In-Hospital Benefits
Rate of Cover for Specialist fees during hospitalisation Hospitals that may be utilized (Pre-authorisation is required before treatment starts, or in case of an emergency within the next two business days) Overall limits & Deductibles
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
150% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate Contracted Specialists covered in full
Any Hospital (Private ward up to R2,220 per day)
Unlimited
200% of Scheme Rate Contracted Specialists covered at cost
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
HIGH COVER LEVEL 2
BONITAS
2021
BonClassic
BESTMED
2021
Page
DISCOVERY
2021
Essential Comprehensive
FEDHEALTH
MEDIHELP
2021
Elite
MOMENTUM
2021
Extender: Any (Chronic: Any)
100% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
MEDIUM-HIGH LEVEL 1 COVER
BONITAS
2021
BonComplete
BESTMED
2021
Pace 1
DISCOVERY
2021
Classic Priority
FEDHEALTH
MEDIHELP
MOMENTUM
200% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
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
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered at cost
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
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
100% of Scheme Rate (Contracted Specialists paid in full)
Network Hospitals
(30% co-payment for use of non-network hospitals)
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered in full
Delta Hospital Network
Unlimited
(R8,700 co-pay for use of non-network hospital)
100% of Scheme Rate Contracted Specialists covered at cost
Network Private Hospitals
Unlimited
(Co-payments: R12,500 for use of non-network hospitals and R2,000 for use of non-network day facilities)
100% of Scheme Rate
Network Hospitals
Unlimited
(35% co-pay for use of non-network hospitals)
200% of Scheme Rate (Associated specialists covered in full)
Associated Hospitals
Unlimited
(30% co-payment for use of non-network hospital)
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
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered at cost
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
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
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered at cost
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
200% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
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
100% of Scheme Rate (Contracted Specialists paid in full)
Network Hospitals
(30% co-payment for use of non-network hospitals)
Unlimited
100% of Scheme Rate
Network Hospitals
Unlimited
(R11,847 co-payment for use of non-DSPs)
100% of Scheme Rate Contracted Specialists covered in full
Delta Hospital Network
Unlimited
(R8,700 co-pay for use of non-network hospital)
100% of Scheme Rate Contracted Specialists covered at cost
Network Private Hospitals
Unlimited
(Co-payments: R12,500 for use of non- network hospitals and R2,000 for use of non-network day facilities)
100% of Scheme Rate
Network Hospitals
Unlimited
(35% co-pay for use of non-network hospitals)
200% of Scheme Rate (Associated specialists covered in full)
Associated Hospitals
Unlimited
(30% co-payment for use of non-network hospital)
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
100% of Scheme Rate Contracted Specialists covered in full
Delta Hospital Network
Unlimited
(R8,700 co-pay for use of non-network hospital)
100% of Scheme Rate (Contracted Specialists paid in full)
Network Hospitals
(30% co-payment for use of non-network hospitals)
Unlimited
100% of Scheme Rate
Network Hospitals
Unlimited
(R11,847 co-payment for use of non-DSPs)
100% of Scheme Rate Contracted Specialists covered at cost
Network Private Hospitals
Unlimited
(Co-payments: R12,500 for use of non-network hospitals and R2,000 for use of non-network day facilities)
100% of Scheme Rate
Network Hospitals
Unlimited
(35% co-pay for use of non-network hospitals)
200% of Scheme Rate (Associated specialists covered in full)
Associated Hospitals
Unlimited
(30% co-payment for use of non-network hospital)
HOSPITAL COVER 1
BONITAS
2021
Hospital Standard
BESTMED
2021
Beat 1
DISCOVERY
2021
Essential Core
FEDHEALTH
MEDIHELP
MOMENTUM
2021
Custom – Any Hospital, Associated Chronic
100% of Scheme Rate (Contracted Specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
(R1,640 co-payment applies)
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
100% of Scheme Rate (Contracted specialists paid in full)
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate Contracted Specialists covered in full
Any Hospital
Unlimited
100% of Scheme Rate
Any Hospital
Unlimited
100% of Scheme Rate (Associated specialists covered in full)
Any Hospital
Unlimited
(R1,640 co-payment applies)
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
100% of Scheme Rate (Contracted specialists paid in full)
Network Hospitals
(30% co-payment for use of non-network hospitals)
Unlimited
100% of Scheme Rate (Contracted specialists paid in full)
Delta Hospital Network
Unlimited
(R8,700 co-payment for use of non-network hospital)
100% of Scheme Rate Contracted Specialists covered in full
Delta Hospital Network
Unlimited
(R8,700 co-payment for use of non-network hospital)
100% of Scheme Rate Contracted Specialists covered at cost
Network Private Hospitals
Unlimited
(Co-payments: R7,000 for use of non-network hospitals and R2,000 for use of non-network day facilities)
100% of Scheme Rate
Network Hospitals
Unlimited
(35% co-pay for use of non-network hospitals)
100% of Scheme Rate (Associated specialists covered in full)
Associated Hospitals
Unlimited
(R1,640 co-payment applies)
30% co-payment for use of non-network hospital
Primary Care Network
BONITAS
2021
BonCap
BESTMED
2021
Pulse 1
DISCOVERY
2021
KeyCare Plus
FEDHEALTH
MyFed
MEDIHELP
Ingwe Network
MOMENTUM
2021
Necesse Network
100% of Scheme Rate
Network Hospitals
Unlimited
(*R10,000 co-payment for use of non-network hospitals *Sub-limits apply – refer to last page)
100% of Scheme Rate
Network Hospitals
Unlimited
(R11,847 co-payment for use of non-DSPs)
100% of Scheme Rate
KeyCare Network Hospitals
Unlimited (*exclusions apply)
100% of Scheme Rate Contracted Specialists covered at cost
Network Private Hospitals
Unlimited
(Co-payments: R12,500 for use of non- network hospitals and R2,000 for use of non-network Day Clinics)
Limit of R2,400 per beneficiary for non- network GPs and Specialists
100% of Scheme Rate (Specialist Network applies for PMBs)
Necesse Network Hospitals
Unlimited
100% of Scheme Rate
Ingwe Network Hospitals
(30% co-payment for use of non-network hospital)
Unlimited
(ICU ltd to 10 days per admission)