Wellness Benefits
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Immunisation programmes
Baby immunisation programme
Covered for the first six years of a child's life
As required by the Department of Health
100%
of Scheme rate
Flu vaccinations
Once a year - all beneficiaries
ICD-10 code Z25.1100%
of Scheme rate
Tetanus diphtheria booster
As needed - all beneficiaries
ICD-10 code Z23.8100%
of Scheme rate
Pneumococcal vaccinations
As needed - beneficiaries 60 years and older and high-risk beneficiaries
ICD-10 code Z23.8100%
of Scheme rate
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Early detection programmes
General physical examination (in GP's rooms)
Tariff codes 190 - 192
Tariff code 4188 - urine dipstick test Adults 21 to 29 years old - one medical examination every five years
Adults 30 to 59 years old - one medical examination every three years
Adults 60 to 69 years old - one medical examination every two years
Adults 70 years and older - one medical examination every year
ICD-10 code Z0.00100%
of Scheme rate
Cholesterol test (Pathologist)
Tariff codes 4025, 4026 and 4147
Once a year - all beneficiaries
ICD-10 code Z13.6100%
of Scheme rate
Pap smear consultation (GP/Gynaecologist)
Tariff codes 190 - 192
Once a year - females 15 years and older
ICD-10 code Z01.4100%
of Scheme rate
Pap smear
Tariff code 4566
Covered by the Administrator
ICD-10 code Z01.4100%
of Scheme rate
DEXA bone density scan (Radiologist)
Tariff code 50120
Once every three years - beneficiaries 50 years and older
ICD-10 code Z01.6
ORDEXA bone density scan (GP/Gynaecologist)
Tariff code 3604
Once every three years - beneficiaries 50 years and older
ICD-10 code Z01.6
100%
of Scheme rate
Immunological faecal occult blood test (Pathologist)
Tariff code 4352
Once a year - beneficiaries 40 years and older
100%
of Scheme rate
Colorectal screening test (Pathologist)
Tariff code 4352
Once a year - beneficiaries 40 years and older
100%
of Scheme rate
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Additional tests covered at no cost to you
Cholesterol screening (Pathologist)
Tariff code 4027
Once every two years - adult beneficiaries
100%
of Scheme rate
Mammogram (Radiologist)
Tariff codes 34100 and 34101
Once every two years - females 40 years and older
Once a year - females with risk factors where clinically indicated family history exists
100%
of Scheme rate
Mammogram (GP/Gynaecologist)
Tariff code 3605
Once every two years - females 40 years and older
Once a year - females with risk factors
100%
of Scheme rate
Glaucoma screening
Tariff code 3014
One screening every two years - adults 40 years and older
100%
of Scheme rate
Prostate screening
Tariff code 4519
One screening every year - males 50 years and older
100%
of Scheme rate
HIV test (Pathologist)
Tariff code 3932
Once a year - beneficiaries 15 years and older
100%
of Scheme rate