Hospital Plans with Limited Day to Day Cover - 2019

These hospital plans include Hospital Cover as well as a limited amount for day-to-day cover e.g. consultations and medicines.  This can be in the form of a medical savings account and / or a traditional benefit, which will give specific annual limits per provider type i.e. doctors and dentistry. This type of benefit does however not carry forward from year to year like savings does.  Any unused benefit falls away at the end of each year.

 
 

Plans:
Medshield Medivalue Momentum Incentive Opt 1 Bonitas Primary
FlexiFed 2 ANY
(replaces Maxima Saver)
Flex (Old Resolution Progressive Flex Plan) Momentum Incentive Opt 2
Medshield MediPlus
FlexiFed 3 ANY
(replaces Maxima Basis)
MediHelp Dimension Prime 3
Bonitas Standard
   
 
MEDSHIELD
MEDIVALUE
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Co-payments apply for certain  
  procedures (e.g 40% for the use of a  
  non-DSP)  
  Take home medicine limited to  
  R400 per admission   
  Annual Sub-limits per family:  
     
  Psychiatric treatment          PMB  
   (per family)  
  Hospice Care (per person):   R28,000  
     
  Oncology                          Unlimited  
     
       
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% of Cost  
  27 PMB Chronic Disease Conditions  
  subject to scheme formulary  
   Only from Medshield Pharmacy  
   Network  
     
     
  ANNUAL DAY TO DAY BENEFIT (including savings)  
  100% Scheme Rate  
   Limits per Annum  
  Member R 5 380  
  Member + 1 R 5 860  
  Member + 2 R 6 600  
  Member + 3 R 7 670  
  Member + 4+ R 8 500  
       
       
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Member R 1,932  
  Spouse/Adult dependant R 1,689  
  Per Child (Max 3) R 540  
     
MOMENTUM INCENTIVE 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 R36,100  
  Hospice Care (including     R51,000  
   rehab & step-down    
    facilities)    
       
       
  Oncology R400,000    
    thereafter 20% co-pay    
  Internal Prostheses:    
      see detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  6 additional conditions limited to  
  R 9,800 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 2,412  
  Member+Spouse R 4,308  
  Member+Spouse+Child1 R 5,232  
  Member+Spouse+Child2 R 6,156  
  Member+Spouse+Child3 R 7,080  
  Member+Child 1 R 3,336  
  Member+Child 2 R 4,260  
  Member+Child 3 R 5,184  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,006  
  Spouse/Adult dependant R 1,583  
  Per Child (Max 3) R 769  
       
BONITAS
PRIMARY
  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 165,500  
   Psychiatric Treatment R15,830  
   Hospice Care R16,550  
       
       
       
               
               
               
               
               
               
               
  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)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 2,310  
  Member + 1 R 4,140  
  Member + 2 R 4,860  
  Member + 3 R 5,230  
  Member + 4 + R 5,660  
    Network GP Limit:  
  Member R 1,900  
  Member + 1 R 3,490  
  Member + 2 R4,130  
  Member + 3 R4,440  
  Member + 4 + R5,030  
     
  Once Annual Day to Day Benefit is  
  exhausted, there is R1,270 Wellness  
  Extender Benefit for GP, Physiotherapy  
  Biokineticist, Dietician visits  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,240  
  Spouse/Adult dependant R 1,752  
  Per Child R 713  
               
 
FEDHEALTH
FLEXIFED 2 ANY (replaced FedHealth Maxima Saver)
  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 23,700  
  Hospice care R 31,000  
  Oncology (only at DSP) R 277,900  
  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)  
   100% Scheme Rate  
     
   Member              R300  
   Spouse               R252  
   Per Child            R84  
     
  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             R4,200  
  Member + 1       R7,800  
  Member + 2       R9,000  
  Member + 2 +    R10,800  
       
  ANNUAL THRESHOLD BENEFIT  
  Member             R4,200  
  Member + 1       R7,800  
  Member + 2       R9,000  
  Member + 2 +    R10,800  
     
  MONTHLY CONTRIBUTIONS  
  Member R 2,086  
  Spouse/Adult dependant R 1,768  
  Per Child (Max 3) R 615  
       
HEALTH SQUARED
FLEX (Old Resolution Progressive Flex Plan)
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used,  
  otherwise 30% co-payment  
  Co-payments are due for certain  
  procedures (eg. R4,000 Arthroscopy)  
     
  *7 day take home medication  
  Emergency Casualty Annual
 
  Limit: R1,765per family  
     
  Annual Sub-limts per person:  
  Psychiatric Treatment PMB  
  Hospice Care 12 Days  
  Oncology (subject to ICON R289,738  
   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)
 
