Our Member Area is here to assist you.
Here we offer you the ability to download all the information you need on your Plan, including details of service providers, rates and co-payments and how to claim correctly.
We want to make sure you understand your plan so that you can receive the right medical care for yourself and your dependents.
As Sisonke Health Medical Scheme is a restricted scheme for employees and former employees of Sibanye Gold Ltd and Gold Fields Ltd, only the following are eligible for membership on the scheme:
Your spouse or common-law spouse
Your biological children, stepchildren or legally adopted children or children legally placed in your foster care
Immediate family who are financially dependent on you.
Here we offer you the ability to download all the information you need on your Plan, including details of service providers, rates and co-payments and how to claim correctly.
We want to make sure you understand your plan so that you can receive the right medical care for yourself and your dependents.
As Sisonke Health Medical Scheme is a restricted scheme for employees and former employees of Sibanye Gold Ltd and Gold Fields Ltd, only the following are eligible for membership on the scheme:
Your spouse or common-law spouse
Your biological children, stepchildren or legally adopted children or children legally placed in your foster care
Immediate family who are financially dependent on you.
The Pride Plan offers unlimited private hospital cover at a nationwide network of hospitals.
Remember: in the case of a life-threatening emergency, the closest hospital will be paid in full and no co-payment will be payable
You and your dependents will have unlimited day-to-day primary care benefits through the scheme’s network providers such as the Scheme’s multi-disciplinary Medical Centres and other contracted providers.
Various healthcare professionals, such as doctors, dentists and nurses are available at these medical centres for your convenience. The medical centre staff can also assist you with wellbeing, preventative care, authorisations and account queries. At these medical centres, no co-payments are payable and there is no limit to the number of times you may visit the medical centres for primary healthcare.
Members and dependants not living close to the existing Sisonke Health Medical Centres may also use the scheme’s contracted network of health care professionals.
No cover is available outside of the network on this option.
The Heritage Plan offers unlimited private hospital cover at a nationwide network of hospitals.
Remember: in the case of a life-threatening emergency, the closest hospital will be paid in full and no co-payment will be payable.
The Heritage plan also gives you the option to go to any hospital of your choice with a 20% co-payment, up to
a maximum of R6 000.
Members have the freedom of choice to use any provider.
If you wish to use a private doctor or dentist who is not part of the scheme’s network, your claims will be covered at 80% of the medical aid rate, subject to the benefit limit allocation.
Comprehensive unlimited GP and dental consultations are also available through the scheme’s network providers such as the Scheme’s multi-disciplinary Medical Centres and other contracted providers.
The Pride Plan offers unlimited private hospital cover at a nationwide network of hospitals.
Remember: in the case of a life-threatening emergency, the closest hospital will be paid in full and no co-payment will be payable. You and your dependents will have unlimited day-to-day primary care benefits through the scheme’s multi-disciplinary network providers such as the Scheme’s Multidisciplinary Medical Centres and other contracted providers.
Remember: in the case of a life-threatening emergency, the closest hospital will be paid in full and no co-payment will be payable. You and your dependents will have unlimited day-to-day primary care benefits through the scheme’s multi-disciplinary network providers such as the Scheme’s Multidisciplinary Medical Centres and other contracted providers.
Unsure about how to claim?
Click the link below for all the necessary information you need to process your claim quickly and effectively.
WANT TO SWITCH TO A DIFFERENT PLAN?
You are able to switch plans in the months of OCTOBER and NOVEMBER only.
At all other times, please refer to the scheme rules.
You are able to switch plans in the months of OCTOBER and NOVEMBER only.
At all other times, please refer to the scheme rules.