Prescribed/ Acute Medicine

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

Subject to Savings and ATB. Limit of R15,000 pf in ATB

Subject to Savings first, then limited to Acute:

M=R1,544 | M1+R3,800 and OTC:
R683 pfpa.

Subject to overall day-to-day limit

Subject to available Savings and Threshold. DEB limits (schedule 3 and above): M- R35,750 | M+1-R41,950 | M+2-R48,700 |
M+3-R55,950 before and after threshold. OTC medication subject to available Savings only

Subject to Savings and Threshold. Limited to R7,650 per beneficiary and R14,150 per family before and after Threshold

Limited to R6,440 per beneficiary per year, pooled per family

Subject to available Savings & Threshold (Extender Cover limit of R18,200 pb and R34,400 pf). OTC meds subject to available Savings (does not accumulate to Threshold)

HIGH COVER LEVEL 2

BONITAS

2021
BonClassic

BESTMED

2021
Page

DISCOVERY

2021
Essential Comprehensive

FEDHEALTH

MEDIHELP

2021
Elite

MOMENTUM

2021
Extender: Any (Chronic: Any)

Subject to Savings

Subject to Savings first, then limited to Acute: M=R4,869 | M1+R9,737 and OTC:
R683 pfpa. Subject to overall day-to-day limit

Subject to Savings. Extender Benefit (DEB): Covers unlimited pharmacy clinic consultations (DSP Dischem and MediCare) and pharmacy clinic referred GP consultations per year up to the DHR. Network GP needs to meet digital criteria (in Self Payment Gap). Unlimited after Threshold is reached

Limited to M: R4,000 | M+1: R5,000 | M+2: R6,000 | M+3+: R7,000 . Subject to Day-to- Day Benefits after Savings is depleted

Subject to available Savings & Threshold (Extender Cover limit of R18,200 pb and R34,400 pf). OTC meds subject to available Savings (does not accumulate to Threshold)

MEDIUM-HIGH LEVEL 1 COVER

BONITAS

2021
BonComplete

BESTMED

2021
Pace 1

DISCOVERY

2021
Classic Priority

FEDHEALTH

MEDIHELP

MOMENTUM

Subject to Savings and ATB

Subject to Savings first, then limited to Acute: M=R2,352 | M1+R4,869 and OTC:
R683 pfpa. Subject to overall day-to-day limit

Subject to available Savings and Threshold. DEB limits (schedule 3 and above): M- R22,850 | M+1-R27,700 | M+2-R33,350 |
M+3-R36,400 before and after threshold. OTC medication subject to available Savings only

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

Subject to Day-to-Day Benefits, DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R815 | M+=R2,480

Subject to Savings first, then limited to Acute: M=R2,352 | M1+R4,869 and OTC:
R683 pfpa. Subject to overall day-to-day limit

Subject to available Savings and Threshold. DEB limits (schedule 3 and above): M- R22,850 | M+1-R27,700 | M+2-R33,350 |
M+3-R36,400 before and after threshold. OTC medication subject to available Savings only

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Savings, if available

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

Subject to Day-to-Day Benefits, DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R815 | M+=R2,480

Subject to Savings first, then limited to Acute: M=R2,352 | M1+R4,869 and OTC:
R683 pfpa. Subject to overall day-to-day limit

Subject to available Savings and Threshold. DEB limits (schedule 3 and above): M- R22,950 | M+1-R27,950 | M+2-R33,650 |
M+3-R36,700 before and after threshold. OTC medication subject to available Savings only

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Savings, if available

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

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

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

Subject to Day-to-Day Benefits, DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R515 | M+=R1,510

Subject to Savings

Subject to available Savings

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Savings, if available

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

Subject to Day-to-Day Benefits, DSP and formulary (else 20% co-pay applies). OTC Meds limit: M=R515 | M+=R1,510

Subject to Savings

Subject to available Savings

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Savings, if available

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

Subject to Savings

Subject to Savings

Subject to available Savings

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Savings, if available

HOSPITAL COVER 1

BONITAS

2021
Hospital Standard

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

MOMENTUM

2021
Custom – Any Hospital, Associated Chronic

No Benefit

No Benefit

No Benefit

Subject to Health Saver, if available

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

No Benefit

No Benefit

No Benefit

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

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

No Benefit

No Benefit

No Benefit

Subject to Savings/ Wallet or self-funded

Subject to Day-to-Day Benefits

Subject to Health Saver, if available

Primary Care Network

BONITAS

2021
BonCap

BESTMED

2021
Pulse 1

DISCOVERY

2021
KeyCare Plus

FEDHEALTH

MyFed

MEDIHELP

Ingwe Network

MOMENTUM

2021
Necesse Network

Limits: M=R1,940 | M+1=R3,230 | M+2=R3,860 | M+3=R4,220 | M+4=R4,680.
Cover for acute medicine, x-rays and blood tests. Subject to GP referral, DSP and medicine formulary
OTC meds limit R280 pbpa (R100 per script)

Unlimited. Subject to Provider Network formulary (prescribed by Network GP). OTC medication limit of R387, subject to Network formulary and Pharmacy Network

Unlimited. Subject to the Network Acute Medicine Formulary prescribed by KeyCare Network GP

Unlimited at dispensing contracted GP. Non-dispensing GP, subject to acute formulary. No Benefit for OTC medication

Must be prescribed by Network GP and obtained from dispensing GP or network pharmacy. OTC meds ltd to R300 pbpa, max R110 per event

Subject to prescribed formulary. OTC medication not covered