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