advertisement
07 July 2011

What are day-to-day limits?

Knowing the limits of you medical schemes and hospital plans are very important. Here's what you need to know.

0

What are limits?

Last updated: 27 June 2005

These are limits, either overall or in categories, which are the maximum that a member and his dependants can spend in a particular year for out-of-hospital expenses. Schemes work according to a financial year, 01 January to the end of December. These categories usually include things such as visits to the doctor, prescribed medication, glasses or contact lenses, specialists, physiotherapists and so forth.

On low-cost medical schemes these day-to-day limits are often not very high, but the hospital cover is quite sufficient. This is how that particular option within a medical scheme can afford to keep the monthly contributions low. On some options within a medical scheme, the day-to-day limits could be high, but this will then be reflected in the higher monthly contribution. If a medical scheme covers 80% of the NRPL rate of a visit to the GP, the remainder of 20% will have to be paid by the member. If the GP charges more than NRPL rate, the difference will be for the member's own account.

 
advertisement

Read Health24’s Comments Policy

Comment on this story
0 comments
Comments have been closed for this article.

Live healthier

The struggle is real »

5 things to know before taking an antihistamine How to cope with seasonal allergies

15 tips for students with allergies

For university students, moving out of home can be daunting at the best of times but for those with severe allergies or asthma, it may feel close to impossible.

Coffee and wine for the win! »

Could heartburn drugs upset your 'good' gut bacteria? Life is a gut reaction

Good news! Coffee & wine may promote a healthy gut

Diverse bacteria help your gut stay healthy. Here's how what you eat and drink can help or harm that balance - and it's not all bad news.