General Practitioner Visits

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

Subject to Savings and Above Threshold Benefit

Subject to Savings first, then limited to

M=R4,394, M1+R8,906.

Subject to overall day-to-day limit

Subject to Savings. Extender Benefit (DEB):

Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria (in Self Payment Gap).

Unlimited after Threshold is reached

Subject to Savings then unlimited from Risk at Fedhealth Network GPs

Subject to Pooled Benefit Limit

Subject to Savings, if available.

(Unlimited once Threshold is reached)

HIGH COVER LEVEL 2

BONITAS

2021
BonClassic

BESTMED

2021
Page

DISCOVERY

2021
Essential Comprehensive

FEDHEALTH

MEDIHELP

2021
Elite

MOMENTUM

2021
Extender: Any (Chronic: Any)

Subject to Savings

Subject to Savings first, then limited to

M=R4,394, M1+R8,906.

Subject to overall day-to-day limit

Subject to Savings. Extender Benefit (DEB):

Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria (in Self Payment Gap).

Unlimited after Threshold is reached

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

Subject to Savings, if available.

(Unlimited once Threshold is reached)

MEDIUM-HIGH LEVEL 1 COVER

BONITAS

2021
BonComplete

BESTMED

2021
Pace 1

DISCOVERY

2021
Classic Priority

FEDHEALTH

MEDIHELP

MOMENTUM

Subject to Savings. Extender Benefit (DEB):

Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Subject to Savings and Above Threshold Benefit

Subject to Savings first, then limited to M=R2,245, M1+R4,512. Subject to overall day-to-day limit

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

Nominate 2 Network GPs. Limits (sub-limits for non-network GP):

M=R4,390 (R1,430) | M+1=R6,440 (R2,200) | M+2=R7,140 (R2,410) | M+3=R7,500 (R2,510) | M+4=R8,140 (R2,710)

Subject to Savings first, then limited to M=R2,245, M1+R4,512.

Subject to overall day-to-day limit

Subject to Savings. Extender Benefit (DEB):

Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Unlimited consultations at nominated Network GP. Non-network GP paid from Savings/ Wallet or self-funded and Threshold

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

Subject to Savings, if available

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

Subject to use of Network GP. Limits:
 
M=R4,390 | M+1=R6,440 | M+2=R7,140 | M+3=R7,500 | M+4=R8,140.

Subject to Savings first, then limited to M=R2,245, M1+R4,512.

Subject to overall day-to-day limit

Subject to Savings. Extender Benefit (DEB):

Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria (in Self Payment Gap). Unlimited after Threshold is reached

Unlimited consultations at nominated Network GP. Non-network GP paid from Savings/ Wallet or self-funded and Threshold

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

Subject to Savings, if available

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

Subject to Savings

Subject to Savings

Subject to Savings. Extender Benefit (DEB):

Covers up to 6 pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Subject to Savings/ Wallet or self-funded. Unlimited consultations at nominated Network GP, once Benefit Maximizer Threshold Level is reached

Subject to Savings
CHILD CARE BENEFITS:

Limited to R1,100
for GP consults for children 2 to 12yrs, once savings is depleted

Subject to Savings, if available

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

Nominate 2 Network GPs. Limits (sub-limits for non-network/nominated GP):

M=R1,960 (R635) | M+1=R3,610 (R1,200) | M+2=R4,270 (R1,360) | M+3=R4,590 (R1,530) | M+4=R5,200 (R1,810)

Subject to Savings

Subject to Savings. Extender Benefit (DEB):

Covers up to 4 pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Subject to Savings/ Wallet or self-funded. Unlimited consultations at nominated Network GP, once Benefit Maximizer Threshold Level is reached

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

Subject to Savings, if available

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

Nominate 2 Network GPs. Limits:

M=R1,960
| M+1=R3,610 | M+2=R4,270 | M+3=R4,590
| M+4=R5,200

Subject to Savings

Subject to Savings. Extender Benefit (DEB):

Covers up to 4 pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Subject to Savings/ Wallet or self-funded. Unlimited consultations at nominated Network GP, once Benefit Maximizer Threshold Level is reached

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

Subject to Savings, if available

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

Subject to Savings

Subject to Savings

Subject to Savings. Extender Benefit (DEB):

Covers up to 4 pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria

Subject to Savings/ Wallet or self-funded. Unlimited consultations at nominated Network GP, once Benefit Maximizer Threshold Level is reached

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

Subject to Savings, if available

HOSPITAL COVER 1

BONITAS

2021
Hospital Standard

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

MOMENTUM

2021
Custom – Any Hospital, Associated Chronic

No Benefit

No Benefit

No Benefit

No Benefit

Subject to Health Saver, if available

No Benefit

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

No Benefit

No Benefit

No Benefit

Subject to Day-to-Day Benefits

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

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

No Benefit

No Benefit

No Benefit

Subject to Savings/ Wallet or self-funded. Unlimited consultations at nominated Network GP, once Benefit Maximizer Threshold Level is reached

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

Primary Care Network

BONITAS

2021
BonCap

BESTMED

2021
Pulse 1

DISCOVERY

2021
KeyCare Plus

FEDHEALTH

MyFed

MEDIHELP

Ingwe Network

MOMENTUM

2021
Necesse Network

Unlimited consultations (max 2 Network GPs). Pre-auth required from 8th visit. 1 Out- of-Network visit pb (max 2 pf) limited to R1,100 (20% co-pay applies)

Unlimited GP visits, subject to Bestmed Pulse1 Network. Out-of-network GP visits limited to R1,425 pfpa

Unlimited at chosen KeyCare Network GP. Second GP can be nominated. Authorisation required after the 15th visit. 4 Out-of- Network GP visit per beneficiary

Unlimited at contracted nominated GP (can nominate 2 GPs per beneficiary). Monitoring after 10 visits. Non-nominated GP limited to 2 visits per beneficiary at a contracted GP

9 Consultations per beneficiary per year, thereafter only for PMB conditions (subject to pre-auth)

Unlimited at Primary Care Network GP. Pre- auth required from 11th visit. Subject to out- of-network GP, casualty OR after-hours visits: 1 visit pbpa, max of 2 visits pfpa.
R100 co-payment applies per visit. Subject to authorisation within 72 hours else 30% co-payment applies