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
Subject to Savings first, then limited to Acute:
M=R2,000 | M1+R4,500 and OTC: R1,057 pfpa.
Subject to overall day-to-day limit
Subject to Savings and ATB. Limit of R16,970 pf in ATB
Subject to Savings and Threshold. Limited to R7,940 per beneficiary and R14,700 per family before and after Threshold
Limited to R7,850 per beneficiary per year, pooled per family
Subject to available Savings & Threshold (Extender Cover limit of R21,100 pb and
R407,000 pf). OTC meds subject to available Savings (does not accumulate to
Threshold)
Subject to day-to-day benefit. Limits apply.
OTC meds limit of R2,156 per family. 20% co-pay applies
Comprehensive
(High Cover)
BESTMED
Pace 2
BONITAS
BonClassic
DISCOVERY
-
FEDHEALTH
-
MEDIHELP
MedElite
MOMENTUM
Extender
(Associated Hospital,
Any Chronic)
PROFMED
-
Subject to Savings first, then limited to Acute:
M=R3,000 | M1+R6,000 and OTC: R1,057 pfpa.
Subject to overall day-to-day limit
Subject to Savings
–
–
M: R4,600 |
M+1: R5,750 |
M+2: R6,900 |
M+3+: R8,050 Subject to Day-to- Day Benefits after Savings is depleted
Subject to available Savings & Threshold (Extender Cover limit of R21,100 pb and
R407,000 pf). OTC meds subject to available Savings (does not accumulate to Threshold)
–
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
Subject to Savings first, then limited to Acute:
M=R2,591 | M1+R5,363 and OTC: R1,057 pfpa.
Subject to overall day-to-day limit
Subject to Savings and ATB
–
Subject to Savings and Day-to-Day Benefits, once savings is depleted
Subject to Savings, if available
Subject to day-to-day benefit. Limits apply.
OTC meds limit of R1,745 per family. 20% co-pay applies
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
–
Subject to Day-to-Day Benefits. Sub-limits:
M=R3,200 | M+1=R4,790 | M+2=R5,330 |
M+3+=R6,390. DSP and formulary (else 20% co-pay applies). OTC Meds limit:
M=R850 | M+=R2,660
Subject to Savings or self-funded and Threshold. Limited to R6,330 pbpa and R12,770 pfpa before and after Threshold
Subject to Savings and Day-to-Day Benefits, once savings is depleted
Subject to Savings, if available
Subject to day-to-day benefit. Limits apply.
OTC meds limit of R1,745 per family. 20% co-pay applies
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)
–
Subject to Day-to-Day Benefits. Sub-limits:
M=R3,200 | M+1=R4,790 | M+2=R5,330 |
M+3+=R6,390. DSP and formulary (else 20% co-pay applies). OTC Meds limit:
M=R850 | M+=R2,660
Subject to Savings or self-funded and Threshold. Limited to R6,330 pbpa and R12,770 pfpa before and after Threshold
Subject to Savings and Day-to-Day Benefits, once savings is depleted
Subject to Savings, if available
Subject to day-to-day benefit. Limits apply.
OTC meds limit of R1,745 per family. 20% co-pay applies
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
-
Subject to Savings
Subject to Savings
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
–
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
Subject to Savings
Subject to Day-to-Day Benefits. Sub-limits:
M=R1,600 | M+1=R2,660 | M+2+=R3,200.
DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R535 |
M+=R2,130
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Day-to-Day Benefits. Selfmedication limit of R560 pbpa and R1,650 pfpa
Subject to Savings, if available
80% Single Exit Price plus dispensing fee.
Limits apply
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)
Subject to Savings
Subject to Day-to-Day Benefits. Sub-limits:
M=R1,600 | M+1=R2,660 | M+2+=R3,200.
DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R535 |
M+=R2,130
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings and Day-to-Day Benefits, once savings is depleted
Subject to Savings, if available
80% Single Exit Price plus dispensing fee.
Limits apply
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)
–
Subject to Savings
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings and Day-to-Day Benefits, once savings is depleted
Subject to Savings, if available
80% Single Exit Price plus dispensing fee.
Limits apply
Capitation
(Low Cover)
BESTMED
-
BONITAS
BonStart Plus
(Network)
DISCOVERY
Classic Smart
(Network)
FEDHEALTH
-
MEDIHELP
-
MOMENTUM
Evolve
(Network)
PROFMED
-
–
Limited to R3,160 per family per annum.
Cover for acute medicine (20% co-payment applies), x-rays and blood tests. Subject to GP referral and medicine formulary (else 40% co-pay applies)
OTC meds limit R785 pfpa (R165 per script)
Limit of R1,820 pbpa and R3,030 pfpa for schedule 3 and above. Subject to network formulary and use of a network pharmacy (Clicks and Dis-Chem). OCT meds limit of R835 pfpa
–
–
Subject to Health Saver, if available
–
Capitation
(Low Cover)
BESTMED
-
BONITAS
BonStart
(Network)
DISCOVERY
Essential Smart
(Network)
FEDHEALTH
-
MEDIHELP
MedMove
(Network)
MOMENTUM
Evolve
(Network)
PROFMED
-
–
Limited to R1,690 per family per annum.
Cover for acute medicine (20% co-payment applies), x-rays and blood tests. Subject to GP referral and medicine formulary (else 40% co-pay applies)
OTC meds limit R520 pfpa (R105 per script)
OTC meds ONLY. Limit of R560 pfpa, subject to network pharmacy
–
Limited to R1,575 per family per year. OTC meds: R100 per event, R475 per family per year.
Subject to Health Saver, if available
–
Hospital Plan
(Hospitalization Cover)
BESTMED
-
BONITAS
Hospital Standard
DISCOVERY
Classic Core
FEDHEALTH
-
MEDIHELP
-
MOMENTUM
-
PROFMED
-
–
No Benefit
No Benefit
–
–
–
–
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
-
No Benefit
Subject to BENEFIT BOOSTER
No Benefit
Subject to Savings/ Wallet or self-funded
Subject to Day-to-Day Benefits
Subject to Health Saver, if available
–
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)
No Benefit
Subject to BENEFIT BOOSTER
No Benefit
Subject to Savings/ Wallet or self-funded
Subject to Day-to-Day Benefits
Subject to Health Saver, if available
–
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
-
Unlimited. Subject to Provider Network formulary (prescribed by Network GP)
Limits: M=R2,190 | M+1=R3,650 |
M+2=R4,370 | M+3=R4,770 | M+4=R5,290.
Cover for acute medicine, x-rays and blood tests. Subject to GP referral, DSP and medicine formulary OTC meds limit R315 pbpa (R110 per script)
Unlimited. Subject to the Network Acute Medicine Formulary prescribed by KeyCare Network GP
Subject to Savings or self-funded
Subject to Day-to-Day Benefits. Self-medication limit of R560 pbpa and R1,650 pfpa
Subject to prescribed formulary. OTC medication not covered
–