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- Are you currently on a medical aid?*
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- Do you earn less than R11 001 per month? (combined household income before any deductions)*
- Would you mind being limited to basic treatments and benefit restrictions, to reduce your premium?*
- Do you or your dependents require chronic medication?*
- Would you be interested in joining a loyalty program?*
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- Select choice of hospital cover required*
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- Enhance hospital benefits with GAP cover?*
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- Gender*
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- Should be Empty: