Suremed Health Shuttle Plan
Overall, the Suremed Health Shuttle Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and enhanced major medical benefits to up to 3 Family Members. The Suremed Health Shuttle Medical Aid Plan starts from R1,029 ZAR.
| 👤 Main Member Contribution | R1,029 – R2,343 |
| 👥 Adult Dependent Contribution | R1,029 – R2,343 |
| 🍼 Child Dependent Contribution | R549 – R1,200 |
| 🔁 Gap Cover | ✅ Yes |
| ➡️ Hospital Cover | Unlimited |
| 💶 Medical Savings Account | None |
| 💙 Maternity Benefits | ✅ Yes |
| 🟦 Pre- and Postnatal Care | ✅ Yes |
| 🔵 Chronic Conditions | ✅ Yes |
| 📉 Optometry Benefit | ✅ Yes |
Suremed Health Shuttle Plan – 7 Key Point Quick Overview
- ✅ Suremed Health Shuttle Plan Overview
- ✅ Suremed Health Shuttle Plan Contributions
- ✅ Suremed Health Shuttle Plan Benefits and Cover Comprehensive Breakdown
- ✅ Suremed Health Shuttle Plan Exclusions and Waiting Periods
- ✅ Suremed Health Shuttle Plan vs Similar Plans from Other Medical Schemes
- ✅ Our Verdict on the Suremed Health Shuttle Plan
- ✅ Suremed Health Shuttle Plan Frequently Asked Questions
Suremed Health Shuttle Plan Overview
The Suremed Health Shuttle Medical Aid Plan is one of 4, starting from R1,029, and includes extensive hospital cover, enhanced major medical benefits via preferred providers, and more. Members also have access to the Suremed Health app 24/7, and all services are offered via PrimeCure. Gap Cover is available on the Suremed Health Shuttle Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Suremed Health has a trust rating of 2.1.
Suremed Health Medical Aid Scheme has the following plans:
Suremed Health Shuttle Plan Contributions
| 💴 Income Bracket | 👤 Main Member | 👥 Adult Dependent | 🍼 Child Dependent |
| 💵 R0 – R9,000 | R1,029 | R1,029 | R549 |
| 💶 R9,001 – R13,000 | R1,371 | R1,371 | R714 |
| 💷 R13,001 – R17,000 | R2,057 | R2,057 | R1,057 |
| 💴 R17,001 – R30,000 | R2,200 | R2,200 | R1,114 |
| 💵 R30,000> | R2,343 | R2,343 | R1,200 |
Suremed Health Shuttle Plan Benefits and Cover Comprehensive Breakdown
| 📌 Prescribed Minimum Benefits (PMB) | Unlimited cover provided.
Covered up to 100% of the cost.
Only a Prime Cure Network Hospital can be used.
Alternatively, a Prime Cure DSP can approve a non-DSP provider.
Pre-authorization is necessary. |
| 📍 Emergency Stabilisation and Transportation | Netcare 911 is the preferred provider for road or air transport and stabilization. |
| ☑️ Hospitalization | Unlimited coverage is offered.
Covered up to 100% of the Prime Cure Agreed Rate at a Prime Cure Network Hospital.
The benefit covers the following:
Hospital stays
Nursing Services
Surgical Procedures
Related Accounts (anesthesia, etc.)
Co-payments will apply to specific procedures performed in-hospital. |
| ✅ Planned Procedures – Day Clinics | Covered up to 100% of the Prime Cure Agreed Rate.
Pre-approval is required before admission.
There is a co-payment of R2,000 for planned procedures performed in a day clinic. |
| 🟥 Alternatives to Hospitalisation | Limited to R11,440 per beneficiary or family per year.
Frail care facilities are not covered. |
| 🟧 Specialized Radiology | There is a combined in and out-of-hospital radiology sub-limit of R9,800 per beneficiary and R20,800 per family per year.
Pre-authorization is required for specific tests. |
| 🟨 Maxillo-facial Surgery | Limited to R17,680 per family per year.
Covered up to 100% of the Prime Cure Agreed Rate.
Limited to PMBs.
Subject to pre-approval.
Surgery must be performed in a Prime Cure Network Hospital. |
| 🟩 Dental Surgery | Limited to removing impacted third molars and procedures related to sudden, unforeseen injury to the mouth and teeth requiring urgent treatment after an accident or trauma.
Only children under 7 are covered.
Subject to pre-approval and case management.
Co-payments might apply to certain procedures. |
| 🟦 Private Ward Cover | Covered up to 100% of the Prime Cure Agreed Rate.
Only if required for medical reasons. |
| 🟪 GP Consultations | Unlimited GP visits within the Prime Cure Network.
Covered up to 100% of the Prime Cure Agreed Rate.
Members can nominate two GPS and authorize visits in the Suremed app. |
| 1️⃣ Out-of-Network and After-Hour GP Consultations | Limited to one visit per beneficiary or two per family at a registered emergency medical facility.
Paid at cost and includes X-rays, blood tests, and medicine.
