29 Jun Third Party Consent Form
- Version
- Download 15
- File Size 367.28 KB
- File Count 1
- Create Date June 29, 2026
- Last Updated June 29, 2026
 |
Network Hospital: DSP hospital group is Netcare – No limits |
 |
Attending Doctors: 100% CBT only at DSP |
 |
27 Chronic Conditions: medication and consultations. |
 |
Radiology Advanced scans limited to R49 965 per family (combined limit for in and out of hospital.) Limit before PMB/CDL applies. R5 845 per beneficiary for basic radiology (on referral by nominated GP or specialist for out of hospital) |
 |
Screening Benefits: PSA, Pap Smear, Mammogram |
 |
Vaccines |
 |
Any Private Hospital –Â No limits |
 |
Attending Doctors and Specialists: 100%Â CBT |
 |
27 Chronic Conditions: medication and consultations. |
 |
Radiology Advanced scans limited to R49 965 per family (combined limit for in and out of hospital.) Limit before PMB/CDL applies. R5 845 per beneficiary for basic radiology |
 |
Screening Benefits: PSA, Pap Smear, Mammogram |
 |
80% of GP, Specialists, Dental, Optometry, Checkups, ECG, Vaccines |
 |
Essential Plus: Any Private Hospital – No limits Essential Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
 |
Attending Doctors and Specialists: 200% of CBT |
 |
27 Chronic Conditions: Medication and consultations |
 |
Unlimited X-Rays and Blood Tests IN hospital including MRI and CT scans |
 |
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
 |
Checkups and Vaccines: GP, Specialist, Dental, Optometry, ECG |
 |
Vital Plus: Any Private Hospital – No limits Vital Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
 |
Attending Doctors and Specialists: 300% of CBT |
 |
60 Chronic Conditions: Medication and consultations. Covers the medication and necessary consultations and procedures |
 |
Unlimited X-Rays and Blood Tests IN hospital, limits apply to advanced scans |
 |
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
 |
3 Months post-hospitalisation benefit |
 |
External Appliances: Wheelchair, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor, Insulin pump |
 |
Checkups and Vaccines: GP, Specialist, Dental, Optometry, ECG |
 |
Double Plus: Any Private Hospital – No limits Double Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
 |
Attending Doctors and Specialists: 300% CBT |
 |
64 Chronic Conditions Medication and Consultations. Biological medication for non-PMB conditions is available in exceptional cases on Alliance options, a 20% co-payment will apply (not on biologics approved for CDL conditions) |
 |
Unlimited X-rays and Blood Tests In and Out of Hospital including MRI and CT Scans |
 |
Screening Benefits Melanoma, PSA, Pap Smear, Mammogram |
 |
3 Months post-hospitalisation benefit |
 |
External Appliances: wheelchair, Insulin pump, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor (on referral from a nominated network GP or a specialist for Double Network) |
 |
Checkups and Vaccines: GP (nominated network GP referral applies for Double Network), Specialist, Dental, Optometry (PPN optometrist for Double Network), ECG |
 |
Infertility R83 050 per family |
 |
Alliance Plus: Any Private Hospital – No limits. Private wards for childbirth confinements (subject to availability and pre-authorisation) Alliance Network: DSP hospitals are Life Healthcare and Netcare – No limits, private wards for childbirth confinements (subject to availability and pre-authorisation) (20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies) |
 |
Attending Doctors and Specialists: 300%Â CBT |
 |
65 Chronic Conditions medication and consultations. Biological medication for non-PMB conditions is available in exceptional cases on Alliance options, a 20% co-payment will apply (not on biologics approved for CDL conditions) |
 |
Unlimited X-Rays and Blood Tests IN and OUT of hospital including MRI and CT scans |
 |
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
 |
3 Months post-hospitalisation benefit |
 |
External Appliances: Wheelchair, Insulin pump, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor (on referral from a nominated network GP or a specialist for Alliance Network) |
 |
Checkups and Vaccines: GP (nominated network GP referral applies for Alliance Network), Specialist, Dental, Optometry (PPN optometrist for Alliance Network), Dermatologist, ECG, Dietician |
