The Radiology Benefit Explained

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Get Unlimited X-Rays

1 Month Waiting Period
Single Benefit Level
Nationwide Network

You get unlimited B&W single or double sided X-rays for out-of-hospital events on the Radiology benefit. As often as you need them, no limit.

Radiology is part of the Day-to-Day Plan with cover for all of this and more.

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What is Covered?

The Radiology Benefit is designed to give you access to black & white, single or double sided X-rays for out-of-hospital events. It also includes ultrasound sonar scans during pregnancy.

The benefit is unlimited which means that it can be used as many times during the year as is medically needed. There is no limit on the number of X-rays you can have.

Prenatal (pregnancy) ultrasound scans are limited to one in the first trimester and one in the second trimester (making a total of two).

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How Do I Use the Benefit?

All you need is a referral from a network doctor or specialist. You can take this referral to any radiology practice for your x-rays. Then, when the radiology practice sends the invoice, it can be submitted directly for claims handling. See the Claims page for more details.

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What is Not Covered?

Other scans like MRI and CT scans are not covered under Day-to-Day benefits. These may be covered under your Hospital benefits if you've included them in your plan.

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Will There be Co-Payments?

The benefit is unlimited but not uncapped. The limits are stated and the various protocols will apply. Most of the radiology procedures are fully covered but if the radiologist needs to perform a procedure that is not fully covered then you may have to pay in.

If you are unsure about what is covered then it is best to consult your network doctor about it or speak to us and we can assist.

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Answers to Your Questions

What does "unlimited" benefit mean?

When a health insurance benefit is "unlimited" it means that the benefit can be used as many times as you need without any specific annual limits.

The only conditions are that the claim or consultation is medically necessary.

Unlimited benefits are usually managed. This means that pre-authorisation is needed after a certain number of times that the benefit is used to ensure that it is you utilising the benefit and that you are getting the proper care that you deserve. You can find more details on the Network page.

What is the Radiology benefit waiting period?

The waiting period on the Radiology Benefit is 1 month.

This means that after the first month of your policy's inception, you can use the benefit.

Where I can find the radiology providers?

There is no network of radiology practices, you can use any practice in South Africa. All you need is a referral script from a network doctor. The Network page has all the information needed.

How are claims paid?

Claims are paid directly to the medical providers. You can find all the details on our claims page.

What are the age limits?

All new members joining a policy must be younger than 65 years on date of application.

Child dependants must be younger than 21 years before they will need to start their own policy.

However, if your child is still a registered full-time student and unmarried, then they may stay on the policy as a child dependant until they turn 26.

How many people can be on a policy?

Episodic health insurance policies can include:

  • you
  • your spouse/partner
  • up to 6 children