HIV/Aids

Sub limits on Medicine might 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 registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

Comprehensive

(High Cover)

BESTMED

Pace 2

BONITAS

BonClassic

DISCOVERY

FEDHEALTH

MEDIHELP

MedElite

MOMENTUM

Extender
(Associated Hospital,
Any Chronic)

PROFMED

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

–

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

–

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

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

–

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Antiretroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

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, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

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, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

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

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

–

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

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

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)

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

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, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Anti- retroviral treatment, R87,900 per family for HIV related admissions

Benefits through the HIV Programme (Lifesense)

Capitation

(Low Cover)

BESTMED

BONITAS

BonStart Plus
(Network)

DISCOVERY

Classic Smart
(Network)

FEDHEALTH

MEDIHELP

MOMENTUM

Evolve
(Network)

PROFMED

–

Subject to PMB and registration on the HIV/AIDS programme (Aid for AIDS). Chronic meds must be obtained from the DSP (30% co-payment for use of non-DSP)

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

–

At chosen network provider: Unlimited Anti- retroviral treatment, R45,900 per family for HIV related admissions

–

Capitation

(Low Cover)

BESTMED

BONITAS

BonStart
(Network)

DISCOVERY

Essential Smart
(Network)

FEDHEALTH

MEDIHELP

MedMove
(Network)

MOMENTUM

Evolve
(Network)

PROFMED

–

Subject to PMB and registration on the HIV/AIDS programme (Aid for AIDS). Chronic meds must be obtained from the DSP (30% co-payment for use of non-DSP)

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

–

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

At chosen network provider: Unlimited Anti- retroviral treatment, R45,900 per family for HIV related admissions

–

Hospital Plan

(Hospitalization Cover)

BESTMED

BONITAS

Hospital Standard

DISCOVERY

Classic Core

FEDHEALTH

MEDIHELP

MOMENTUM

PROFMED

–

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

–

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

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Unlimited, subject to registration on the HIV/AIDS programme (Aid for Aids). Chronic medication must be be obtained by a DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Antiretroviral treatment, R81,300 per family for HIV related admissions

–

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)

Unlimited. Subject to registration on the HIV/AID programme. DSP and protocols apply

Subject to PMB and registration on the HIV/AIDS programme (Aid for AIDS). Chronic meds must be obtained from the DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited at cost at PMB level of care. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: Unlimited Antiretroviral
treatment, R81,300 per family for
HIV related admissions

Benefits through the HIV Programme (Lifesense)

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 at DSPs

Subject to PMB and registration on the HIV/AIDS programme (Aid for AIDS). Chronic meds must be obtained from the DSP

Subject to registration on HIVCare Programme and use of Network Providers. 20% co-pay applies for use of non DSP

Unlimited. Medication must be obtained from Pharmacy Direct or 40% co-payment will apply

LifeSense Disease Management is the managed healthcare partner for HIV/Aids. DSP for HIV/Aids medicine: Dis-Chem Direct and Medipost

At chosen network provider: R38,500 per family for Anti-retroviral treatment, R39,000 per family for HIV related admissions

–