Select a scheme and option
View the benefits, health management programmes and chronic conditions covered by your patient’s medical scheme and option.
| Benefit summaries | |
|---|---|
| Day-to-day benefits |
Members will receive their day-to-day services through the Universal Healthcare networks. This includes all general practioners (GPs) and Pharmacies and dental and optical services. Members can find details of their nearest network provider by calling Universal on 0861 686 278. |
| Major medical benefis |
Admissions will be covered in a Universal Healthcare private hospital network. Emergency admissions related to accidents or trauma (motor vehicle, bike or pedestrian) will be covered in a Universal Healthcare private hospital network hospital, subject to authorisation within 48 hours of the accident. State hospitals are the DSPs for admissions related to cancer treatment. Please call 0861 686 278 to obtain the required pre-authorisaton. |
| Chronic medication benefits |
Paid at the Transmed rate according to the network medicine formulary, formulary reference pricing and protocols. Only Universal network pharmacies. Subject to pre-authorisation and registration on the Universal chronic medicine programme. Please call 0861 686 278 to register a member on the Universal chronic medicine programme. |
| Preventative care benefits |
Subject to Universal protocols and guidelines. Please call 0861 686 278. Preventative Care Benefits:
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| Early detection benefits |
Screening tests covered under the Early Detection enefits:
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| Healthcare programmes Members need to register on health management programmes to gain access to the benefits outlined below. | |
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Please call Universal Healthcare on 0861 686 278 for information regarding healthcare programmes for Link Plan. |
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| Chronic condition lists | |
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| Prescribed minimum benefits (PMB) | |