Value Care Plan

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. Treatment funding is subject to the Family Hospital Limit, authorisation and must adhere to the Scheme protocols.

We fund 1 examination and 1 pair of spectacles every 2 years per beneficiary.

Endoscopies are funded subject to the Family Hospital Limit, and the procedure must be performed in a PrimeCure hospital contracted for endoscopic procedures.

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.

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 700 per qualifying beneficiary.

Pharmacy Advised Therapy (PAT)
R365 per family per year (R120 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.

We encourage you to know and manage your health status proactively. Detecting health risks or disease early could prevent a disease or at least improve the success rate of the treatment. Find your preventative care benefits here and make use of them today.

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.