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

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R56,960 per family.

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R35,800 at Healthcare Professional Tariff

In & Out of Hospital: R52,400 per beneficiary to max of R69,900 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R42,367 per family. Subject to pre-auth and use of DSPN, subject to PMB only

Comprehensive

(High Cover)

BESTMED

Pace 2

BONITAS

BonClassic

DISCOVERY

-

FEDHEALTH

-

MEDIHELP

MedElite

MOMENTUM

Extender
(Associated Hospital,
Any Chronic)

PROFMED

-

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R50,070 per family. Subject to use of a DSP or 30% co-payment will apply

In & Out of Hospital: R42,100 per beneficiary to max of R58,400 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R39,150 per family. Subject to use of a DSP or 30% ci-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

In & Out of Hospital: R34,700 per beneficiary to max of R46,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R28,245 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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

In hospital: R49,330 per family.

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R28,000 at Healthcare Professional Tariff

In & Out of Hospital: R34,700 per beneficiary to max of R46,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R28,245 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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)

In Hospital: R49,330 per family. Subject to use of a DSP or 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R28,000 at Healthcare Professional Tariff

In & Out of Hospital: R34,700 per beneficiary to max of R46,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R28,245 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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

-

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R39,150 per family.

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R28,000 at Healthcare Professional Tariff

In & Out of Hospital: R28,900 per beneficiary to max of R39,900 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In Hospital: R18,120 per family.

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R26,400 at Healthcare Professional Tariff

In & Out of Hospital: R22,900 per beneficiary to max of R34,700 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R21,183 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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)

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In Hospital: R18,120 per family. Subject to use of a DSP or 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R26,400 at Healthcare Professional Tariff

In & Out of Hospital: R28,900 per beneficiary to max of R39,700 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R21,183 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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)

In hospital: R39,150 per family. Subject to use of a DSP or 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to R26,400 at Healthcare Professional Tariff

In & Out of Hospital: R28,900 per beneficiary to max of R39,700 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R46,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R21,183 per family. Subject to pre-auth and use of DSPN, subject to PMB only

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart Plus
(Network)

DISCOVERY

Classic Smart
(Network)

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

Evolve
(Network)

PROFMED

-

Subject to PMB and Network Provider, or a R12,050 co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Limited to Prescribed Minimum Benefits, 21-day limit applies to drug and alcohol rehabilitation

Capitation

(Low Cover)

BESTMED

-

BONITAS

BonStart
(Network)

DISCOVERY

Essential Smart
(Network)

FEDHEALTH

-

MEDIHELP

MedMove
(Network)

MOMENTUM

Evolve
(Network)

PROFMED

-

Subject to PMB and Network Provider, or a R12,050 co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

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

Limited to Prescribed Minimum Benefits, 21-day limit applies to drug and alcohol rehabilitation

Hospital Plan

(Hospitalization Cover)

BESTMED

-

BONITAS

Hospital Standard

DISCOVERY

Classic Core

FEDHEALTH

-

MEDIHELP

-

MOMENTUM

-

PROFMED

-

In hospital: R36,860 per family. Subject to use of a DSP or 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

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

-

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R36,860 per family.

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Unlimited at cost at PMB level of care

In & Out of Hospital: R22,800 per beneficiary to max of R34,700 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R43,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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)

21 Days per beneficiary. Limit of R37,352 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

In hospital: R36,860 per family. Subject to use of a DSP or 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Unlimited at cost at PMB level of care

In & Out of Hospital: R22,800 per beneficiary to max of R34,700 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R43,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Limit of R21,183 per family. Subject to pre-auth and use of DSPN, subject to PMB only

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

-

PMBs only. Subject to network facilities. Limited to 21 days per beneficiary

Subject to PMB and Network Provider, or a 30% co-payment will apply

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB and DSP. Cover up to 80% if non-DSP is used

Unlimited at cost at PMB level of care

In & Out of Hospital: R22,900 per beneficiary to max of R34,700 per family Out of hospital benefit applicable to psychiatric treatment only

Limited to Prescribed Minimum Benefits at State facilities, 21-day sub-limit applies to drug and alcohol rehabilitation