Xelus Fusion 2014 DL Communication/Xelus... · 2014-09-27 · medical scheme with additional c over...
Transcript of Xelus Fusion 2014 DL Communication/Xelus... · 2014-09-27 · medical scheme with additional c over...
Welcome to Xelus – the smart choice for your health cover.
At Xelus we understand that when you buy health cover it is an important decision for you and your family and that you want to have the best medical care available at a�ordable prices.
The rising cost of healthcare means that it is essential to complement your medical scheme with additional cover in order to ensure access to the highest quality private healthcare.
Fusion is designed to provide comprehensive bene�ts for exactly such purposes, o�ering the best supplementary gap cover available on the market today.
Specialised Risk SOLUTIONS
Fusion 2014
Fusion provides you with total peace of mind.
Xelus recognises that not all expenses incurred from health events are direct costs and has thus included the Bene�t Extender in your cover at no extra cost.
Core Bene�ts Fusion
R 1 million500% of Scheme Tari�UnlimitedMax R30,000 per event/condition20% (max R250,000 pb)Scopes | Wisdoms | Oncology | Dialysis | Births
Overall Annual LimitTari� Shortfalls
Co-Payments & DeductiblesShortfalls from Sub-Limits
Oncology Co-PaymentsTari� Shortfalls
In-Hospital
Out-of-Hospital
Family Booster Birth 42 days or more before due date R 10,000 per event Hospital Booster
Daily lump sum from Day 7 to 13 R500 / day
Daily lump sum from Day 14 to 20 R1000 / day
Daily lump sum from Day 21 to 30 R1500 / day
1st Tier Hospital Booster Bene�ts are paid from day 1 for Trauma admissions & Family Booster claims
Family Protector Death or Permanent Disability (Illness Related) R10,000 pb
Death or Permanent Disability (Accidental) R20,000 pb
Dental Reconstruction Bene�t for Oncology Treatment or Trauma up to R30,000 per event/condition Medical Scheme Contribution Waiver
Death or Permanent Disability 6 Months (max R3,000 pm)
Bene�t Extender
Terms & Conditions
Specialised Risk SOLUTIONS
Fusion 2014
Tel: 011 327 2811 • Fax: 086 501 8521
Email: [email protected]
www.xelus.co.zaXelus is an authorised �nancial services provider (FSP No: 36931)
■ Maximum entry age is 65 (60 for groups < 20 members and individuals).■ Waiting periods may apply – see member schedule or marketing o�er.■ Cover only applies to the member, spouse & children (up to 26).■ A spouse dependant on the medical scheme can be the Xelus principal member.■ This brochure is a summary of the cover – please refer to your policy
document for all conditions of cover.
In order to ensure the long term sustainability of Fusion, certain exclusions apply. The salient points are detailed below:
No bene�t is payable for any service directly or indirectly attributable to or as a consequence of:■ Cosmetic surgery or treatment for obesity; ■ Any claim excluded by your medical scheme or paid as ex-gratia;■ A co-payment / deductible that is not a �xed amount (excl oncology);■ Any penalty, co-payment or limit applied by your medical scheme for
non-adherence to the bene�t rules or authorisation procedures;■ Specialised Dental Procedures such as implants, crowns, bridges,
orthognathic surgery, etc (Basic In-Hospital Dentistry such as surgical extractions or �llings for young children are covered);
■ Any provider fee charged as a separate item from the tari� charge;■ Claims that are older than four months.
A comprehensive description of the exclusions and terms and conditions are available in the policy documents. Please read this carefully to ensure you understand your cover details. If you have any queries please contact your healthcare consultant or feel free to contact us on any of the contacts listed below.
Exclusions
Underwritten by Centriq, a Santam Group Company