Emergency Ward Treatment

Emergency Ward Treatment

which does not result in Hospitalisation

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

Wound care benefit: Savings first. Limit of R10,500 per family, subject to overall day-to-day limit

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

Subject to available Savings and Threshold

Unlimited at 100% of Fedhealth Rate

Limited to R4,300 per person (pooled per family)

Subject to available Savings & Threshold (Unlimited once Threshold is reached)

Subject to day-to-day benefits

Comprehensive

(High Cover)

BESTMED

Pace 2

BONITAS

BonClassic

DISCOVERY

-

FEDHEALTH

-

MEDIHELP

MedElite

MOMENTUM

Extender
(Associated Hospital,
Any Chronic)

PROFMED

-

Wound care benefit: Savings first. Limit of R7,535 per family, subject to overall day-to-day limit

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

Limited to
  • M: R3,550
  • M+1: R4,600
  • M+2: R5,750
  • M+3+: R6,900
Subject to Day-to-Day Benefits after Savings is depleted

Subject to available Savings & Threshold (Unlimited once Threshold is reached)

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

Wound care benefit: Savings first. Limit of R4,188 per family, subject to overall day-to-day limit

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

Subject to available Savings and Threshold

Subject to Savings and Day-to-Day Benefits, once savings is depleted

Subject to Savings, if available

Subject to day-to-day benefits

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

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings and Threshold

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Subject to Savings and Day-to-Day Benefits, once savings is depleted

Subject to Savings, if available

Subject to day-to-day benefits

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)

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings and Threshold

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Subject to Savings and Day-to-Day Benefits, once savings is depleted

Subject to Savings, if available

Subject to day-to-day benefits

Hospital & Savings

(Low to Medium Cover)

BESTMED

Beat 3
(Network)

BONITAS

BonSave

DISCOVERY

Classic Delta Saver
(Network)

FEDHEALTH

FlexiFed 3
(GRID)
Fixed

MEDIHELP

MedSaver

MOMENTUM

Incentive
(Any Hospital,
Associated Chronic)

PROFMED

-

Wound care benefit: Limit of R4,079 per family

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Subject to Savings

Subject to Savings, if available

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

Wound care benefit: Limit of R4,079 per family

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Outpatient emergency unit services, medicine and services by a non-network GP paid at 80% of MT up to R1,350 pbpa and R2,700 pfpa

Subject to Savings, if available

Subject to day-to-day benefits

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)

Wound care benefit: Limit of R4,079 per family

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings

Unlimited at 100% of Fedhealth Rate. Co- payment of R750 per visit for non-PMBs

Subject to Savings

Subject to Savings, if available

Subject to day-to-day benefits

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)

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk. Additional 2 for beneficiaries under the age of 6 years, payable from Overall annual limit

Subject to available Savings

Unlimited at 100% of Fedhealth Rate. Co- payment of R750 per visit for non-PMBs

Subject to Savings

Subject to Savings, if available

Subject to day-to-day benefits

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart Plus
(Network)

DISCOVERY

Classic Smart
(Network)

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

Evolve
(Network)

PROFMED

-

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

No Benefit

Subject to Health Saver, if available

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart
(Network)

DISCOVERY

Essential Smart
(Network)

FEDHEALTH

-

MEDIHELP

MedMove
(Network)

MOMENTUM

Evolve
(Network)

PROFMED

-

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

No Benefit

Subject to Prescribed Minimum Benefits. Listed essential cases – clinical guidelines and pre-authorisation apply

Subject to Health Saver, if available

Hospital Plan

(Hospitalization Cover)

BESTMED

-

BONITAS

Hospital Standard

DISCOVERY

Classic Core

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

-

PROFMED

-

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

No Benefit

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

-

Wound care benefit: Limit of R4,079 per family

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

No Benefit

Unlimited at 100% of Fedhealth Rate. Co-payment of R800 per visit for non-PMBs

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

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)

Wound care benefit: Limit of R4,079 per family

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

No Benefit

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

Subject to PMB

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

-

PMBs only

2 Emergency consultations per family at a casualty ward or emergency room facility of a hospital paid from risk

Cover for one casualty visit at any casualty unit within Keycare Hospital Network.
Member pays first R475 of consultation

Unlimited at 100% of Fedhealth Rate. Co- payment of R800 per visit for non-PMBs

Outpatient emergency unit services, medicine and services by a non-network GP paid at 80% of MT up to R1,350 pbpa and R2,700 pfpa

Subject to out-of-network GP, casualty OR after-hours visits: 1 visit pbpa, max of 2 visits pfpa. Subject to authorisation within 72 hours else 30% co-payment applies