medical-lifestyle-plus-product-summary

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Medical Lifestyle PLUS
Medical Lifestyle PLUS (ML+) pays a benefit for diagnoses requiring hospitalisation, surgery, chronic conditions, rehabilitation, and crisis care (locally and internationally). A
health diagnosis triggers the payment of a lump sum. This lump sum is determined using an internationally accepted scoring system, which is essentially a pre-determined
percentage of the sum assured applicable to your plan type.
High Cover
Extended Cover
Hospitalisation
Benefit
Benefits pay out as a percentage of the sum assured of R75 000
Benefits pay out as a percentage of the sum assured of R25 000
The Hospitalisation Benefit is
payable in the event of a
medical practitioner making a
diagnosis which requires
surgical intervention and/or the
hospitalisation of the Life
Assured for no less than 24
hours, within 30 days of the
diagnosis.
Hospitalisation is the
central component of
Medical Lifestyle PLUS.
Non-Surgical Diagnosis
Surgical Diagnosis
Basic Benefit
per day or
part thereof
Benefit for
High Care
per day
Benefit for
ICU per day
Day 1
0.225%
2.700%
5.175%
Day 2
0.675%
3.150%
5.625%
Day 3
1.125%
3.600%
6.075%
Day 4
1.575%
4.050%
6.525%
Day 5
2.025%
4.500%
6.975%
Day 6 and
onwards
2.475%
4.950%
7.425%
Measurement Parameter
Highest level of care required
during a day for the diagnosis:

General/ semi-private/
private ward

High Care

ICU
Theatre time required for the
diagnosis
Highest level of prosthesis or
embedded device required for
the diagnosis:

Compound plating

Major plating

Life or organ sustaining
plating
Accelerated Benefit
The Accelerated Benefit forms part of the Hospital Benefit. Specific
conditions are listed where Liberty will immediately pay a stated
percentage of Sum Assured on diagnosis of the condition.
Benefits

2.75% per day or part
thereof

5.50% per day or part
thereof

8.25% per day or part
thereof

3.75% for every fifteen
minutes or part thereof

10.0%
30.0%
45.0%


The Accelerated Benefit is payable upon diagnosis of conditions such as:







Abcess of liver
Cholera
Cleft palate
Delivery – childbirth
Fracture of Femur
Malignant melanoma of skin
Viral Meningitis
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Chronic Benefit
This benefit is payable upon diagnosis of specific long-term medical conditions
as listed. The Chronic Benefit pays a percentage of the sum assured on a
monthly basis.
The maximum Chronic Benefit payable in respect of a Life Assured in any
contract year is limited to the sum assured.
The Chronic Benefit is payable upon diagnosis of the following conditions:
Cancer
Chronic Renal Failure
Diabetes (Type 1 only)
End Stage Lung Disease









Crisis Care Benefit
This benefit is split into Emergency Transport
Southern Africa* (Netcare 911) and emergency
international cover and care through Europ
Assistance.
The maximum emergency international benefit
is R5 million for any one period of overseas
travel of less than 90 days.
This benefit is available for lives assured under
the age of 81 years, and is subject to certain
terms and conditions.
* Southern Africa: South Africa, Botswana,
Swaziland, Zimbabwe; Lesotho,
Mozambique, Namibia.
Recovery Benefit
Crisis Care Benefits in Southern Africa










Emergency medical response to a scene of a medical
emergency by road or air ambulance
Emergency (telephonic 911 type) medical advice and
information
Transfer of the Life Assured to the most appropriate medical
facility
Transfer of life saving medications and emergency blood if
required
Hospital admission deposit guarantees, currently R 5,000, if
required
Non-emergency/general medical (telephonic) consultation and
advice
Repatriation of Life Assured or the return of mortal remains
Companionship and/or care of stranded minors
Rape Crisis Centres of Excellence
Specialised Travel Advice.
This benefit will pay a percentage of the sum assured in the event of a
Life assured requiring specific therapy, as a result of a:
Epilepsy
Heart Failure
Transplant organ rejection
Cystic fibrosis
Parkinson’s Disease
International Crisis Care Benefits










Emergency medical expenses
Related expenses
Emergency medical assistance
Transportation / repatriation
Return after medical treatment
Burial, cremation or return of mortal
remains
Transmission of urgent messages
Consular referral
Emergency travel and accommodation
arrangements
Direct payment of medical bills.
Examples include:

Rehabilitation facilities

Violent Crime event;

Step-down facilities

Hospitalisation related to a surgical diagnosis;

Hospice

Hospitalisation related to any one or more eligible non-surgical
diagnoses.

Physiotherapy

Speech Therapy.
The Recovery Benefit is limited to the 42 days immediately following either the
date on which the violent crime took place, or the end date to which the
Hospitalisation Benefit relates.
Statutory notice: Medical Lifestyle PLUS is not a medical scheme. A medical scheme is indemnity based and pays actual medical costs subject to plan type limits. Medical Lifestyle PLUS is a
non-indemnity product and pays a fixed percentage determined by your selected sum assured on the occurrence of a health event - actual cost is irrelevant, as is what you choose to do with the
payment.
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