Introduction
A decision isn’t a decision without a range of options to choose from; a selection of alternatives to think about and then use to empower yourself. At Liberty Medical Scheme (now incorporating Medicover), we believe in giving you access to the easy–to–follow info you need to make the right choices. We believe in helping you feel free. Because true freedom only comes from informed decision–making.
Use the handy coloured tabs above, to read up on each product option. Or, compare benefits below.Compare Benefits
Find out which of our product options is best for you and what your monthly contributions would be.
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Service Provider List 2010
Document Library
Use our Document Library to easily access important medical aid-related documents, forms or guides.
Corporate Network
The entry-level solutionEmployer? HR or healthcare manager for a group or corporate entity? The Corporate Network plan is Liberty Medical Scheme’s
complete and affordable salary-based offering. Offering four salary bands for contributions, Corporate Network is the preferred option for employers who want value for money cover for lower–income earners, like those who work in factories or mines, for example.
There have been significant changes from 2009 to 2010 on the Corporate Network Option. The Scheme has implemented the following new initiatives:
- Specialist referral program
- Designated Service Provider (DSP) network of hospitals
Summary of Important Information
Specialist Referral program
Members must contact the Liberty Medical Scheme Contact Centre on 0860 002 163 to obtain authorisation before any specialist visit takes place. In case of emergency, the member can be seen by any specialist provided you inform your Scheme as soon as possible of the emergency.
Designated Service Provider (DSP) network of hospitals
Hospitalisation is delivered via a dedicated hospital network. Members must contact the
Liberty Medical Scheme Contact Centre on 0860 002 163 to obtain authorisation for hospitalisation. The normal authorisation process and rules apply. The DSP Hospital Network consists of the following hospital groups:
Click here for a Map to locate your nearest DSP hospital or click on the web links above for further information on the hospitals.
In the case of an emergency, you are free to be admitted to any hospital, provided you follow the standard pre-authorisation procedure. You are also allowed to go outside of the DSP hospital network if a DSP hospital is not within reasonable distance. Should you be voluntarily admitted to a non-DSP hospital, a 100% co-payment is applicable.
Prime Cure, an accredited managed care organisation, provides specific primary care benefits from an open
national network of private providers. The following primary care benefits are covered by Prime Cure: GP visits, dentistry, optometry, basic radiology and basic pathology. Acute and chronic medication is also covered as part of primary care, provided that the medication is prescribed by a Prime Cure doctor.
Members must contact Prime Cure ONLY for primary care benefits. Prime Cure is available on
0861 665 665. For members on the Corporate Network Option who require HIV related services, kindly contact Prime Cure to register.
Prime Cure Reimbursement Form
When requesting reimbursement, kindly submit the following:
- Full detailed account
- Proof of payment
- Copy of ID
- Completed Prime Cure reimbursement form
Flu Vaccination Policy for 2010
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
“The Designated Service Provider for primary care services and the management of HIV registered members on the Corporate Network option is Prime Cure. They are available on
www.primecure.co.za” should you wish to get in touch with them or locate a provider in your area.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Bona Plus
A low-cost family optionWant your family to be covered for
all hospital stays? Our Bona Plus plan is a low-cost option for families who need comprehensive cover at an affordable price and who are able to access the designated primary care service provider network,
CareCross. You´ll be pleased with the unlimited general practitioner consultation benefit, as well as the comprehensive in-hospital benefit offering.
Bona Plus covers hospitalisation, dentistry, psychiatric treatment and radiology, as well as the
25 Chronic Conditions. It also has unlimited cover for certain out-of-hospital expenses, which are available from
CareCross–contracted providers.
Bona Plus provides cover at 100% of the Scheme Tariff. This means that if a medical service provider charges above this rate, the member is responsible for covering the difference in tariff.CareCross Reimbursement Form
When requesting reimbursement for fully paid for services obtained from out-of-area providers, kindly submit the completed CareCross reimbursement form and submit it directly to CareCross.
