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