Value Care Plan

Value Care Plan members are entitled to obtain emergency ambulance services from a Prime Cure network provider only. Call Prime Cure on 0861 665 665 and select the option for a Medical Emergency. You will need to provide personal details to validate your membership, such as the membership number or ID number/passport number of the member. If the member is not able to contact the call centre, a friend or family member can assist them. The member, a family member or healthcare provider must authorise the event by calling Prime Cure on 0861 665 665 within 72 hours of the event. Authorise inter-hospital transfers before the event. Voluntary use of non-DSP results in a 30% co-payment

Ambulance services are subject to the Family Hospital Limit, unless it is a Prescribed Minimum Benefit condition.

Value Care Plan members are entitled to receive cancer (oncology) treatment, provided a Prime Cure Network provider refers them to a specialist.

For all consultations (doctor, nurse, allied healthcare provider and specialist), including maternity consultations, members of the Value Care Plan will need to use Prime Cure facilities and the practitioner network.

Should you suspect that you have COVID-19, please contact our COVID-19 Medical Line for medical-related advice on prevention, diagnosis and treatment. Call 0861 493 587 and select option five (2) for member and then select option seven (7) for patient management/COVID-19.

Members of the Value Care Plan are entitled to the following dental benefits:
Preventative treatment, Conservative treatments, Specialised dentistry, Emergency consultations and Dental hospital admission.

Members of the Value Care Plan, diagnosed with diabetes, need to register their condition with Prime Cure on 0861 665 665. On registration, members will receive a detailed treatment plan indicating the services and medicine that are allowed, according to the relevant protocols. The relevant doctor will inform the member of the benefits available.

Every Value Care Plan beneficiary is entitled to one eye examination per year and one pair of spectacles (lenses and frames) every 2 years. The benefit does not cover contact lenses or sunglasses.
If you get a prescription for spectacles, you need to obtain your spectacles within one month.

Prime Cure offers HIV-positive members and dependants of the Value Care Plan a confidential management programme, aimed at keeping them well and providing access to increased benefits to help manage their condition more effectively.

Members on the Value Care Plan must obtain authorisation for hospitalisation and must use Prime Cure private hospitals or public hospital facilities. A Prime Cure doctor referral and authorisation is necessary for all planned hospital admissions as well as for admissions following a casualty visit.

Value Care Plan members have access to antenatal and postnatal care through Prime Cure facilities and network doctors.

Antenatal care: Consultations, GP and specialists
You are entitled to antenatal vitamins (folic acid), GP consultations, 3 specialist consultations and 2 ultrasound (up to the price of 2D) scans per pregnancy.

Confinement in hospital
We treat the delivery in hospital as a normal hospital admission and the annual Family Hospital Limit applies. Please ensure your Prime Cure healthcare provider registers you on the maternity management programme by phoning 0861 665 665.

Acute medicine, inclusive of dental medication
Formulary medicine only, to be obtained at a network GP, dentist or pharmacy.

Contraceptive medicine is subject to Family Hospital Limit and a limit of R2 635 per qualifying beneficiary.

Pharmacy Advised Therapy (PAT)
R345 per family per year (R115 per purchase up to a maximum of 3 purchases per beneficiary).
Formulary medicine only, to be obtained at a Prime cure Network GP, dentist or pharmacy.

All medical schemes in South Africa have to include the Prescribed Minimum Benefits in the plans they offer to their members. No matter what plan you decide on, there are some common benefits that apply to all members on all plans subject to Scheme protocols.

Flu Vaccine
For members of the Value Care Plan, Prime Cure pays the cost of one flu vaccine per year, per beneficiary.

Vitality Health check
The Scheme pays one Health check per beneficiary per year. The Health check must be done at Wellness partners. It includes the measurement of your cholesterol, blood glucose, BMI and blood pressure.

Read more about other benefits of the Value Care Plan, such as treatment for Alcohol and Drug treatment, Kidney Disease, and Pathology and Radiology services.