Hippo Partners - Topmed

Topmed

Topmed provides cover for approximately 50 000 lives and offers a choice of 8 different plan options with premiums for a single member ranging from R319 (students) to R6070. The Active Saver option has the most members.

A good maternity programme is offered to Topmed members.

Options:

Comprehensive
Comprehensive is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 300%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures.
Day to day claims are payable from a yearly limit with additional benefits applying after the yearly limits are exhausted.

Family
The Family option is suited for individuals requiring extensive medical cover. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 150%. Co-payments are applied to a comprehensive list of in-hospital procedures.
Day to day claims are payable from a yearly limit with some additional benefits applying after the yearly limits are exhausted and a self payment gap.

Executive
The Executive option provides all round general cover and is suitable for young families and individuals. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 200%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures.
Day to day claims are paid from savings, a self payment gap and then from a limited above threshold benefit.

Savings
The Savings option is suited for young families and individuals. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures.
Day to day claims are payable from available savings.

Active Saver
The Active Saver option is suited for young families and individuals. It offers unlimited hospital cover at a hospital of choice, with in-hospital specialist bills paid at 100%. Co-payments are applied to specialized radiology and / or scopes and a few other in-hospital procedures. A comprehensive list of in-hospital exclusions applies to this option.
Day to day claims are payable from available savings. No benefit for specialized dentistry.

Network
The Network option is an entry level capitated network plan which is affordable and ideal for low earning individuals. It offers unlimited hospital cover at a network of hospitals and all treatments are subject to provider network protocols.

Essential
This hospital plan is ideal for young and health individuals. It offers unlimited hospital cover, with in-hospital specialist bills paid at 150%. No benefit for in-hospital dentistry. Co-payments are applied to specialized radiology and / or scopes.
Apart from some preventative care benefits and specialized radiology, no other cover for day to day claims is provided.


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