Click hereFlu Vaccination Policy for 2010
The CareCross GP would usually offer the flu vac to specific patients particularly those members falling into the following categories:
- Age 55 years or older
- Have chronic lung or heart disease
- Live in a nursing home or extended care facilities
- Have kidney disease, anemia, severe asthma, diabetes, or chronic liver disease
- Have a weakened immune system (including those with cancer or HIV/AIDS)
- Receive long–term treatment with steroids for any condition
- Expect to be past the 3rd month of pregnancy during the flu season
We have however recently become aware of nationwide stock shortages of flu vacs. We have accessed all our resources and contacts in an attempt to secure stock for our GPs but to no avail as everybody including most pharmacies are sitting with the same dilemma.
The shortage is apparently as a result of the government purchasing all stock in preparation for the Soccer World Cup, and as a result, we may be faced with a challenge in providing this benefit to members in 2010.
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
“CareCross is the Designated Service Provider for primary care services on the Bona Plus option. They are available on
www.carecross.co.za” should you wish to locate a service provider.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Silver Focus
Exactly what you needIf you´re
young, independent and in good health, Liberty Medical Scheme´s Silver Focus is your plan. It´s about peace of mind – giving you cover for medical treatments in hospital (including emergencies on the road) and for the management of
chronic conditions. There is also a range of
preventative measures packed in, to identify potential health risk factors early on.
In addition to the health programmes, certain tests and immunisations that are included, you´re able to access Netcare 911 medical rescue throughout South Africa, rehabilitation and counselling following a crime trauma, testing for and treatment of
HIV/Aids, cover for scans and oncology benefits in the private sector. And because this plan only gives you what you need, neither day-to-day benefits nor a savings function are included. Visits to the GP or dentist and cold and flu medicines, etc, are self–funded.
Third Party Provider links
“Pharmacy Direct, who are the designated service provider for Silver Focus are available on
www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you. They are also the preferred chronic medicine provider for all LMS options.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or
call 0861 444 405.
Liberty Health‚s Oncology Programme, together with ICON‚s extensive oncology benefits, has been specifically designed to assist and care for LMS members on this plan who are diagnosed with cancer. Please contact our Oncology Management Team on
0860 002 163 or
email them.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Gold Focus
Starting out as a familyAre you a young couple? Maybe about to start a family, or with a baby on the way? It´s important to make sure you´re able to get (and give your family) the best healthcare you can afford. The Gold Focus plan from Liberty Medical Scheme offers unlimited cover in the event of an accident, generous cover for in-hospital medical treatments, and enormous help with managing
chronic conditions. And because you should only pay for what you need, there are no day-to-day benefits or savings.
What´s more, there are certain free childhood immunisations, a
casualty benefit and
preventative measures – as well as rehabilitation and counselling following a crime trauma, cover for extreme or professional sports, generous cover for diagnostic scans like MRI / CAT scans, an
oncology benefit that covers supportive treatment for 12 months after active treatment, and testing for and treatment of
HIV/Aids. And these are just some of the ways in which LMS cares about your physical and emotional wellbeing.
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on
www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Gold Plus
Everything a family needsAre you a family with kids?
You have unique requirements, and LMS understands them. There´s none of that one-size-must-fit-all stuff happening here. At Liberty Medical Scheme, we know how hard it is to manage family, home and work, while keeping all of the balls in the air. And that´s why we offer families the Gold Plus plan, with its comprehensive range of child-specific benefits and savings function.
In addition to the four chronic benefits for kids, Gold Plus means generous cover for medical treatments in hospital and for the management of
chronic illnesses, as well as a range of
preventative measures to maintain good family health. Then there´s cover for accidental trauma, common childhood procedures, day–to–day medical expenses, special maternity requirements,
Liberty Baby and even seasonal flu vaccinations. However, visits to the GP/dentist, cold and flu medicines, blood tests and contact lenses are self–funded.
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
Maternity benefits on this plan are provided by DLA. Further information is available at
www.dlagroup.co.zaNetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Titan
Perfect cover for the familyDo you have a young family? Are you looking for freedom of choice in terms of out-of-hospital and in-hospital benefits, as well as the safety and security of threshold cover? The comprehensive Titan plan is ideal, as it covers emergencies, maternity care, hospitalisation, dentistry, radiology and psychiatric treatment – as well as the
27 Chronic Conditions. Titan also has a savings function, covering out-of-hospital expenses through a generous Medical Savings Facility, available for immediate use.