 |
Infertility R117 760 per family |
|
Network Hospital: DSP hospital group is Netcare – No limits |
|
Attending Doctors: 100% CBT only at DSP |
|
27 Chronic Conditions: medication and consultations. |
|
Radiology Advanced scans limited to R47 586 per family and R5 565 per beneficiary for basic radiology (on referral by nominated GP or specialist for out of hospital) |
|
Screening Benefits: PSA, Pap Smear, Mammogram |
|
Vaccines |
|
Any Private Hospital –Â No limits |
|
Attending Doctors and Specialists: 100%Â CBT |
|
27 Chronic Conditions: medication and consultations. |
|
Radiology Advanced scans limited to R47 586 per family and R5 565 per beneficiary for basic radiology |
|
Screening Benefits: PSA, Pap Smear, Mammogram |
|
80% of GP, Specialists, Dental, Optometry, Checkups, ECG, Vaccines |
|
Essential Plus: Any Private Hospital – No limits Essential Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
|
Attending Doctors and Specialists: 200% of CBT |
|
27 Chronic Conditions: Medication and consultations |
|
Unlimited X-Rays and Blood Tests IN hospital including MRI and CT scans |
|
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
|
Checkups and Vaccines: GP, Specialist, Dental, Optometry, ECG |
|
Vital Plus: Any Private Hospital – No limits Vital Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
|
Attending Doctors and Specialists: 300% of CBT |
|
60 Chronic Conditions: Medication and consultations. Covers the medication and necessary consultations and procedures. Includes appropriate biological medication for CDL chronic conditions and specialised technology |
|
Unlimited X-Rays and Blood Tests IN hospital, limits apply to advanced scans |
|
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
|
3 Months post-hospitalisation benefit |
|
External Appliances: Wheelchair, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor, Insulin pump |
|
Checkups and Vaccines: GP, Specialist, Dental, Optometry, ECG |
|
Double Plus: Any Private Hospital – No limits Double Network: DSP hospitals are Life Healthcare and Netcare – No limits 20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies. |
|
Attending Doctors and Specialists: 300% CBT |
|
64 Chronic Conditions Medication and Consultations. Includes unlimited appropriate biological medication for CDL chronic conditions, limited benefits for additional chronic conditions and specialised technology |
|
Unlimited X-rays and Blood Tests In and Out of Hospital including MRI and CT Scans |
|
Screening Benefits Melanoma, PSA, Pap Smear, Mammogram |
|
3 Months post-hospitalisation benefit |
|
External Appliances: wheelchair, Insulin pump, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor (on referral from a nominated network GP or a specialist for Double Network) |
|
Checkups and Vaccines: GP (nominated network GP referral applies for Double Network), Specialist, Dental, Optometry (PPN optometrist for Double Network), ECG |
|
Infertility R79 095 per family |
|
Alliance Plus: Any Private Hospital – No limits. Private wards for childbirth confinements (subject to availability) Alliance Network: DSP hospitals are Life Healthcare and Netcare – No limits, private wards for childbirth confinements (subject to availability) (20% co-payment applies for utilisation of non-DSP hospitals for non-emergencies) |
|
Attending Doctors and Specialists: 300%Â CBT |
|
65 Chronic Conditions medication and consultations. Includes unlimited appropriate biological medication for CDL chronic conditions, limited benefits for additional chronic conditions and specialised technology |
|
Unlimited X-Rays and Blood Tests IN and OUT of hospital including MRI and CT scans |
|
Screening Benefits: Melanoma, PSA, Pap Smear, Mammogram |
|
3 Months post-hospitalisation benefit |
|
External Appliances: Wheelchair, Insulin pump, hearing aid (DSP is HearConnect), breast pump, baby sleep monitor (on referral from a nominated network GP or a specialist for Alliance Network) |
|
Checkups and Vaccines: GP (nominated network GP referral applies for Alliance Network), Specialist, Dental, Optometry (PPN optometrist for Alliance Network), Dermatologist, ECG, Dietician |
|
Infertility R112 152 per family |
Sorry, the comment form is closed at this time.