BCIMA Basic Option
Benefits and Limits
BCIMA offers generous limits, both in and out of 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 R460 000 per member family
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Chronic Medication Limit R12 500 per family
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Annual Limit Day-to-day R20 850 per family, with various sublimits, e.g. GPs and Specialists (Refer to Member Brochure 2022)
5.1%
Contribution Increase
Contribution Increases
The contribution increases for 2022 is only 5.1%. The benefit limits increased with an average of 4.2%.
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Benefit Enhancement
The following New Benefits and Enhancement will be implemented in 2022 to assist our members:
Covid-19
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Unlimited Benefit for Admissions and In-Hospital related treatment.
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PMB Tariffs will apply and will not affect the Annual Hospital Limit.
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BCIMA Tariff + 200%.
Alcohol and Drug Addiction
Alcoholism and drug addiction was previously an Exclusion on the Fund.
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From 2022 there will be a benefit of 21 days per beneficiary per year, in a rehab centre and will be paid from the Hospital Limit.
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, as well as non-emergency telephonic medical advice to members and dispatch an ambulance if it is clinically indicated.