Whether you’re starting a family or already juggling school runs and teenage milestones, one thing remains constant — your family’s health always comes first.
Introducing the Gold Ascend and the Gold Ascend EDO Plans from Sizwe Hosmed. This comprehensive, family-focused Plan is built to support you through every life stage and offers benefits that grow as your needs do.
The Gold Ascend Plan provides access to any hospital, while the Gold Ascend EDO Plan offers the same benefits but limits access to hospitals within the Scheme network only.
- Private hospital access - no overall annual limits
- Specialist cover - paid at 100% of scheme rate
- Day-to-day care - including GP visits, dental, optical, and medication through our trusted provider network
- Family health benefits - from maternity and childhood immunisations to mental health, chronic care, and preventative screenings
R4468
R4291
R1234
R4249
R4077
R1171
In-hospital Benefits
Hospital and related
- No overall annual limit (100% Scheme rate)
- Private hospitals (EDO plan network hospitals)
- Specialists cover a 100% medical aid rate
- To-Take-Out medication (TTO): seven (7) days
- Maternity cover within medical protocols (100% Scheme rate)
- Internal and external prosthesis: R35 935.99 per family
- Oncology: unlimited for PMB and 80% scheme rate cover above R252 825.30
- Specialised radiology: combined in and out of hospital, R26 225.17 per family per annum
- Ambulance and Emergency Services – Europe Assist (0860 117 799) 24-hour access. Authorisation is required within 72 hours of an emergency event
Out-of-hospital Benefits
Day-to-Day benefits include
- GP, Specialist (excluding Psychiatrists) outpatient facilities, Physiotherapy, Radiology, Pathology and Acute medication. EDO plan – access benefits from Network providers
- Benefits ranging from R7 968.87 to R21 779.89 based on family size
Dental care – Benefit managed by Dental Risk Company
- Benefit cover for conservative dentistry per beneficiary
- Two (2) consultations per beneficiary
- Oral Hygiene
- Extractions
- Fillings
- Intra and extra-oral x-rays
- Root Canal Treatment
- Plastic Dentures: One (1) set, full or partial in a four (4) year period
Optical – Benefit managed by Isoleso
- 24-month treatment cycle
- One (1) eye test per beneficiary
- Frames: R808.50 per beneficiary
- Lenses: single vision – R259.69 and up to R563.60 per lens for bifocal & multifocal
- Or choose contact lenses up to R1 782.90
Maternity benefits – Register on the Bambino programme
- Ten (10) antenatal visits per pregnancy, six (6) either with a GP or midwife and four (4) with a Specialist Obstetrician.
- Specified maternity blood tests covered
- Vitamins: R297.68
- Two (2) 2D Scans
- Childhood Immunisation, as per the Department of Health, is for children up to 12. 1 heart, hearing and vision screening for babies under 2 years of age
Mental health benefit – Psychiatrists and Clinical Psychologist
- R6 590 per family per annum
Medical appliances benefit (Includes nebulizer, C-Pap machine)
- R1 423.33 single member or R2 287.69 per family
Auxiliary
- R1 411.20 per beneficiary per annum
Wheelchair and hearing aid benefit (four [4]-year cycle)
- Wheelchair R2 633.87 per family
- Hearing Aids R21 047.83 per family per annum
Chronic Benefits
Cover for 26 PMB chronic conditions, subject to registration and approval. Covered medication, bloods and GP within PMB protocols and authorisations.
- Addison’s disease
- Asthma
- Bipolar Mood Disorder
- Bronchiectasis
- Cardiac failure
- Cardiomyopathy
- Chronic obstructive pulmonary disease
- Chronic renal disease
- Coronary artery disease
- Crohn’s disease
- Diabetes insipidus
- Diabetes mellitus types 1 & 2
- Dysrhythmias
- Epilepsy
- Glaucoma
- Haemophilia
- HIV/Aids
- Hyperlipidaemia
- Hypertension
- Hypothyroidism
- Multiple sclerosis
- Parkinson’s disease
- Rheumatoid arthritis
- Schizophrenia
- Systemic Lupus Erythematosus
- Ulcerative colitis
Preventative Care Benefits
Health screening is an essential part of preventative healthcare and is vital to maintaining overall well-being and improving outcomes by providing care at the earliest possible stage.
Preventative Care and Screening Benefits include
- Wellness Consultation limit, R2 061.68 per family per annum
- One (1) pap smear for females over 18 years per beneficiary per annum
- One (1) mammogram for females over 40 years of age per beneficiary per annum
- One (1) skin cancer screening per beneficiary above 55 years of age, annually
- One (1) PSA for males over 40 years per beneficiary per annum
- Blood sugar, cholesterol, blood pressure, Body Mass Index, HIV
Vaccinations Benefit
- Covid-19 vaccination per beneficiary
- Flu vaccination
- HPV vaccination
- Pneumococcal vaccine
Female Contraceptive Benefit
R3 672.43 per family
