A Comparison of Comprehensive Medical Aid Plans 2014

Comprehensive Medical Aid plans have unlimited hospital cover and comprehensive day-to-day benefits.  In new generation plans, initial claims will be funded from a medical savings account.  Thereafter when all accumulated day-to-day claims reach a specified threshold, another risk benefit kicks in and continues to pay claims until the end of the year.

Traditional options have generous amounts of day-to-day cover for all the different medical providers except for GP's consultations and conservative dentistry where cover is generally unlimited and no benefits carry forward to the next year.

 
Comprehensive
Plans:
Discov Classic Compr Momentum Extender Option Resolution Supreme
Discov Classic Delta Compr Fedhealth Maxima Exec
 
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,000  
  Oncology R400 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
  Specialised medicine & technology  
   benefit R200,00  
     
     
     
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Add. 23 Chronic Disease Conditions  
     
     
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 10,080  
  Member+Spouse R 19,620  
  Member+Spouse+Child1 R 21,624  
  Member+Spouse+Child2 R 23,628  
  Member+Spouse+Child3 R 25,632  
  Member+Child 1 R 12,084  
       
   Insured Network Benefit  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 11,350  
  Spouse/Adult independant R 11,350  
  Per Child (Max 3) R 2,150  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,362  
  Spouse/Adult dependant R 3,180  
  Per Child (Max 3) R 670  
     
     
MOMENTUM EXTENDER OPTION
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *Co-payments apply for certain  
  procedures  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :  
       
   Psychiatric Treament R27,400    
   Hospice Care (including R38,000   
      rehab & step-down    
       facilities)    
       
    Oncology R500,000    
     thereafter 20% co-pay    
   Internal Prostheses:    
      see detailed benefits    
       
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  36 additional conditions limited to  
  R 7, 400 per family  
     
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
 
 
  Member R 10,104  
  Member+Spouse R 18,168  
  Member+Spouse+Child1 R 21,336  
  Member+Spouse+Child2 R 24,504  
  Member+Spouse+Child3 R 27,672  
  Member+Child 1 R 13,272  
       
   For more savings, please enquire  
   about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 12,300  
  Spouse/Adult dependant R 10,600  
  Per Child (Max 3) R 3,600  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,367  
  Spouse/Adult dependant R 2,687  
  Per Child (Max 3) R 1,056  
       
       
RESOLUTION HEALTH
SUPREME
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (eg R3,180 Arthroscopy)  
  *7 days Take Home Medicine  
  Emergency Casualty Annual   
   Limit: R1,350 per family  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R25,400  
  Hospice Care 21 days  
  Oncology (subject to ICON Unlimited  
   network & scheme    
   protocols    
    Internal Prosthesis    
     (see detailed benefits)    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  (Additional 25 Chronic disease  
  conditions)  
     
  Annual Limit  
       
   Single R4,650  
   Family R9,300  
       
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
     
  Out of Hospital Annual Limit  
       
       
   Member R12,720  
  Member + Spouse R22,260  
  Member+ Spouse + 1 Child R23,600  
  Member+ Spouse+ 2 Child. R24,940  
  Member+ Spouse+ 3 Child. R26,280  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
     
     
   Does not apply  
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,035  
  Spouse/Adult dependant R 2,951  
  Per Child (max 3) R 777  
               
       
.
 FEDHEALTH
MAXIMA EXEC
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R1,900 Arthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral Contraceptives  
  *Emergency Trauma at Out Patients  
  Annual Sub-limits per person:  
  Psychiatric Treatment R 25,900
  Hospice Care R 25,000
  Oncology Unlimited
  Specialised Medication R140,185
  Benefit  
  Internal Prosthesis:  
  See detailed benefits  
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 26 Chronic Disease  
  Conditions  
  Annual limit:  
  Single R 5,760  
  Per Family R 10,700  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 7,446  
  Member + Spouse R 13,448  
  Member + Spouse + Child 1 R 14,855  
  Member + Spouse + Child 2 R 16,262  
  Member + Spouse + Child 3 R 17,669  
  Member + Child 1 R 8,853  
       
  Unlimited Network GP benefit    
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,990  
  Spouse/Adult dependant R 6,870  
  Per Child (Max 3) R 2,320  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,803  
  Spouse/Adult dependant R 2,388  
  Per Child R 836  
               
     
     
     
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric benefit 21 days  
  Hospice care R 40,000  
  Oncology: R400, thereafter 20%  
   20% co-payment  
  Specialised Medicine &  R200,000  
    Technology Benefit        
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  (Add. 23 Chronic Disease Conditions)  
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 9,084  
  Member+Spouse R 17,676  
  Member+Spouse+Child1 R 19,476  
  Member+Spouse+Child2 R 21,276  
  Member+Spouse+Child3 R 23,076  
  Member+Child 1 R 10,884  
       
   Insured Network Benefit  
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 11,350  
  Spouse/Adult independant R 11,350  
  Per Child (Max 3) R 2,150  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,028  
  Spouse/Adult dependant R 2,864  
  Per Child (Max 3) R 602  
               
       
       
       
 
  IN HOSPITAL BENEFIT  
     
     
     
     
     
     
       
       
       
       
       
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
     
     
     
     
     
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
     
       
       
       
       
       
       
       
     
     
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
       
       
       
     
  MONTHLY CONTRIBUTIONS  
       
       
       
       
       
       
       

 

As additional Comprehensive Medical Aid Plans are made available we will continue to update this page in our effort to provide our clients with the most up to date information and advice on the medical aid industry in South Africa. If you are still deciding which plan type is best suited to your situation, why not take a look at the Medical Aid Plans page to see the full range of plans.

For more detailed information on any of the above plans, just click on the name of the relevant hospital plan in the tables above. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 0866 200 320 . Alternatively, if you would like us to confirm some of the finer details and pricing just fill in our Medical Aid Quote Request form and we will get back to you promptly.

Finally, we invite you to contact us on +27 21 712-8866 at any point in your decision making process for further information on these Comprhensive Medical Aid Plans.