2026 Rules Active
2026 Strategy Validated
Fund Your Elective Joint Replacement
Senior Funding Elective Joint Replacement strategy verified
Covering 0 family members
2026 rates applied
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Actuarial Strategy Reference
This strategy is generated based on the 2026 Council for Medical Schemes (CMS) registered rules and actuarial pricing matrices.
VERIFIED: 2025-12-20 | SOURCE: SCHEME_BENEFIT_GUIDE_2026
Similar Situations
Key Terms Explained
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R14,724 included in your premium. You use this for day-to-day expenses like GP visits and scripts. [Source: Council for Medical Schemes Official Benefit Rules]
Common Questions
Do I have to pay upfront for an MRI scan? [Senior Funding Elective Joint Replacement]
Yes, there is a co-payment of R1,500 per scan, unless it is a confirmed PMB condition. Strategy reference: der-2026.
Is there a limit on how much the scheme pays for hip replacements? [Senior Funding Elective Joint Replacement]
Yes, while the overall family prosthesis limit is R146,642, hip replacements specifically are sub-limited to R66,033. Strategy reference: der-2026.
Will I be charged if I have a day procedure like a gastroscopy in a normal hospital? [Senior Funding Elective Joint Replacement]
Yes, a co-payment of R2,872 applies if a day procedure is performed in an acute hospital instead of a day hospital. Strategy reference: der-2026.
Is my depression medication covered? [Senior Funding Elective Joint Replacement]
Yes, Major Depression is covered under the Non-CDL benefit (20 conditions), subject to an annual limit of R11,488 for a main member. Strategy reference: der-2026.
Does the plan cover travel vaccines? [Senior Funding Elective Joint Replacement]
Yes, mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis, and cholera are covered from Scheme risk. Strategy reference: der-2026.
How much is allocated to my Medical Savings Account? [Senior Funding Elective Joint Replacement]
For a main member, R14,724 is allocated annually to the savings account for day-to-day expenses. Strategy reference: der-2026.
Are contraceptives covered under the preventative benefit? [Senior Funding Elective Joint Replacement]
Yes, oral, injectable, or implantable contraceptives are covered up to R2,801 per beneficiary per annum. Strategy reference: der-2026.
Is there a limit on internal prosthetics like pacemakers? [Senior Funding Elective Joint Replacement]
Yes, pacemakers are limited to R79,255, subject to the overall prosthesis limit of R146,642. Strategy reference: der-2026.