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