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

–