered up to 100% of the scheme tariff. Extra 9 GP maternity appointments, of which 6 are for a GP or Midwife, and three are for a Specialist Obstetrician visit. |
💜 Antenatal Pathology Screening Haemoglobin Syphilis Chlamydia Bacteriuria Hepatitis B Rhesus incompatibility | Two Haemoglobin Measurement Tests One Blood Grouping Test One VDRL Test for Syphilis Two HIV blood tests Twelve urine Analysis Tests One complete blood count FBC test |
🤍 Vitamins | R120, subject to the day-to-day limit. |
🖤 Child Immunisation Benefit | According to the Immunisation schedule of the Department of Health, only up to 6 years old. |
🟥 Wellness Consultations | Limited to R1,781 per family per year. |
🔴 COVID-19 Vaccination | Covered according to guidelines. |
❤️ Diabetic eye care | Covered |
🟧 Pap Smear for female beneficiaries 18> | One per qualifying beneficiary yearly. |
🟠 Mammogram for female beneficiaries 40> | One per qualifying beneficiary yearly. |
🧡 PSA for Male Beneficiaries 40> | One per qualifying beneficiary yearly. |
🟨 Cholesterol Test for beneficiaries 20> | One per qualifying beneficiary yearly. |
🟡 Flu Vaccine for all beneficiaries | One per beneficiary yearly. |
💛 Blood Sugar | Test for those 15> – one test per qualifying beneficiary. |
🟩 Colon Cancer Blood Test for beneficiaries 50> | One per qualifying beneficiary yearly. |
🟢 Blood Pressure test for all beneficiaries. | One per beneficiary yearly. |
💚 HIV test for all beneficiaries | One per beneficiary yearly. |
🟦 HPV Vaccines for beneficiaries between 9 and 12. | One per qualifying beneficiary. |
🔵 Pneumococcal Vaccines for beneficiaries 65> | One per qualifying beneficiary yearly. |
💙 Bone density testing for female beneficiaries between 50 and 69 and male beneficiaries 65 years old. | One per qualifying beneficiary yearly. |
🟪 HIV/AIDS Management Program | Covered up to 100% of the scheme tariff. Treatment is subject to the treatment care plan. Clinical protocols per CDL apply. |
🟣 COVID-19 Screening, Diagnosis, and Treatment | Covered up to 100% of the scheme tariff. Subject to PMB. |
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Sizwe Hosmed Titanium Executive covers the following chronic conditions on the CDL list:
and many more.
Sizwe Hosmed Plus covers the following additional non-PMB conditions:
and many more.
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Sizwe Hosmed indicates that the following are excluded. However, these are only a few items; the complete list can be viewed on the Sizwe Hosmed website.
and many more.
When new members join the plan, they may be subject to a three-month general waiting period during which they cannot receive benefits. Except in the case of Specified Minimum Benefits, if the new member has a pre-existing ailment, they may be subject to a one-year condition-specific waiting period.
🔎 Medical Aid Plan | 🥇 Sizwe Hosmed Titanium Executive | 🥈 Bestmed Pace 4 | 🥉 Fedhealth Maxima PLUS |
👤 Main Member Contribution | R8,415 | R10,343 | R14,289 |
👥 Adult Dependent Contribution | R7,446 | R10,343 | R12,334 |
🍼 Child Dependent Contribution | R1,719 | R2,423 | R4,415 |
📉 Annual Limit | Unlimited Hospital Cover | Several limits and sub-limits | Unlimited Hospital Cover |
💙 Hospital Cover | Unlimited for PMBs | Unlimited | Unlimited |
Sizwe Hosmed Titanium Executive Plan is a comprehensive medical aid plan that offers members access to private hospital care, specialist consultations, and a range of benefits, such as chronic medication coverage, dental and optical benefits, and wellness programs. The plan also provides access to a network of healthcare providers, which helps to reduce the cost of medical services. However, the main advantage of the Titanium Executive plan is that it offers a high level of coverage for both in-hospital and out-of-hospital medical expenses. The plan also includes a unique feature known as the ‘Flexi Limit,’ which allows members to access additional funds for medical expenses if they have exhausted their annual limit. However, the disadvantage of this plan is that it is one of the most expensive medical aid plans offered by Sizwe Hosmed, which may not be affordable for some individuals or families.
Compared to other Sizwe Hosmed plans, the Titanium Executive plan is designed for individuals who require a high level of coverage and access to top-tier medical services. Unlike other plans, the Titanium Executive plan covers specialized medical procedures and treatments, such as oncology and dialysis, which are not covered by other plans. Additionally, the plan offers more generous limits for certain benefits such as chronic medication coverage, dental and optical benefits, and wellness programs. Overall, the Sizwe Hosmed Titanium Executive Plan is an excellent option for individuals willing to pay a higher premium for comprehensive medical coverage and access to top-tier healthcare services.
The Sizwe Hosmed Titanium Executive Plan is a comprehensive medical aid plan that provides members with access to private hospital care, specialist consultations, and a range of benefits, such as chronic medication coverage, dental and optical benefits, and wellness programs.
The benefits of the Titanium Executive Plan include comprehensive cover for in-hospital and out-of-hospital medical expenses and access to a network of healthcare providers. Titanium Executive also has a unique feature known as the Flexi Limit, which allows members to access additional funds for medical expenses if they have exhausted their annual limit.
The Titanium Executive Plan is designed for individuals who require a high level of coverage and access to top-tier medical services. It includes cover for specialized medical procedures and treatments, such as oncology and dialysis, which are not covered by other plans. Additionally, the plan offers more generous limits for certain benefits such as chronic medication coverage, dental and optical benefits, and wellness programs.
he main advantage of the Titanium Executive plan is that it offers a high level of coverage for both in-hospital and out-of-hospital medical expenses. The plan also includes a unique feature known as the Flexi Limit, which allows members to access additional funds for medical expenses if they have exhausted their annual limit.
If a member of the Titanium Executive Plan has exhausted their annual limit, they can apply to access additional funds through the Flexi Limit. The additional funds are subject to specific terms and conditions.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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