Psychiatric & Psychological Treatment

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

In hospital: R48,470 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R34,500 at Healthcare Professional Tariff

In & Out of Hospital: R44,700 per beneficiary to max of R61,000 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

HIGH COVER LEVEL 2

BONITAS

2021
BonClassic

BESTMED

2021
Page

DISCOVERY

2021
Essential Comprehensive

FEDHEALTH

MEDIHELP

2021
Elite

MOMENTUM

2021
Extender: Any (Chronic: Any)

In hospital: R42,610 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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: R36,700 per beneficiary to max of R51,000 per family Out of hospital benefit applicable to psychiatric treament only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

MEDIUM-HIGH LEVEL 1 COVER

BONITAS

2021
BonComplete

BESTMED

2021
Pace 1

DISCOVERY

2021
Classic Priority

FEDHEALTH

MEDIHELP

MOMENTUM

In hospital: R33,310 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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

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

In Hospital: R41,980 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R27,000 at Healthcare Professional Tariff

In & Out of Hospital: R30,400 per beneficiary to max of R40,800 per family Out of hospital benefit applicable to psychiatric treament only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

In Hospital: R41,980 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R27,000 at Healthcare Professional Tariff

In & Out of Hospital: R30,400 per beneficiary to max of R40,800 per family Out of hospital benefit applicable to psychiatric treament only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

In hospital: R33,310 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R27,000 at Healthcare Professional Tariff

In & Out of Hospital: R25,300 per beneficiary to max of R34,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

In Hospital: R16,370 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R25,500 at Healthcare Professional Tariff

In & Out of Hospital: R25,300 per beneficiary to max of R34,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

In Hospital: R16,370 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R25,500 at Healthcare Professional Tariff

In & Out of Hospital: R25,300 per beneficiary to max of R34,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

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

In hospital: R33,310 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 R27,000 at Healthcare Professional Tariff

In & Out of Hospital: R25,300 per beneficiary to max of R34,800 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R39,500 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

HOSPITAL COVER 1

BONITAS

2021
Hospital Standard

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

MOMENTUM

2021
Custom – Any Hospital, Associated Chronic

In hospital: R33,110 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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 Hospital: R37,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

HOSPITAL COVER 2 

BONITAS

2021
Bon-Essential

BESTMED

2021
Beat 1

DISCOVERY

2021
Essential Core

FEDHEALTH

MEDIHELP

Custom – Any Hospital, Associated Chronic

MOMENTUM

2021
Prime

In hospital: R33,110 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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: R20,050 per beneficiary to max of R30,400 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R37,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

HOSPITAL 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

In hospital: R33,110 per family. Subject to use of a DSP

21 Days per beneficiary. Limit of R32,299 per beneficiary for treatment of chemical or substance abuse, subject to network facilities

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: R20,050 per beneficiary to max of R30,400 per family Out of hospital benefit applicable to psychiatric treatment only

In Hospital: R37,000 per beneficiary OR Out of Hospital: Sub-limit of 21 days for drug and alcohol rehab, subject to treatment at a preferred provider

Primary Care Network

BONITAS

2021
BonCap

BESTMED

2021
Pulse 1

DISCOVERY

2021
KeyCare Plus

FEDHEALTH

MyFed

MEDIHELP

Ingwe Network

MOMENTUM

2021
Necesse Network

Subject to PMB and Network Provider

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

In Hospital: 21 Days per beneficiary OR Out of Hospital: 15 consultations per beneficiary. Subject to PMB

Limit of R9,400 per family per year

In & Out of Hospital: Subject to Specialised Radiology limit of R17,100 per family, as requested by Specialist on referral by Network GP

Limited to Prescribed Minimum Benefits at State facilities