A Comparison of Comprehensive Medical Aid Plans 2019

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:
FedHealth FlexiFed 4
Discovery Classic Priority FedHealth Maxima Exec
Discovery Delta Comprehensive
Discovery Classic Comprehensive





 
 
 FEDHEALTH
FLEXIFED 4 ANY (replaced FedHealth Maxima Standard)
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R2,400 Anthroscopy )  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
       
  Psychiatric Treatment R 25,100  
  Hospice care R 31,000  
  Oncology (only at DSP) R 444,700  
  Internal Prosthesis: R 25,000  
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  43 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
           Pharmacy Direct    
       
       
       
               
  ANNUAL DAY TO DAY BENEFIT (including savings)  
   100% Scheme Rate  
     
   Member              R300  
   Spouse               R264  
   Per Child            R96  
     
  MediVault Savings amounts are not   
   pro-rated and can be transferred  
  back to your wallet at any time and  
  paid back interest free over a period  
  of 12 months  
     
  Member             R7,600  
  Member + 1       R14,100  
  Member + 2       R16,200  
  Member + 2 +    R19,500  
       
  ANNUAL THRESHOLD BENEFIT  
  Member             R13,650  
  Member + 1       R24,150  
  Member + 2       R27,660  
  Member + 2 +    R31,500  
     
  MONTHLY CONTRIBUTIONS  
  Member R 2,294  
  Spouse/Adult dependant R 2,018  
  Per Child (Max 3) R 818  
     
     
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  Oncology R200,000 thereafter 20%  
   co-payment  
     
     
  Internal Prostheses: See detailed  
   benefit schedule  
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
    Limits per annum:  
  Member R 10,500  
  Member + Spouse R 18,780  
  Member + Spouse + Child1 R 22,980  
  Member+Spouse+Child2 R 27,180  
  Member+Spouse+Child3 R 31,380  
  Member+Child 1 R 14,700  
  Member+Child 2 R 18,900  
  Member+Child 3 R 23,100  
     
   Day-to-Day Extender Benefit  
     
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 15,510  
  Spouse/Adult independant R 11,620  
  Per Child (Max 3) R 5,080  
       
       
  MONTHLY CONTRIBUTIONS  
              
  Principal Member R 3,501  
  Spouse /Adult dependant R 2,761  
  Per Child (Max 3) R1,401  
       
 FEDHEALTH
MAXIMA EXEC
     
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R2,400 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 32,000
  Hospice Care R 31,000
  Oncology R555,900
  Specialised Medication R173,400
  Benefit  
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  51 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
           Pharmacy Direct  
  Add. Disease List Annual limit:  
  Single R 7,100  
  Per Family R 13,100  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R8,040  
  Member + Spouse R15,000  
  Member + Spouse + Child 1 R17,508  
  Member + Spouse + Child 2 R20,016  
  Member + Spouse + Child 3 R22,524  
  Member + Child 1 R10,548  
  Member + Child 2 R13,056  
  Member + Child 3 R15,564  
       
   Unlimited Network GP benefit    
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Member R 13,651  
  Mem+Spouse/Adtdependant R 10,482  
  Per Child (Max 3) R 3,511  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 5,336  
  Spouse/Adult dependant R 4,625  
  Per Child (Max  3) R 1,666  
     
     
.
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
   Network Hospitals to be used  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  Oncology R400,000 thereafter 20%  
    co-payment  
   Specialised Medicine & Technology      
    benefit: R200,000  
   Internal Prostheses: See detailed  
    benefit schedule  
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from MedXpress  
   (Add. 23 Chronic Disease Conditions)  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% scheme rate  
    Limits per annum:  
  Member R14,496  
  Member + Spouse R28,224  
  Member + Spouse + Child1 R31,104  
  Member+Spouse+Child2 R33,984  
  Member+Spouse+Child3 R36,864  
  Member+Child 1 R17,376  
  Member+Child 2 R20,256  
  Member+Child 3 R23,136  
       
  Day-to-Day Extender Benefit    
     
  ANNUAL THRESHOLD BENEFIT  
  Principal Member  R 18,800  
  Spouse/Adult independant R 18,800  
  Per Child (Max 3) R 3,600  
       
       
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 4,834  
  Spouse /Adult dependant R 4,577  
  Per Child (Max 3) R 962  
       
       
       
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 62,200  
  Oncology R400,000 thereafter 20%  
   co-payment    
   Specialised Medicine & Technology       
    benefit R200,000  
   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  R16,140  
   Member+Spouse  R31,332  
   Member+Spouse+Child1  R34,536  
   Member+Spouse+Child2  R37,740  
   Member+Spouse+Child3  R40,944  
   Member+Child1  R19,308  
   Member+Child2  R22,512  
   Member+Child3  R25,716  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
     
 
Principal Member                 R18,800
 
  Spouse /Adult dependant     R18,800  
  Per Child (Max 3)                R3,600  
     
  MONTHLY CONTRIBUTIONS  
     
  Principal Member R 5,368  
  Spouse /Adult R 5,077  
  dependant    
  Per Child (Max 3) R 1,070  
       
       
 
 
     

 
     

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.