2010 Medshield Medical Aid Quote

Should you wish to get an idea of what a Medshield medical aid will cost, please complete the blocks below and send to me.
I will send you costs, based on your plan selection - no obligation at all.

GOTO MEDSHIELD MEDICAL AID for full details.

Your Details

Do you have to join your company medical aid scheme or can you choose a scheme?
Company scheme
Own

Your email address:
Your telephone/cell number:
Your name and surname:
Your Date of Birth:
Your partner's name and surname (if required):
Your partner's Date of Birth:
First child's name:
Child's Date of Birth:
Second child's name:
Child's Date of Birth:
Third child's name:
Child's Date of Birth:
Any OTHER (NOT ALREADY STATED ABOVE) dependants - adults or children you want to add?

Type of plan. Please select from the following; Refer to Medshield Medical Aid for details.

PLAN A MEDIVALUE- R 600,000l per family, per year in-hospital cover at private rates (provided the Top Up is taken)! Any hospital you want. No co-payments! Provides you with all the essential day-to-day benefits like GP consults and optical visits paid by the scheme! Good maternity benefits, like 12 GP/Midwife consultations, two 2D scans, Amniocentesis test! Confinement at private rates. Child dependants to age 30! 25 chronic conditions covered. Savings balance for other out of hospital costs. Flu vaccine, pap smear and bone density paid by the scheme. Average monthly single rate R 1,027 and family R 2,148 pm	Yes
PLAN B - MEDIPLUS - No overall annual limit, in-hospital cover at private rates (provided the Top Up is taken)! Any hospital you want. No co-payments! Provides you with all the essential day-to-day benefits like GP consults, basic dentistry and optical visits paid by the scheme! Good maternity benefits, like 12 GP/Midwife consultations, two 2D scans, Amniocentesis test! Confinement at private rates. Child dependants to age 30! 66 chronic conditions covered. Savings balance for other out of hospital costs. Flu vaccine, pap smear and bone density paid by the scheme. Refractive eye surgery benefit included! Average monthly single rate R 1,484 and family R 2,967 pm	Yes
MEDIBONUS - No overall annual limit, in-hospital cover at private rates! Any hospital you want. No co-payments! Provides you with all the essential day-to-day benefits like GP consults, basic dentistry and optical visits paid by the scheme! Good maternity benefits, like 12 GP/Midwife consultations, two 2D scans, Amniocentesis test! Confinement at private rates. Child dependants to age 30! 66 chronic conditions covered. Savings balance for other out of hospital costs. Flu vaccine, pap smear and bone density paid by the scheme. Refractive eye surgery benefit included! Average monthly single rate R 2,050 and family R 4,143 pm	Yes

Any other information we should know about?

Your current medical aid plan (if any): Please state the actual plan as well.

Would you like to receive my informative letter on personal financial matters? Yes

NEED A MEDSHIELD MEDICAL AID APPLICATION? Please go here

Please note:

• The submission of this request does not constitute any legal obligation, either on your or Peter J Pyburn's behalf.
  It is simply a request to get some medical aid options.
• All information provided will be strictly confidential at all times and will be freely transmitted to the email address provided.
  Peter J Pyburn will not be responsible should the information be incorrectly transmitted or not reach the correct recipient.
• Your email address will never be given to any other person or organisation.
  (I would never be in business if this happened!)
• YOU MUST CONSULT THE SCHEMES BROCHURES FOR COMPREHENSIVE BENEFIT DESCRIPTIONS AND CONSULT THE SCHEME DIRECTLY FOR ANY UNDERWRITING CONCERNS.
• AT ALL TIMES, THE SCHEME RULES WILL OVERRIDE ANYTHING PETER J PYBURN HAS SAID OR WRITTEN AND AS SUCH YOU AGREE WITH THE DISCLAIMER AS PRESENTED IN THE QUOTE/S YOU HAVE ACTED UPON.

I confirm that I have read and understood the notes above. Yes

pyburn@peterpyburn.co.za