Specialist Visits

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

Subject to Savings first, then GP limit

Subject to available Savings. Unlimited after Threshold is reached (100% of Scheme Tariff for non-contracted specialists)

Subject to Savings and Threshold. Unlimited once Threshold is reached (10% co- payment for non GP referral)

Subject to Pooled Benefit

Subject to Savings, if available. (Unlimited once Threshold is reached)

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 GP limit

Subject to available Savings. Unlimited after Threshold is reached (100% of Scheme Tariff for non-contracted specialists)

Subject to Savings and Day-to-Day Benefits, once savings is depleted

Subject to Savings, if available. (Unlimited once Threshold is reached)

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 GP limit

Subject to available Savings and Threshold (ATB limit)

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 and referral from GP

Subject to Savings first, then GP limit

Subject to available Savings and Threshold (ATB limit)

Subject to Savings/ Wallet or self-funded and Threshold. Unlimited once Threshold is reached (20% co-payment for non GP referral)

Subject to Savings and Day-to-Day Benefits, once savings is depleted

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 and referral from GP

Subject to Savings first, then GP limit

Subject to available Savings. Unlimited after Threshold is reached (100% of Scheme Tariff for non-contracted specialists)

Subject to Savings/ Wallet or self-funded and Threshold. Unlimited once Threshold is reached (20% co-payment for non GP referral)

Subject to Savings and Day-to-Day Benefits, once savings is depleted

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 and referral from GP

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

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 and referral from GP

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

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 Savings and Day-to-Day Benefits, once savings is depleted

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

3 visits or R3,280 pbpa | 5 visits or R4,870 pfpa. Subject to referral from a network GP (incl prescribed meds, radiology, pathology etc)

Limited to M=R1,187 | M1+R1,782, subject to referral by a Network Provider and Pulse specialist DSP

R4,400 per beneficiary. Subject to referral by your chosen KeyCare GP and pre-authorisation

2 Specialist consultations up to R1,900 per family per year. Must be referred by contracted GP

Limit of M: R3,300 | M+1: R4,600, subject to referral by Network GP. Incl procedures performed in specialists rooms, acute meds, radiology & pathology requested by specialist

Limit of 2 visits pfpa, limited to R1,100 per visit and up to max R2,200 pfpa. Subject to referral by Primary Care Network GP and pre-authorisation