Limited to R1,145 per event.
Authorization is required within 72 hours of the visit. |
| 2️⃣ Emergency Casualty Visits | Unlimited for medical emergencies.
Authorization is required within 72 hours of the visit. |
| 3️⃣ Specialist Benefit | Unlimited consultations for PMBs.
Covered up to 100% of the Prime Cure Agreed Rate.
Limited to R3,715 per beneficiary and R7,435 per family per year unless additional benefits are pre-authorized by Prime Cure. |
| 4️⃣ Nurse Visits | Unlimited visits to a Prime Cure Network Pharmacy nurse for minor illnesses.
Pre-approval is not required. |
| 5️⃣ Flu Vaccines | One flu vaccine per beneficiary annually using a Prime Cure healthcare provider or pharmacy.
Subject to the Kaelo Prime Cure protocols. |
| 6️⃣ Acute Medicine | Unlimited acute (prescribed) medicine on the Prime Cure Medicine Formulary.
Covered up to 100% of the Prime Cure Agreed Rate.
Must be prescribed by a Prime Cure Healthcare Provider or Specialist.
Must be collected from a dispensing Prime Cure GP or pharmacy in the network if the GP does not dispense medicine. |
| 7️⃣ Over-the-Counter Medicine (OTC) | Limited to R450 per beneficiary.
Limited to R150 per event.
Maximum 3 events per year. |
| 8️⃣ Chronic Medicine | Unlimited cover provided.
Covered up to 100% of the Prime Cure Agreed Rate for prescribed medicine on the formulary.
Members must register for the Chronic Medicine Benefit. |
| 9️⃣ HIV Program | Unlimited cover.
Member must register on the HIV Disease Management Program.
This program includes Antiretroviral (ARV) medicine, pathology, voluntary counseling and testing, and treatment of opportunistic infections. |
| 🔟 Basic Dentistry | Limited to one Prime Cure Dental Network consultation – full mouth exam.
Authorization is not necessary for a consultation.
Limited to one preventative treatment (cleaning, scaling, polishing).
If additional consultations are required for restorations, extractions, or fillings, these are covered up to 100% of the agreed rate but are subject to pre-approval. |
| 🦷 Dentures | Limited to one set of plastic or acrylic dentures for beneficiaries 21 years>.
Treating dentists must be in the Prime Cure network.
Pre-approval is required.
There is a co-payment of 20% of the total account and the laboratory. |
| ➡️ Emergency Dentistry | Limited to emergency pain and sepsis treatment and extractions.
Pre-approval must be obtained.
Limited to one event per beneficiary per year. |
| ↪️ Specialized Dentistry | Covers the removal of impacted third molars.
Covered up to 100% of the Prime Cure Agreed Rate.
Limited to one event per beneficiary yearly.
Pre-approval is required. |
| 📉 Eye Exams | Limited to one consultation and exam per beneficiary per year.
Must use an optometrist in the Prime Cure Network.
Authorization is not required. |
| 📈 Glasses and Lenses | Limited to one pair of glasses every 2 years.
Single vision and bifocal lenses are covered up to 100% of the agreed rate.
Multifocal lenses are limited to R2,500 per beneficiary every 2 years.
Pre-approval is required. |
| 📊 Allied Healthcare Professionals | Covered up to 100% of the Prime Cure Agreed Rate for PMBs.
Certain conditions will apply, and non-PMBs are not covered.
Pre-approval is required and can be obtained from the app before the visit. |
| 🧪 Radiology and Ultrasounds | limited to black-and-white X-rays and ultrasounds according to an approved code list.
Covered up to 100% of the Prime Cure Agreed Rate when referred by a Network GP and using a Network Radiologist. |
| 🅰️ Pathology | Unlimited cover for blood tests.
Covered up to 100% of the Prime Cure Agreed Rate when using a network pathology lab and when requested by a network GP.
Subject to a list of approved pathology codes. |
| 🅱️ Maternity | Pregnant members must register for the Maternity Program on the Suremed Shuttle App.
Limited to 8 visits to a gynecologist, midwife, or GP.
Antenatal vitamins are covered up to R110 for 9 months.
Limited to 2 2D ultrasound scans per pregnancy.
Includes a basket of blood tests.
Delivery must be in a network maternity hospital.
Includes a six-week postnatal consultation. |
Read more about the 5 Best Gap Cover Options for Under R1 000
Suremed Health Shuttle Plan Exclusions and Waiting Periods
Shuttle Plan Exclusions
The Suremed Health Shuttle Plan Exclusions include, but are not limited to, the following:
- Costs exceeding the annual or biennial maximums.
- Medical, surgical, and orthopedic appliances, devices, and products not specifically provided for.
- Operations, medicines, treatments, and procedures for cosmetic purposes or personal reasons.
- Medicines not included in a prescription from a legally entitled medical practitioner or healthcare professional (except schedule 0, 1, and 2 medicines supplied by a registered pharmacist).
