A Comparison of Hospital Plans - 2019

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
Bonitas Bon Essential
FedHealth MyFed
Discovery Keycare Core
Discovery Coastal Core
Discovery Essential Core
Discovery Classic Smart Plan
Health Squared Aspire
Medihelp Dimension Prime 1
Discovery Classic Core
Momentum Custom Option 2
Fedhealth FlexiFed 3 Any
Fedhealth FlexiFed 4 Any
 
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 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
  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 1,285  
  Spouse/Adult dependant R 1,285  
  Per Child (Max 3) R 1,285  
       
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 R48,700  
   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 1,515  
  Spouse/Adult dependant R 1,146  
  Per Child (Max 3) R 537  
       
BONITAS
BONESSENTIAL
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  *R380 Take Home Medicine  
  Annual Sub-limits:  
  Oncology R 344,500  
  Psychiatric Treatment R 32,210  
  Hospice Care Unlimited  
       
       
       
       
       
       
       
       
               
               
  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.  
       
    R910 Wellness Extender Benefit per  
    family for GP, Physiotherapy,  
    Biokineticist, Dietician visits  
       
       
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,731  
  Spouse/Adult dependant R 1,324  
  Per Child R 507  
       
.
FEDHEALTH
MYFED (replaced FedHealth Entryzone)
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used  
  R11,500 co-payment on voluntary  
  non-network admissions  
     
     
   *Oral Contraceptives  
  *7 days Take Home Medicine  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment - R8,800  
  Hospice Care - n/a  
  Internal Prosthesis - PMB  
  Oncology (only at DSP) -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)
 
 
 100% Scheme Rate
 
     
   GP's: No Limit from Network  
    Providers (2 out-of Network visits  
     
   Specialists: 2 Visits limited to R1 750  
     per person from Network Providers  
     (must be referred by Network GP)  
     
   Conservative Dentistry:  
    Only from a Network Provider  
    (Fillings, extractions, consultations)  
     Plastic dentures limited to 1 set per  
     person every 2 years.    
       
       
  ANNUAL THRESHOLD BENEFIT  
   Does not Apply    
     
     
  MONTHLY CONTRIBUTIONS  
  Income p/m   R1 - R5,953    
  Principal Member R 916  
  Spouse/Adult dependant R 784  
  Per Child (Max 3) R 440  
       
  Income pm  R5954 - R9732
   
  Principal Member R1,161  
  Spouse/Adult dependant R 989  
  Per Child (Max 3) R 567  
       
  Income pm  R9733-R12021
   
  Principal Member R1627  
  Spouse/Adult dependant R1393  
  Per Child (Max 3) R624  
       
  Income pm R12022-13739
   
  Principal Member R2,068  
  Spouse/Adult dependant R1,672  
  Per Child (Max 3) R808  
       
  Income pm R13740 +
   
  Principal Member R2,804  
  Spouse/Adult dependant R2,506  
  Per Child (Max 3) R1,068  
       
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 44,050  
  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 R4,050  
    per person per annum. Must be  
     referred by GP    
     
     
       
       
       
       
       
       
       
       
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m:         R0 - R8,500  
   Principal Member R 871  
  Spouse /Adult R 871  
  dependant R225  
  Per Child (Max 3)    
       
  Income p/m: 
R8,551 - R13,050  
  Principal Member R 1,086  
  Spouse /Adult R 1,086  
   dependant    
  Per Child (Max 3) R 268  
     
  Income p/m:               R13,051 +  
  Principal Member R 1,661  
  Spouse /Adult R 1,661  
  dependant    
  Per Child (Max 3) R 376  
       
       
       
       
       
       
       
       
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 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  
   Only from MedXpress  
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,770  
  Spouse/Adult dependant R 1,330  
  Per Child (Max 3) R 704  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
.
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  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  
   Only from MedXpress  
               
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  No Benefit  
       
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,931  
  Spouse/Adult dependant R 1,448  
  Per Child (Max 3) R 776  
       
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 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 1,794  
  Spouse/Adult dependant R 1,415  
  Per Child (Max 3) R 717  
       
HEALTH SQUARED
ASPIRE (Old Resolution HOSPITAL PLAN)
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (e.g. R4,000 Arthroscopy)  
     
  *7 days Take Home Medicine  
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment PMB  
  Hospice Care 10 days  
  Oncology (subject to ICON R189,085  
   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 1 873  
  Spouse/Adult dependant R 1 579  
  Per Child (max 3) R 697  
               
 
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 R1,750 single member  
  and R2,400 per family per annum  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R27,800  
   (per family)    
  Hospice Care Unlimited  
  Oncology (PMB) Unlimited  
  Oncology (non PMB) R200,000  
  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:  R1,150  
   Family:  R2,300  
     
     
       
   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 1,902  
  Spouse/Adult dependant R 1,566  
  Per Child (max 2) R 576  
       
DISCOVERY HEALTH
  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 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 2,248  
  Spouse /Adult dependant R 1,772  
  Per Child (Max 3) R 900  
       
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 R48,700  
   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 2,113  
  Spouse/Adult dependant R 1,667  
  Per Child (Max 3) R 745  
       
.d
FEDHEALTH
FLEXIFED 3 ANY (replaced FedHealth Maxima Core)
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures  
  (e.g R7,800 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 277,900  
  Internal Prosthesis: R 25,000  
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  30 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               R364  
   Per Child            R108  
     
  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             R5,100  
  Member + 1       R9,600  
  Member + 2       R11,100  
  Member + 2 +    R13,200  
       
  ANNUAL THRESHOLD BENEFIT  
  Member             R5,100  
  Member + 1       R9,600  
  Member + 2       R11,100  
  Member + 2 +    R13,200  
     
  MONTHLY CONTRIBUTIONS  
  Member R 2,294  
  Spouse/Adult dependant R 2,018  
  Per Child (Max 3) R 818  
       
 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  
       
 
 

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.