Annual Limits

                      FIRST MUTUAL HEALTH PLAN 

BENEFIT (S) Opal Sapphire Plus Sapphire Amber Ruby Coral Topaz Student  Health Private Student Health General  
Annual Limit per Person $203,500 $82,000 $47,000 $36,000 $21,000 $13,200 $7,900 $7,700 $4,400
Hospitalisation Limit $40,000 $20,000 $12,000 $9,000 $7,000 $3,000 $2,000 $1,500 $1,000
Prescribed Medication
Up to three beneficiaries $5,000 $3,500 $2,500 $1,500 $1,000 $600 $400 $400 $300
Above three beneficiaries $7,000 $4,000 $3,000 $2,250 $1,500 $1,000 $600
Dental Cover $4,000 $3,000 $2,000 $1,600 $1,200 $500 $300 $400 $150
Optical (10 months waiting period thereafter per every Two Years) $1,000 $800 $600 $450 $300 $250 $150 $150 $100
Psychiatric $3,000 $2,000 $1,200 $800 $400 $300 $250 $300 $250
Rehabilitative Services  (physiotherapy) $4,000 $3,000 $2,000 $1,400 $800 $500 $350 $300 $250
Prosthetics Appliances Treatment (Internal 18 months, External 6 months  waiting period) $4,300 $3,300 $2,300 $1,800 $1,100 $500 $300 $500 $300
Pathology $1,600 $1,200 $1,000 $800 $700 $400
Specialised radiology(MRI & CT Scans) $2,500 $2,500 $2,000 $2,000 $2,000 $800 $400 $200 $150
Hearing Aids $1,500 $1,200 $900 $720 $500 $500 $270 $100 $100
General Practitioners
Initial Consultation Visits 12 11 10 9 8 7 6 5 4
Subsequent Consultation Visits 10 9 8 7 6 5 4 2 3
Refraction Fees (Association Tariff) In full In full In full In full In full In full In full In full In full
Homes providing Nursing Services 21/day 14/day 10/day 7/day 3/day 3/day none none none
Ancillary Services** (according to Tariff) In full In full In full In Full In Full In Full In Full In full In Full
Private Ambulance Services (According to Tariff) In Full In Full In Full In Full In Full In Full In Full In full In Full
Homes for the Disabled 15/day 10/day 7/day 5/day 3/day 3/day none 3 days none
Adult Contributions $280 $145 $90 $76 $62 $28 $10 $13 $4
Child Contributions $170 $90 $57 $39 $31 $14 $5