- Healthcare services are not appropriate or necessary for symptoms, diagnosis, or treatment of a medical condition.
- Medicines not registered and approved by SAHPRA for clinical treatment of a condition.
- Treatment where efficacy and safety cannot be scientifically proven.
- MRI scans are ordered by a general practitioner (except in emergencies).
- Specialist referral for second opinions unless authorized by the scheme.
- Injuries sustained while participating voluntarily in certain activities or any injuries arising from professional sports or speed contests.
- Organ and tissue donations to anyone other than a member or dependent of a member.
- Treatment of a sickness condition directly attributable to the failure to carry out medical practitioner instructions (except if the sickness condition is a PMB).
and many more.
Discover the 5 Best Medical Aids under R500
Shuttle Plan Waiting Periods
Waiting periods prevent members from anti-selecting or joining a program solely when ill. There are two types of wait times:
- A 3-month General Waiting Period – The scheme will not fund any claims during this general waiting period.
- A 12-month Condition-Specific Waiting Period – A member is ineligible to claim benefits for a condition for which medical advice, diagnosis, care, or treatment was recommended or received within the 12 months ending on the date of the membership application.
Condition-specific waiting periods may not be imposed on related conditions unless a direct link between the conditions can be demonstrated. Furthermore, the waiting periods can also include prescribed minimum benefit (PMB) conditions for applicants who have never belonged to a medical plan before or for members who have had a break in coverage of more than 90 days.
Suremed Health Shuttle Plan vs Similar Plans from Other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Suremed Health Shuttle | 🥈 KeyHealth Essence | 🥉 KeyCare Start Regional |
| 👤 Main Member Contribution | R1,029 – R2,343 | R1,814 | R930 – R2,190 |
| 👥 Adult Dependent Contribution | R1,029 – R2,343 | R1,454 | R930 – R2,190 |
| 🍼 Child Dependent Contribution | R549 – R1,200 | R654 | R560 – R670 |
| ➡️ Hospital Cover | Unlimited | Unlimited | Network Hospital in the member’s region only – Unlimited |
READ more: How to Calculate Medical Aid Fringe Benefit
Our Verdict on the Suremed Health Shuttle Plan
Suremed Health’s Shuttle Plan is a medical aid plan that provides members with comprehensive cover for in-hospital treatment, chronic medication, day-to-day medical expenses, and preventative care. The plan offers a range of features and benefits that aim to provide members with affordable and accessible healthcare services. One of the key advantages of the Shuttle Plan is that it offers members coverage for a range of medical expenses. Members can access coverage for in-hospital treatment, which includes accommodation, theatre fees, and medication. Some plans also cover chronic medication, day-to-day medical expenses, and preventative care. The Shuttle Plan is designed to cater to a broad range of individuals and families with different budgets and healthcare needs.
Another advantage of the Shuttle Plan is that it offers members access to an extensive network of healthcare providers, including doctors, pharmacies, dentists, optometrists, and hospitals. Unless otherwise indicated, the plan is managed by Prime Cure, the Designated Service Provider (DSP) for all healthcare services. Members can use providers in the Prime Cure Network to avoid co-payments and claim rejections. This feature helps members to access quality healthcare services without worrying about the cost. However, one of the drawbacks of the Shuttle Plan is that it may not offer the same level of coverage as some of the higher-priced medical aid plans. As a result, members may need to choose a plan that suits their healthcare needs and budget. Another potential drawback is that the plan may not cover certain medical conditions or procedures. Therefore, members should carefully check their plan benefits and exclusions before choosing a plan.
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Suremed Health Shuttle Plan Frequently Asked Questions
What is the Suremed Shuttle Plan?
The Suremed Shuttle Plan is a medical aid plan offered by Suremed Health, which provides comprehensive cover for in-hospital treatment, chronic medication, day-to-day medical expenses, and preventative care.
What does the Suremed Shuttle Plan cover?
The Suremed Shuttle Plan covers in-hospital treatment, chronic medication, day-to-day medical expenses, and preventative care.
Can I use any healthcare provider with the Suremed Shuttle Plan?
To avoid co-payments and claim rejections, members must use a provider in the Prime Cure Network.
Will the Suremed Shuttle Plan cover all my medical expenses?
The Suremed Shuttle Plan may not cover all medical conditions or procedures. Therefore, members must ensure that they understand the benefits and limitations of the Suremed Shuttle Plan before signing up.
Can I get coverage for chronic medication with the Suremed Shuttle Plan?
Yes, some plans offer coverage for chronic medication.
Does the Suremed Shuttle Plan cover preventative care?
Yes, some plans offer coverage for preventative care.
What happens if I use a healthcare provider outside the Prime Cure Network?
Members may be subject to co-payments and claim rejections if they use a healthcare provider outside the Prime Cure Network.
How do I avoid claim rejections with the Suremed Shuttle Plan?
Members can avoid claim rejections by using healthcare providers in the Prime Cure Network and ensuring that all claim documentation is accurate and complete.