  100% Scheme Rate  
  GP's: Member 4 visits  
    Member + 1 7 visits  
    Family 9 visits  
  Specialists: Member 2 visits  
    Member + 1 3 visits  
    Family 3 visits  
  Conservative Member R3,451  
   Dentistry Family R5,548  
         
         
     
     
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R2,689  
   Spouse/Adult dependant  R2,490  
   Per Child (max 3) R 824  
               
MOMENTUM INCENTIVE 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 R36,100  
   Hospice Care (including R51,400  
    rehab & step-down    
     facilities)    
       
   Oncology R400,000    
    thereafter 20% co-pay    
  Internal Prostheses:    
    see detailed benefits    
               
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 Chronic Disease Conditions  
  Subject to scheme formulary  
  6 additional conditions limited to  
  R 9,800 per family  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 3,612  
  Member+Spouse R 6,516  
  Member+Spouse+Child1 R 7,872  
  Member+Spouse+Child2 R 9,228  
  Member+Spouse+Child3 R 10,584  
  Member+Child 1 R 4,968  
  Member+Child 2 R 6,324  
  Member+Child 3 R 7,680  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,012  
  Spouse/Adult dependant R 2,423  
  Per Child (Max 3) R 1,126  
       
 
 
MEDSHIELD 
  MEDIPLUS
  IN HOSPITAL BENEFIT   
  100% Scheme Rate  
  No Overall Annual Limit  
  Network Hospitals to be used  
  Co-payments apply for certain  
  procedures (e.g 40% for the use of a   
   non-DSP )  
   Take home medicine limited to  
    R500 per admission  
   Annual Sub-limits per family:  
     
   Psychiatric treatment           R28,000  
   (per family)  
   Hospice Care R57,000  
   (per person)    
   Oncology R230,000  
       
       
     
  100% of Cost  
  27 PMB Chronic Disease Conditions  
  subject to scheme formulary  
   Only from Medshield Pharmacy Netw  
     
   Additional Diseas List Annual Limit  
  Single: R6,025  
  Family                                R12,050  
               
   
 
 
  100% Scheme Rate  
   Limits per Annum  
   Member R7,550  
   Member + 1 R10,530  
   Member + 2 R11,850  
   Member + 3 R13,320  
   Member + 4+ R14,590  
       
       
       
       
       
       
       
       
       
       
       
       
       
     
       
       
  Does not apply   
     
     
     
   Member R3,240  
   Spouse/Adult dependant R2,313  
   Per Child (Max 3)                     R726  
FEDHEALTH
FLEXIFED 3 ANY (replaced FedHealth Maxima Basis)
  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  
MEDIHELP
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments on specific procedures  
  may apply  
  *30 days Post Hospital Cover  
  limited to R1,750 single member  
  R2 400 per family per annum  
  Annual Sub-limits per person:  
  Psychiatric Treatment R37,300  
    (per family)    
  Hospice Care Unlimited  
  Oncology (PMB) Unlimited  
  Oncology (non PMB) R250,000  
       
   Internal Prosthesis:    
    See detailed benefits    
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
  Only from DSP  
               
               
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  GP's  
  Member R 9,000  
  Member + 1 R 14,300  
  Member + 2 R 16,800  
  Member + 3 + R 17,800  
       
    Specialists  
  Shared limit with GP Consultations  
     
  Conservative Dentistry  
  - 2 Consultations, 2 scale and polish  
      per person per annum  
  - 1 filling per tooth in 365 days  
  - 1 set plastic dentures per family  
      every 4 years  
  - 1 Extra oral xray per person every  
     three years  
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
       
       
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,234  
  Spouse/Adult dependant R 2,736  
  Per Child (Max 2) R 942  
 
 BONITAS
STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *R465 Take home medicine   
     
     
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R 40,600
  Hospice Care R 16,550
  Oncology R 344,500
     
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 18 Chronic Disease  
  Conditions  
  Annual limit:  
  Single R 9,610  
  Per Family R 19,280  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Day to Day benefits
 
  Member R 5,820  
  Member + 1 R 8,850  
  Member + 2 R 10,240  
  Member + 3 R 11,180  
  Member + 4 + R 12,180  
       
  Network GP limit
 
  Member R 4,170  
  Member + 1 R 6,110  
  Member + 2 R 6,770  
  Member + 3 R 7,110  
  Member + 4 + R 7,720  
       
  Once Annual Day to Day Benefit is   
   exhausted, there is R1,750 Wellness  
  Extender Benefit for GP, Physiotherapy  
   Biokineticist, Dietician visits  
     
     
       
       
       
     
       
       
  ANNUAL THRESHOLD BENEFIT  
   Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,556  
  Spouse/Adult dependant R 3,083  
  Per Child R 1,043  
               
               
               
               
               
               
               
               
               
               
               
               
               
               

As additional Hospital Plans with limited day to day cover 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 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 Hospital Plans with limited day to day cover.