Titan provides cover at 100% of the Scheme Tariff. This means that if a medical service provider charges above this rate, the member is responsible for covering the difference in tariff.Third Party Provider links
“To locate a provider closest to you and contact details for any queries, click on the following link
http://preferredprovider.co.za”
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on
www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
Maternity benefits on this plan are provided by DLA. Further information is available at
www.dlagroup.co.zaDental Risk Company is the LMS Dental Benefit Service Provider on the Titan and Platinum Complete options. Please visit
www.dentalrisk.com to access more information about their services.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Platinum Focus
Enhancing your life choicesPlatinum Focus from Liberty Medical Scheme is the healthcare plan you need to
enhance your choices in later life, because it covers you for unforeseen medical emergencies and treatment in the best hospitals by the best specialists. There is generous cover for managing
chronic conditions, as well as a range of proactive
preventative measures – but because this plan gives you what you need, without unnecessary extras to pay for, neither day-to-day benefits nor a savings function are included.
There is also cover for chronic medication for certain non-PMB conditions, cover for rehabilitation and counselling after a crime trauma, generous cover for diagnostic scans like MRI / CAT scans, an
oncology benefit that covers supportive treatment for 12 months after active treatment, and
HIV/Aids testing.
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Platinum Plus
Meeting all of your family´s needsAs a mature member of a grown-up family
you have unique healthcare needs, and LMS appreciates that. So if you´re looking for an excellent plan that will support you holistically, Platinum Plus, with its extensive cover and special benefits, is ideal. It covers you for medical emergencies, medical treatments in hospital,
chronic conditions, additional non-PMB conditions and even mental health treatment.
What´s more, there is a medical savings facility, cover for day-to-day procedures, rehabilitation and counselling after a crime trauma, generous cover for diagnostic scans like MRI / CAT scans, an
oncology benefit for supportive treatment for 12 months following active treatment,
Liberty Baby and
HIV/Aids testing. However, visits to the GP/dentist, cold and flu medicines, blood tests and contact lenses are self–funded.
Third Party Provider links
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
Maternity benefits on this plan are provided by DLA. Further information is available at
www.dlagroup.co.zaNetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide
Platinum Complete
The ultimate healthcare optionPlatinum Complete is the ultimate threshold and savings option, offering the best and most comprehensive hospital and day-to-day benefits money can buy. The long list of
chronic illnesses covered is not restricted to Prescribed Minimum Benefits and you´ll also be generously covered for a range of in- and out-of-hospital procedures. This, together with unlimited trauma cover and
healthcare measures to prevent – rather than treat – avoidable illnesses, means total, 100% peace of mind.
Beyond this, there is cover for rehabilitation and counselling following a crime trauma, generous cover for diagnostic scans like MRI / CAT scans, an
oncology benefit that covers supportive treatment for 12 months after active treatment, access to Liberty Baby and testing for and treatment of
HIV/Aids.
Third Party Provider links
“To locate a provider closest to you and contact details for any queries, click on the following link
http://preferredprovider.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“To get in touch with Optipharm, who manage all members registered on the HIV program, kindly click on the following link
www.optipharm.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“Pharmacy Direct, the preferred chronic medicine provider for all LMS options is available on
www.pharmacydirect.co.za” should you require their contact information or would like the chronic medicine process explained to you.
“As the preferred provider of all chronic medicines on all options, you can get your medication from any Clicks Direct Medicines nationally, regardless which Clicks Pharmacy has your prescription. Visit
www.clicks.co.za or call
0860 254 257. Should you wish to have your medication delivered directly to you or arrange for it to be ready for collection, kindly click on the following link
www.directmedicines.co.za” or call
0861 444 405.
Maternity benefits on this plan are provided by DLA. Further information is available at
www.dlagroup.co.zaDental Risk Company is the LMS Dental Benefit Service Provider on the Titan and Platinum Complete options. Please visit
www.dentalrisk.com to access more information about their services.
NetCare 911 is the Emergency Service Provider for all options.
Option summary
Click here to download a brief option summary
Member guide
Click here if you´d like to view the member guide