A Comparison of Hospital Plans - 2018

A Hospital Plan will cover all the services provided in a hospital including the anesthetist and surgeon. You would have to be admitted to a hospital, out patients and trauma units are generally not considered a hospital event if you are not admitted.

The anesthetist and surgeon charge separately and have the choice of charging anywhere between NRPL (National Reference Price List) and Private Rates, which are generally three times higher than the NRPL Rate. Some plans pay at NRPL Rate and some at Private Rates. Hospitals normally have an agreed tariff with the medical aids and if this is the case, the hospital and related bills will be paid in full.

 
Hospital
Plans:
Discovery Essential Smart Plan
Momentum Custom Option 1
Discovery Essential Delta Core
FedHealth Entryzone
Discovery Keycare Core
Bonitas Bon Essential
Discovery Coastal Core
Discovery Classic Smart Plan
Resolution Health Hospital
Medihelp Dimension Prime 1
Discovery Essential Core
Momentum Custom Option 2
Fedhealth Maxima Core Discovery Classic Core
 
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 57,000  
  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  
  Only from MedXpress,Clicks or Dischem  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Unlimited GP Benefit with  
  R100 co-payment for face-to-face  
     consultations  
     
     Video call consultations paid in full  
     
   1 Dental check up with a R150  
    co-payment  
   1 eye test with R100    
    co-payment    
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,180  
  Spouse/Adult dependant R 1,180  
  Per Child (Max 3) R 1,180  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1,300 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R33,900  
  Hospice Care (including R46,400  
   rehab & step-down    
    facilities)    
       
       
  Oncology R300,000    
   thereafter 20% co-pay    
  Internal Prostheses:    
    see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
   Only from state hospitals  
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply   
       
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,366  
  Spouse/Adult dependant R 1,033  
  Per Child (Max 3) R 484  
               
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 57,000  
  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  
   Only from MedXpress  
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
               
               
               
               
               
               
               
               
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,417  
  Spouse/Adult dependant R 1,065  
  Per Child (Max 3) R 569  
       
.
FEDHEALTH
ENTRYZONE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used  
  R6,100 co-payment on voluntary  
  non-network admissions  
  Co-payments are due for  
  certain procedures  
  (eg. R7,500 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment & Ocology PMB  
  Hospice Care - R29,500  
  Internal Prosthesis - PMB  
     
               
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
          Pharmacy Direct    
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
GP and Specialist benefit subject
 
       to PMB and pre-authorisation  
       only at contracted providers  
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
                  Does not apply    
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,424  
  Spouse/Adult dependant R 1,088  
  Per Child R 482  
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Full Cover Network Hosp to be used  
  Certain procedures only covered at  
  Network Day Clinics  
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 40,450  
  Oncology PMB  
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from DSP   
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not Apply  
       
    Specialist benefit limited to R3,860  
    per person per annum. Must be  
     referred by GP    
     
     
       
       
       
       
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:                R0 - R8,550  
  Principal Member R 792  
  Spouse /Adult R 792  
   dependant    
  Per Child (Max 3) R 205  
     
  Income p/m:        R8,551 - R12,200  
  Principal Member R 988  
  Spouse /Adult R 988  
  dependant    
  Per Child (Max 3) R 243  
       
  Income p/m:                    R12,201+  
  Principal Member R 1,525  
  Spouse /Adult R 1,525  
  dependant    
  Per Child (Max 3) R 345  
     
BONITAS
BONESSENTIAL
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  *R360 Take Home Medicine  
  Annual Sub-limits:  
  Oncology R 328,100  
  Psychiatric Treatment R 30,680  
  Hospice Care R 15,760  
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary,  
  only from Pharmacy Direct  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 

 
  Does not apply except for  
       
    6 Antenatal consultations  
    4 postnatal consultations,  
    with Midwife, 2 scans,  
    1 amniocentesis.  
       
    R860 Wellness Extender Benefit per  
    family for GP, Physiotherapy,  
    Biokineticist, Dietician visits  
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,604  
  Spouse/Adult dependant R 1,227  
  Per Child R 470  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
.
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 57,000  
  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  
   Only from MedXpress  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,610  
  Spouse/Adult dependant R 1,209  
  Per Child (Max 3) R 641  
       
