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Our Plans

Ivory

Ivory Plan
Private hospitals, government, municipal and mission facilities

Contributions Schedule

Age Band

Principal Member/Member

Spouse

18 - 25

45

45

26 – 39

53

53

40 – 50

63

63

51 – 60

69

69

61 an over

77

77

+60 first time joiner

99

99

Child

37

Routine Benefit Account

*Entitlement determined by MSA contribution level

MSA Low

MSA Medium

MSA High

MSA Super High

 

 

Allocation per principal member

$208

$250

$300

$360

MEDICAL SAVINGS ACCOUNT CONTIBUTIONS

Level

Member with no dependant

Member with 1 dependant

Member with 2 dependants

Member with 3 dependant

Member with 4 or more dependants

Low

8

17

25

34

42

Medium

13

25

38

50

64

High

17

34

50

67

84

Super High

22

42

64

84

106

Benefits Schedule

Plan Name

IVORY PLAN

Insured Benefit

Annual limit

$35 000

Facility Admission

Private, government, mission, municipal

Ward Admission

Semi-private wards

GP Consultations

Paid at agreed tariff, limited to MSA/RBA

Chronic Medication

Members must register

on the Chronic Care Network

US$400

Generic policy applies.

 

Acute Medicine Excluding over the counter medication

Paid at agreed tariff, limited to MSA/RBA

Dental (annual limit)

Member liable for

dental co-payment

Paid per AHFoZ tariff.

US$2,300

Orthodontic

Max age limit is 18 years

US$1 800

Optical (2 yearly limit)

US$600

Pathology

Paid per AHFoZ tariffs. $550

Radiology

(Pre-notification

required for MRI

scans, CT scans &

Bone densitometry

Scans)

 

Paid per AHFoZ tariffs $500

Prosthesis

i. Internal

ii. External

 

US$5,500

US$450

Oncology

US$12 000

Rehabilitation

Notification required.

US$1 080 per annum

Special Appliances

i) Hearing Aid (lifetime

award)

ii) Glucometer,

Nebuliser, etc.

iii) Ostomy bags.

(Motivation letter from

doctor required)

 

US$620

 

US$200 per 4 years.

 

Paid in full

Funeral Grant

US$550

Medical Emergency

Travel Insurance

US$500 000

Biller Code: 35376                           

one money logoBiller Code: 22411                           Biller Code: 100126 

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