The Preventative Care benefit has been extended to include various diagnostics and will be available to members on the Gold, Platinum, Titanium, Silver, and Bronze benefit options. This benefit is subject to the members’ overall annual limit (OAL) and will not affect their available day-to-day benefits and limits. The vaccinations listed under the Preventative Care benefit also do not affect the day-to-day benefits and limits.

Please note: Members on the Hospital, Blue Diamond, and Litunga benefit options do not qualify for the preventative care benefits as listed.

The Preventative Care benefit on the aforementioned benefit options consists of the following:

Vaccinations

Members older than 50 years: 1 flu vaccination per beneficiary per year.

Children younger than 6 years of age, which include:

• Polio;
• Diphtheria;
• Pertussis;
• Tetanus;
• Haemophilus influenza type B;
• Measles;
• Mumps;
• Rubella;
• Varicella (chickenpox);
• Pneumococcal disease;
• Rotavirus;
• Hepatitis A and B;
• Meningococcal disease.

Preventative Care screening

Women’s health:

• Breast cancer screening with mammography for females older than 40 years: 1 screening every 3 years.
• Cervical cancer screening for females between 21 years of age up to 65 years: 1 pap smear every 2 years. Cervarix vaccination available.
• Mammograms: Breast cancer screening with mammography for females aged 50 to 74 years. 1 Screening every 2 years.
• Pap Smear: Cervical cancer screening for females between 21 to 65 years. 1 Pap smear every 3 years.

Sexual health:

• HIV screening for all lives: 1 every year.

Men’s health:

• PSA test for men aged 50 years and older: 1 test every 2 years.

Cardiac health:

• Cholesterol screening with full lipogram for all lives for members older than 20 years: 1 screening every 5 years.
• The fund will pay for 1 lipogram every 4 years for beneficiaries 20 years and older.

Geriatric health:

• Bone densitometry test for females aged 65 years and older: 1 scan per beneficiary per annum.
• For females aged from 65 years and males ages from 70 years. The Fund will pay for 1 osteoporosis screening per beneficiary every 2 years.

General health:

• Colonoscopy for all lives for members aged 50 years and older.
• For all beneficiaries ages from 50 to 75 years, limited to 1 faecal occult blood test every year.
• 1 flexible sigmoidoscopy screening every 5 years.
• 1 colonoscopy screening every 10 years