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Liberty Medical Scheme (LMS)
Liberty Medical Scheme (LMS) 2013 Brief Overview Options 2013 Private Option Prestige Complete Options Platinum Complete Titan Titan Select Saver options Platinum Saver Gold Saver Network Option Hospital Options Gold Saver Select Platinum Focus Gold Focus Gold Focus Select Bona Plus Major Medical Benefits (MMB) Hospitalisation Other Major Medical Benefits Disease Management Chronic Benefit Day-to-Day Extender paid from MMB Casualty Crime Trauma Preventative Care Day Procedures MRI/CT Scan Day-to-Day Benefits R 19000 Medical Savings Facility Threshold Benefit Medical Savings Facility Self-Fund Network Day-to-Day Benefits Prestige Platinum Complete Titan Select Titan Platinum Saver Gold Saver Select Gold Saver Platinum Focus Gold Focus Gold Focus Select Medical Savings Facility R 19 000 per beneficiary Sub-limits apply to certain benefits 15% 15% M: R6 252 A: R4 644 C: R1 800 M: R 3 396 A: R 2 712 C: R 912 10% M: R 2 436 A: R 2196 C: R 792 15% M: R 2 760 A: R 2 256 C: R 1008 Self-Payment GAP M: R 2 123 A: R 1 621 C: R 703 M: R 919 A: R 679 C: R 319 Self-Funded Threshold Level Above Threshold Benefit •Consultations •Basic Dentistry •Pathology •Basic Radiology Unlimited Benefits M: R 3 290 A: R 1 940 C: R 850 Limited Benefits Basic & Special DENTISTRY paid from RISK •Routine Medication •Specialised Dentistry •Optometry •Therapies •External Appliances •Mental Health LMS Network GP’s will be reimbursed @ 115% of the LMS Rate Claims are paid at the LMS Rate on all options Complementary Products to Liberty Medical Scheme Complementary Products to Liberty Medical Scheme Medical GAP Cover Premium: R 140 pf pm Benefit: R 200 000 pb R 2 million pf Benefit: R 25 000 lump sum (or part thereof) Medical Premium Waiver 24 months – R 103 pf pm 60 months – R 180 pf pm • Covers the difference between LMS Rate and costs incurred for: • In-hospital specialist fees • Out-patient Procedures e.g. Chemotherapy, dialysis, coronary angiogram • Personal Accident Benefit • Any serious accidental injury e.g. MVA, IOD, hi-jacking, etc. that results in permanent total disability of the principal member • Provides principal members of a medical scheme with the assurance that their dependants will receive ongoing funding towards their medical scheme membership should they die or become permanently disabled