(Treatment after discharge pertaining to hospitalisation paid from Risk benefits)

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

Advanced illness benefit in lieu of
hospitalisation: Limited to R133,182 pbpa.
Subject to pre-authorisation and treatment plan

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation.
Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R32,200 pfpa

R68,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R84,619 per family. In lieu of hospitalisation: Limit of R18,288 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

Comprehensive

(High Cover)

BESTMED

Pace 2

BONITAS

BonClassic

DISCOVERY

-

FEDHEALTH

-

MEDIHELP

MedElite

MOMENTUM

Extender
(Associated Hospital,
Any Chronic)

PROFMED

-

Advanced illness benefit in lieu of
hospitalisation: Limited to R133,182 pbpa.
Subject to pre-authorisation and treatment plan

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation.
Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R29,900 pfpa

R68,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

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

Advanced illness benefit in lieu of
hospitalisation: Limited to R83,239 pbpa.
Subject to pre-authorisation and treatment plan

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation. Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R27,500 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R56,252 per family. In lieu of hospitalisation: Limit of R15,437 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

Comprehensive

(Medium to High Cover)

BESTMED

-

BONITAS

Standard Select
(Network)

DISCOVERY

Classic Priority

FEDHEALTH

FlexiFed 4
(GRID)

MEDIHELP

MedPrime Elect
(Network)

MOMENTUM

Incentive
(Associated Hospital,
Associated Chronic)

PROFMED

ProSecure Savvy
(Network)

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation. Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R27,500 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R56,252 per family. In lieu of hospitalisation: Limit of R15,437 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

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)

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation. Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R27,500 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R56,252 per family. In lieu of hospitalisation: Limit of R15,437 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

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

-

Advanced illness benefit in lieu of
hospitalisation: Limited to R66,591 pbpa.
Subject to pre-authorisation and treatment plan

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation.
Speech therapy, occupational therapy & physiotherapy covered up to 30 days after
discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R25,200 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

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

Advanced illness benefit in lieu of
hospitalisation: Limited to R66,591 pbpa.
Subject to pre-authorisation and treatment plan

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Limit of R26,600 for sub-acute care and private nursing services as an alternative to hospitalisation. Palliative Care R20,700 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R28,126 per family. In lieu of hospitalisation: Limit of R13,164 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

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)

Advanced illness benefit in lieu of
hospitalisation: Limited to R66,591 pbpa.
Subject to pre-authorisation and treatment plan

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation. Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R25,200 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R28,126 per family. In lieu of hospitalisation: Limit of R13,164 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

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)

R61,480 per family for physical
rehabilitation. R20,500 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged Trauma Recovery Benefits (refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation. Speech therapy, occupational therapy & physiotherapy covered up to 30 days after discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R25,200 pfpa

R64,000 per family for medical rehabilitation, step-down facilities, Hospice and private nursing. Protocols apply

Reabilitation: Limit of R28,126 per family. In lieu of hospitalisation: Limit of R13,164 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart Plus
(Network)

DISCOVERY

Classic Smart
(Network)

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

Evolve
(Network)

PROFMED

-

R57,230 per family for physical
rehabilitation, subject to pre-authorisation.
R19,100 per family for hospice/step-down facilities. Subject to pre-authorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

R55,000 per family for medical rehabilitation, step-down facilities, private nursing and Hospice. Protocols apply

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart
(Network)

DISCOVERY

Essential Smart
(Network)

FEDHEALTH

-

MEDIHELP

MedMove
(Network)

MOMENTUM

Evolve
(Network)

PROFMED

-

R57,230 per family for physical
rehabilitation, subject to pre-authorisation.
R16,480 per family for hospice/step-down facilities. Subject to pre-authorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

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

R55,000 per family for medical rehabilitation, step-down facilities, private nursing and Hospice. Protocols apply

Hospital Plan

(Hospitalization Cover)

BESTMED

-

BONITAS

Hospital Standard

DISCOVERY

Classic Core

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

-

PROFMED

-

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

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

-

Advanced illness benefit in lieu of
hospitalisation: Limited to R66,591 pbpa.
Subject to pre-authorisation and treatment plan

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation.
Speech therapy, occupational therapy & physiotherapy covered up to 30 days after
discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R22,800 pfpa

R61,000 per family for medical rehabilitation, step-down facilities, private nursing and Hospice. Protocols apply

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)

Advanced illness benefit in lieu of
hospitalisation: Limited to R66,591 pbpa.
Subject to pre-authorisation and treatment plan

R57,890 per family for physical
rehabilitation. R19,310 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

Unlimited at negotiated tariff, subject to protocols, and pre-authorisation. Sub-acute facilities, physical rehab: Unlimited at cost up to PMB level of care

Unlimited sub-acute care and private nursing services as an alternative to hospitalisation.
Speech therapy, occupational therapy & physiotherapy covered up to 30 days after
discharge, limited to R2,200 single member or R3,150 pfpa. Palliative Care R22,800 pfpa

R61,000 per family for medical rehabilitation, step-down facilities, private nursing and Hospice. Protocols apply

Reabilitation: Limit of R28,126 per family. In lieu of hospitalisation: Limit of R13,164 per beneficiary for out-patient care. Subject to pre-authorisation and use of DSPN

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

-

Advanced illness benefit in lieu of
hospitalisation: Approved PMBs at DSPs

R57,890 per family for physical
rehabilitation. R16,860 per family for hospice/step-down facilities. Subject to preauthorisation

Access to Connected Care. Includes cover and treatment for COVID-19 and/or follow-up care once discharged.(refer to brochure for details)

Unlimited at cost at PMB level of care

Limit of R26,600 for sub-acute care and private nursing services as an alternative to hospitalisation. Palliative Care R20,700 pfpa

R15,900 per beneficiary for medical rehabilitation and step-down facilities. No benefit for private nursing and Hospice