Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Comprehensive
(High Cover)
BESTMED
Pace 3
BONITAS
Bon
Comprehensive
DISCOVERY
Classic Comprehensive
FEDHEALTH
Maxima Exec
MEDIHELP
MedPlus
MOMENTUM
Extender
(Any Hospital,
Any Chronic)
PROFMED
ProPinnacle
Unlimited. Subject to pre-authorisation. Protocols apply
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R624,000 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Comprehensive
(High Cover)
BESTMED
Pace 2
BONITAS
BonClassic
DISCOVERY
-
FEDHEALTH
-
MEDIHELP
MedElite
MOMENTUM
Extender
(Associated Hospital,
Any Chronic)
PROFMED
-
Unlimited. Subject to pre-authorisation. Protocols apply
Unlimited at a DSP or 20% co-payment applies at a non-DSP
–
–
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
–
Comprehensive
(Medium to High Cover)
BESTMED
Pace 1
BONITAS
BonComplete
DISCOVERY
Classic Priority
FEDHEALTH
-
MEDIHELP
MedPrime
MOMENTUM
Incentive
(Any Hospital,
Any Chronic + Health Saver)
PROFMED
ProSecure Plus
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
–
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management
Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Comprehensive
(Medium to High Cover)
BESTMED
-
BONITAS
Standard
DISCOVERY
Classic Priority
FEDHEALTH
FlexiFed 4
(Any Hospital)
MEDIHELP
MedPrime
MOMENTUM
Incentive
(Associated Hospital,
Associated Chronic)
PROFMED
ProSecure
–
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R499,100 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Comprehensive
(Medium to High Cover)
BESTMED
-
BONITAS
Standard Select
(Network)
DISCOVERY
Essential Priority
FEDHEALTH
FlexiFed 4
(GRID)
MEDIHELP
MedPrime Elect
(Network)
MOMENTUM
Incentive
(Associated Hospital,
Associated Chronic)
PROFMED
ProSecure Savvy
(Network)
–
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R499,100 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Hospital & Savings
(Low to Medium Cover)
BESTMED
Beat 3
(Network)
BONITAS
BonSave
DISCOVERY
Classic Delta Saver
(Network)
FEDHEALTH
FlexiFed 3
(GRID)
MEDIHELP
MedSaver
MOMENTUM
Incentive
(Any Hospital,
Associated Chronic)
PROFMED
-
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R311,900 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
–
Hospital & Savings
(Low to Medium Cover)
BESTMED
Beat 2
BONITAS
Primary
DISCOVERY
Essential Saver
FEDHEALTH
FlexiFed 2
(Any Hospital)
MEDIHELP
MedElect
(Network)
MOMENTUM
Incentive
(Associated Hospital,
Associated Chronic)
PROFMED
ProActive Plus
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R311,900 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Hospital & Savings
(Low to Medium Cover)
BESTMED
Beat 2
(Network)
BONITAS
Primary Select
(Network)
DISCOVERY
Essential Delta Saver
(Network)
FEDHEALTH
FlexiFed 2
(GRID)
MEDIHELP
MedAdd Elect
(Network)
MOMENTUM
Incentive
(Associated Hospital,
Associated Chronic)
PROFMED
ProActive Plus Savvy
(Network)
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R311,900 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Hospital & Savings
(Low to Medium Cover)
BESTMED
-
BONITAS
BonFit Select
DISCOVERY
Essential Delta Saver
FEDHEALTH
FlexiFed 2
(GRID)
MEDIHELP
MedAdd Elect
(Network)
MOMENTUM
Incentive
(Associated Hospital,
Associated Chronic)
PROFMED
ProActive Plus Savvy
(Network)
–
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R311,900 at 100% of Fedhealth Rate at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management
Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Capitation
(Low Cover)
BESTMED
-
BONITAS
BonStart Plus
(Network)
DISCOVERY
Classic Smart
(Network)
FEDHEALTH
-
MEDIHELP
-
MOMENTUM
Evolve
(Network)
PROFMED
-
–
Unlimited at a DSP or 30% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider or state facility.
–
–
Limited to Prescribed Minimum Benefits at State facilities
–
Capitation
(Low Cover)
BESTMED
-
BONITAS
BonStart
(Network)
DISCOVERY
Essential Smart
(Network)
FEDHEALTH
-
MEDIHELP
MedMove
(Network)
MOMENTUM
Evolve
(Network)
PROFMED
-
–
Unlimited at a DSP or 30% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider or state facility.
–
Subject to Prescribed Minimum Benefits.
Listed essential cases – clinical guidelines and pre-authorisation apply
Limited to Prescribed Minimum Benefits at State facilities
–
Hospital Plan
(Hospitalization Cover)
BESTMED
-
BONITAS
Hospital Standard
DISCOVERY
Classic Core
FEDHEALTH
-
MEDIHELP
-
MOMENTUM
-
PROFMED
-
–
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider, otherwise co-payments will apply
–
–
–
–
Hospital Plan
(Hospitalization Cover)
BESTMED
Beat 1
BONITAS
BonEssential
DISCOVERY
Essential Core
FEDHEALTH
FlexiFed 1
(Network)
No Medivault
MEDIHELP
MediVital
MOMENTUM
Custom
(Any Hospital,
Associated Chronic)
PROFMED
-
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider, otherwise co-payments will apply
Unlimited at cost at PMB level of care at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management
Programme
–
Hospital Plan
(Hospitalization Cover)
BESTMED
Beat 1
(Network)
BONITAS
BonEssential Select
(Network)
DISCOVERY
Essential Delta Core
(Network)
FEDHEALTH
FlexiFed 1 Elect
(Network)
No Medivault
MEDIHELP
MediVital Elect
(Network)
MOMENTUM
Custom
(Associated Hospital,
Associated Chronic)
PROFMED
ProSelect Savvy
(Network)
PMBs only. Subject to DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider, otherwise co-payments will apply
Unlimited at cost at PMB level of care at DSP. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Unlimited, subject to Management
Programme
Unlimited, subject to Disease Management Programme and pre-authorisation
Primary Care
(Network & Income Based)
BESTMED
Rhythm 1
(Network)
BONITAS
BonCap
(Network)
DISCOVERY
KeyCare Plus
(Network)
FEDHEALTH
FlexiFed Savvy
(Network)
MEDIHELP
MedElect Student
(Network)
MOMENTUM
Ingwe
(Network)
PROFMED
-
Approved PMBs and DSPs
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Subject to registration, approval of treatment plan and use of network provider or state facility.
Unlimited at cost at PMB level of care at DSP
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to preauthorisation and clinical protocols)
Limited to Prescribed Minimum Benefits at State facilities
–