| SERVICES | LOYALTY | PRIMARY | MAIN | SUPER | EXECUTIVE |
| GLOBAL LIMIT | 152592 | 342144 | 660000 | 1151172 | 2435400 |
| Monthly Contribution | 1169 | 1774 | 3282 | 5301 | 10093 |
| General Practitioners ( up to 12 Consultations P/A) | Paid to AHFoZ Tariff | Paid to AHFoZ Tariff | Paid to AHFoZ Tariff | Paid to AHFoZ Tariff | Paid to AHFoZ Tariff |
| Specialists | 126720 | 205920 | 356400 | 728640 | 1520640 |
| Hospitalisation (P/A) | 44352 | 66528 | 88704 | 139392 | 285120 |
| Rehabilitation Hospitalisation Covered Under Hospitalisation | | | | | |
| Prescription Drugs (P/A) | 69696 | 69696 | 139392 | 158400 | 316800 |
| Chemotherapy (P/A) | To AHFoZ Max 9 Sessions | To AHFoZ Max 18 Sessions | To AHFoZ Max 18 Sessions | To AHFoZ Max 18 Sessions | To AHFoZ Max 18 Sessions |
| Haemodialysis (P/A) | To AHFoZ Max 9 Sessions | To AHFoZ Max 12 Sessions | To AHFoZ Max 15 Sessions | To AHFoZ Max 18 Sessions | To AHFoZ Max 24 Sessions |
| Dentistry (P/A) | 19008 | 31680 | 63360 | 95040 | 126720 |
| Orthodontic Treatment Per Life Time | Nil | Nil | 76032 | 117216 | 158400 |
| Refraction Test | Paid to AHFoZ Tariff Max 2 | Paid to AHFoZ Tariff Max 2 | Paid to AHFoZ Tariff Max 2 | Paid to AHFoZ Tariff Max 2 | Paid to AHFoZ Tariff Max 2 |
| Spectacles (Per 2 Years) | 19008 | 25344 | 50688 | 82368 | 158400 |
| Family Planning (P/A) | Nil | Paid to Tariff | Paid to Tariff | Paid to Tariff | Paid to Tariff |
| Infertility ( Once in Lifetime) | Nil | | | | |
| Maternity(Max4) on Member Subj to waiting period | Nil | 38016 | 46080 | 95040 | 190080 |
| Hearing Aids ( Per 4 Years) | 13939 | 38016 | 63360 | 95040 | 190080 |
| Appliance Repairs (Per 2 Years) | 33.3% Of Award | 33.3% Of Award | 33.3% Of Award | 33.3% Of Award | 33.3% Of Award |
| Glucometer (Per 5 Years) | 6336 | 6336 | 9504 | 12672 | 15840 |
| Ostomy Appliances | 8 Flunges & 4 Bags per month | 8 Flunges & 4 Bags/Month | 8 Flunges & 4 Bags/Month | 8 Flunges & 4 Bags/Month | 8 Flunges & 4 Bags/Month |
| Pathology | 38016 | 47520 | 79200 | 158400 | 316800 |
| Radiology | 38016 | 47520 | 79200 | 158400 | 316800 |
| Blood Transfusion | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation |
| Home Based Care (Per Day) | 70% of AHFoZ tariff Pre-Authorisation | 70% of AHFoZ tariff Pre-Authorisation | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation | Paid to AHFoZ Tariff Pre-authorisation |
| Psychiatric Services | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ |
| Rehabilitation Services excl. IOD & Domestic Violence | AHFoz Max 8 sessions Pre authorise external | AHFoz Max 16 sessions Pre authorise external | AHFoz Max 24 sessions Pre authorise external | AHFoz Max 32 sessions Pre authorise external | AHFoz Max 40 sessions Pre authorise external |
| Tonometry | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ |
| Chiropody | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ | Paid To AHFoZ |
| Nebulizing Kit | Paid in Full And Made Personal (Max 1 P/A) | Paid in Full And Made Personal (Max 2 P/A) | Paid in Full And Made Personal (Max 2 P/A) | Paid in Full And Made Personal (Max 2 P/A) | Paid in Full And Made Personal (Max 2 P/A) |
| Parenteral Nutrition P/A Covered under hospitalisation | | | | | |
| Lega Clip P/A | | | | | |
| Surgical Prosthesis (Per 2 Years) | 126720 | 190080 | 316800 | 633600 | 950400 |
| Private Ambulances | Paid to Gvt/Municipal tariff | Paid to Gvt/Municipal tariff | Paid to Gvt/Municipal tariff | Paid to Gvt/Municipal tariff | Paid to Gvt/Municipal tariff |
| Govt/Municipal Ambulances | Paid in Full | Paid in Full | Paid in Full | Paid in Full | Paid in Full |
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