2021 Benefit:

Endoscopic examinations:

Paid at three times the Fund’s tariff rate if performed in doctors’ rooms/outpatient/ medical or surgical facilities.

R2 300 co-payment applies if performed in hospital and patient is admitted to a ward.

Anaesthetic costs related to these scopes are limited to local or regional anaesthetic.

General anaesthetic costs are not covered.

Authorisation: 0800 118 666

2022 Benefit:

Endoscopic examinations:

• Gastroscopy
• Oesophagoscopy
• Colonoscopy
• Sigmoidoscopy

These procedures can be performed in doctors’ rooms, and in outpatient/medical/surgical facilities
If performed in hospital, it will attract a member co-payment.

Paid at three times the Fund’s tariff rate if performed in doctors’ rooms/outpatient/ medical or surgical facilities.

R2 400 co-payment applies if performed in hospital and patient is admitted to a ward.

Anaesthetic costs related to these scopes are limited to local or regional anaesthetic.

General anaesthetic costs are not covered.

Pathology costs related to these procedures will be covered from major medical expenses.

Authorisation: 0800 118 666.