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 57,000  
  Oncology R200 000 thereafter 20%  
   co-payment    
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
               
               
               
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from MedXpress,Clicks or Dischem  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Unlimited GP Benefit with  
  R50 co-payment for face-to-face  
       consultations    
       
  Video call consultations paid in full   
     
  Prescribed medication limited to:  
  12 prescriptions p/person per annum  
   with a R10 co-payment per item  
     
  2 Specialist Consultations for sports  
   related injuries only with a R100  
   co-payment  
       
    1 Dental check up with a R100   
     co-payment    
       
    1 eye test with R50  
     co-payment    
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,647  
  Spouse/Adult dependant R 1,298  
  Per Child (Max 3) R 658  
       
RESOLUTION HEALTH
HOSPITAL PLAN
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (e.g. R3,957 Arthroscopy)  
     
  *7 days Take Home Medicine  
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment PMB  
  Hospice Care 10 days  
  Oncology (subject to ICON R180,081  
   network & scheme    
   protocols    
   Internal Prosthesis    
    (see detailed benefits)    
       
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
  Does not apply  
     
  2 GP consultation per family per annum  
  with a R150 co-payment  
     
   Specialist consultations  
    subject to PMB and    
    pre-authorisation only at    
    contracted providers    
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1 720  
  Spouse/Adult dependant R 1 450  
  Per Child (max 3) R 640  
       
 
MEDIHELP
DIMENSION PRIME 1
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments on specified  
  procedures may apply  
     
  *30 days Post Hospital Cover  
  limited to R1,700 single member  
  and R2,300 per family per annum  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R26,500  
   (per family)    
  Hospice Care Unlimited  
  Oncology (PMB) Unlimited  
  Oncology (non PMB) R80,000  
  Internal Prosthesis:    
   See detailed benefits    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
            Only from DSP    
       
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
  Does not Apply  
   GP's:  
   Single:  R1,100  
   Family:  R2,200  
     
     
       
   Conservative Dentistry: removal of  
   impacted wisdom teeth only  
       
   Specialists: Shared limit with  
    GP consultatants    
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,728  
  Spouse/Adult dependant R 1,422  
  Per Child (max 2) R 522  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 57,000  
  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  
   Only from MedXpress  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
     
     
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,773  
  Spouse/Adult dependant R 1,329  
  Per Child (Max 3) R 712  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R1,300 co-payment except for  
  Emergencies, MVA's and maternity  
  Associated Hospitals to be used  
  (Life and Mediclinics)  
  Annual Sub-limits :
 
     
  Psychiatric Treament R33,900  
  Hospice Care (including R46,400  
   rehab & step-down    
    facilities)    
       
       
  Oncology R300,000    
   thereafter 20% co-pay    
  Internal Prostheses:    
     see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  Does not apply   
       
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,885  
  Spouse/Adult dependant R 1,487  
  Per Child (Max 3) R 665  
       
.d
FEDHEALTH
MAXIMA CORE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R6,900 Anthroscopy )  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  Oral Contraceptives  
  *Emergency Trauma at Out Patients  
       
  Psychiatric Treatment R 23,900  
  Hospice care R 29,500  
  Oncology (only at DSP) R 264,500  
  Internal Prosthesis:    
  See detailed benefits    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite,Clicks, Dischem &  
           Pharmacy Direct    
       
               
  ANNUAL DAY TO DAY BENEFIT (including savings)  
  GP and Specialist benefit subject  
  to PMB and pre-authorisation  
  only at contracted providers  
     
       
  ANNUAL THRESHOLD BENEFIT  
                 Does not apply    
       
     
  MONTHLY CONTRIBUTIONS  
  Member R 2,082  
  Spouse/Adult dependant R 1,806  
  Per Child R 732  
       
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment 21 days  
  Hospice Care R 57,000  
  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  
  Only from MedXpres  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
     
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,064  
  Spouse /Adult R 1,626  
  dependant    
  Per Child (Max 3) R 826  
 
     
     
     
     
     
       
       
     
       
       
     
               
               
               
               
               
               
               
     
     
     
     
     
               
               
   
 
 
     
     
       
       
       
     
     
       
       
     
       
       
       
       
 

As additional standard Hospital Plans become 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 or 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 Hospital Plans.