Prosthetic Sublimits
Prosthetic Sublimits 2010
Kindly note: The annual overall limit for prosthesis as outlined in the benefit summary is subject to certain sub-limits per type of prosthesis. These sub-limits are outlined below:
| Prosthesis | Hospital | Fundamental | Progressive | Prestige |
| Knee | R32 000 | R20 000 | R26 000 | R32 000 |
|---|---|---|---|---|
| Hip | R29 000 | R20 000 | R24 000 | R29 000 |
| Shoulder, Elbow, Ankle | R37 000 | R28 875 | R37 000 | R37 000 |
| External fixator | R42 000 | R28 875 | R42 000 | R42 000 |
| Spinal Fusion | Hospital | Fundamental | Progressive | Prestige | ||||
| Spinal Fusion | Cervical | Lumbar, dorsal | Cervical | Lumbar, dorsal | Cervical | Lumbar, dorsal | Cervical | Lumbar, dorsal |
|---|---|---|---|---|---|---|---|---|
| 1 level | R15 000 | R17 000 | R14 000 | R16 000 | R14 000 | R16 000 | R15 000 | R17 000 |
| 2 levels | R23 000 | R27 000 | R22 000 | R26 000 | R22 000 | R26 000 | R23 000 | R27 000 |
| 3 levels | R32 000 | R34 000 | R26 000 | R28 875 | R30 000 | R32 000 | R32 000 | R34 000 |
| 4+ levels | R42 000 | R42 000 | R28 875 | R28 875 | R40 000 | R40 000 | R42 000 | R42 000 |
| Coronary stents | ||||||||
| 1 stent | R16 000 | R16 000 | R16 000 | R16 000 | ||||
| 2 stent | R26 000 | R26 000 | R26 000 | R26 000 | ||||
| Total | R42 000 | R42 000 | R42 000 | R42 000 | ||||
| Pelvic Floor | R5 250 | R5 250 | R5 250 | R5 250 | ||||
| Hernia Mesh | R5 250 | R5 250 | R5 250 | R5 250 | ||||
Note: sublimits for other prostheses determined per case
