BCIMA Basic Option
Benefits and Limits
BCIMA offers generous limits, both in and out of the hospital
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Disease Management Benefit - LifeSense (HIV & TB) Unlimited
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Covid-19 - Unlimited
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PMB Preventative Care Benefit - Unlimited
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Hospital Limit R1 000 000 per member family
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Chronic Medication Limit R13 300 per family
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Annual Limit Day-to-day R20 850 per family, with various sub-limits, e.g., GPs and Specialists.
Contribution Increases
The contribution increases for 2023 is only 6.5%. The benefit limits increased by an average of 6.5%.
Benefit Enhancement
The following benefits will be available to assist our members in 2023:
Basic Option Enhancements
6.5%
PLUS OPTION - Exceptional Benefits!
BASIC OPTION
Enhanced Benefits
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An exciting enhancement on the Basic Option is the increase in the Overall Annual Hospital Limit to a Million Rand.
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Benefit limits on the Basic Option are very generous and will increase by 6.5% in 2023.
PLUS OPTION
Exceptional Benefits
Fitness assessment and Exercise prescription benefit as well as Nutritional assessment and Healthy Plan Benefit.
The Fitness assessment and Exercise Prescription benefit provides access to the Universal Network of Biokineticists for an annual fitness assessment, Exercise Prescription and regular monitoring.
These are subject to preauthorization and scheme protocol.
PREVENTATIVE CARE BENEFIT
This benefit is unlimited and will not affect your Hospital and Day-to-day Limits.
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Conservative Dentistry
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For beneficiaries under 6 years of age (100% of the BCIMA Tariff)
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Mental Health Benefit
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1 Clinical Psychologist consultation, per beneficiary per year.
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HEALTH-ON-LINE
Assistance and advice are just a phone call away, on 082 911 through Netcare's 911's Health-on-Line, a 24-hour Emergency Operations Centre, which provides emergency and non-emergency telephonic medical advice to members and dispatches an ambulance if it is clinically indicated.