Dialysis
HIGH COVER LEVEL 1
BONITAS
2021
BonComprehensive
BESTMED
2021
Pace 3
DISCOVERY
2021
Classic Comprehensive
FEDHEALTH
2021
MaximaExec
MEDIHELP
2021
Plus
MOMENTUM
2021
Extender –
Any Hospital,
Any Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to pre-authorisation. Protocols apply
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R600,600 per family at DSP
Unlimited. Subject to pre-authorisation and clinical protocols
Unlimited, subject to Management Programme
HIGH COVER LEVEL 2
BONITAS
2021
BonClassic
BESTMED
2021
Page
DISCOVERY
2021
Essential Comprehensive
FEDHEALTH
MEDIHELP
2021
Elite
MOMENTUM
2021
Extender: Any (Chronic: Any)
Unlimited at a DSP or 20% co-payment applies at a non-DSP
Unlimited. Subject to pre-authorisation. Protocols apply
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Unlimited. Subject to pre-authorisation and clinical protocols
Unlimited, subject to Management Programme
MEDIUM-HIGH LEVEL 1 COVER
BONITAS
2021
BonComplete
BESTMED
2021
Pace 1
DISCOVERY
2021
Classic Priority
FEDHEALTH
MEDIHELP
MOMENTUM
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
MEDIUM-HIGH LEVEL 2 COVER
BONITAS
2021
Standard
BESTMED
2021
Pace 1
DISCOVERY
2021
Classic Priority
FEDHEALTH
2021
FlexiFed 4 Any Hospital
MEDIHELP
2021
Prime 3
MOMENTUM
2021
Incentive:
Any Hospital, Any Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R480,400 at 100% of Fedhealth Rate
Unlimited. Subject to pre-authorisation and clinical protocols
Unlimited, subject to Management Programme
MEDIUM-HIGH LEVEL 3 COVER
BONITAS
2021
Standard Select
BESTMED
2021
Pace 1
DISCOVERY
2021
Essential Delta Comprehensive
FEDHEALTH
2021
FlexiFed 4 GRID
MEDIHELP
2021
Prime 3 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R480,400 at 100% of Fedhealth Rate
Unlimited. Subject to pre-authorisation and clinical protocols
Unlimited, subject to Management Programme
MEDIUM-LOW COVER 1
BONITAS
2021
BonSave
BESTMED
2021
Beat 3
DISCOVERY
2021
Classic Saver, Coastal Saver & Classic Delta Saver
FEDHEALTH
2021
Unify
MEDIHELP
2021
Prime 3 (Network)
MOMENTUM
2021
Incentive – Any Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R300,200 at 100% of Fedhealth Rate
Unlimited. Subject to pre-authorisation and clinical protocols
Unlimited, subject to Management Programme
MEDIUM-LOW COVER 2
BONITAS
2021
Primary
BESTMED
2021
Beat 2
DISCOVERY
2021
Essential Saver
FEDHEALTH
2021
FlexiFed 2 Any Hospital
MEDIHELP
2021
Prime 2
MOMENTUM
2021
Incentive – Any Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Unlimited at cost at PMB level of care (e.g aorta stent-grafts, intraocular lenses etc.) Refer to member guide for full details
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to pre- authorisation and clinical protocols)
Unlimited, subject to Management Programme
MEDIUM-LOW COVER 3
BONITAS
2021
Primary Select
BESTMED
2021
Beat 2 Network
DISCOVERY
2021
Essential Delta Saver
FEDHEALTH
2021
FlexiFed 2 GRID
MEDIHELP
2021
Prime 2 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R300,200 at 100% of Fedhealth Rate
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to pre- authorisation and clinical protocols)
Unlimited, subject to Management Programme
MEDIUM-LOW COVER 4
BONITAS
2021
BonFit Select
BESTMED
2021
Beat 3 Network
DISCOVERY
2021
Essential Delta Saver
FEDHEALTH
2021
FlexiFed 3 GRID
MEDIHELP
2021
Prime 2 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Unlimited. Subject to approval of treatment plan and use of network provider, otherwise co-payment will apply
Limited to R300,200 at 100% of Fedhealth Rate
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to pre- authorisation and clinical protocols)
Unlimited, subject to Management Programme
HOSPITAL COVER 1
BONITAS
2021
Hospital Standard
BESTMED
2021
Beat 1
DISCOVERY
2021
Essential Core
FEDHEALTH
MEDIHELP
MOMENTUM
2021
Custom – Any Hospital, Associated Chronic
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Subject to registration, approval of treatment plan and use of network provider, otherwise co-payments will apply
Unlimited, subject to Management Programme
HOSPITAL COVER 2
BONITAS
2021
Bon-Essential
BESTMED
2021
Beat 1
DISCOVERY
2021
Essential Core
FEDHEALTH
MEDIHELP
Custom – Any Hospital, Associated Chronic
MOMENTUM
2021
Prime
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
Subject to registration, approval of treatment plan and use of network provider, otherwise co-payments will apply
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to pre- authorisation and clinical protocols)
Unlimited, subject to Management Programme
HOSPITAL COVER 3
BONITAS
2021
Bon-Essential Select
BESTMED
2021
Beat 1 Network
DISCOVERY
2021
Essential Delta Core & Coastal Core
FEDHEALTH
FlexiFed 1 Network Hospitals
MEDIHELP
Custom – Associated Hospital, Associated Chronic
MOMENTUM
2021
Prime 1 Network
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
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
Unlimited. Acute (subject to hospital authorisation) and Chronic (subject to pre- authorisation and clinical protocols)
Unlimited, subject to Management Programme
Primary Care Network
BONITAS
2021
BonCap
BESTMED
2021
Pulse 1
DISCOVERY
2021
KeyCare Plus
FEDHEALTH
MyFed
MEDIHELP
Ingwe Network
MOMENTUM
2021
Necesse Network
Unlimited at a DSP or 20% co-payment applies at a non-DSP
PMBs only. Subject to DSPs
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. A 40% co-payment is applicable, for voluntary non-DSP utilisation
Subject to Prescribed Minimum Benefits
Limited to Prescribed Minimum Benefits at State facilities