Hospital Plans with Limited Day to Day Cover - 2018

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
Fedhealth Maxima Saver
Resolution Progressive Flex Momentum Incentive Opt 2
Medshield MediPlus
Fedhealth 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 5 100  
  Member + 1 R 5 555  
  Member + 2 R 6 255  
  Member + 3 R 7 270  
  Member + 4+ R 8 055  
       
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
       
  does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Member R 1,680  
  Spouse/Adult dependant R 1,464  
  Per Child (Max 3) R 459  
     
     
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 R34,400  
  Hospice Care (including     R46,400  
   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 9,300 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 2,196  
  Member+Spouse R 3,924  
  Member+Spouse+Child1 R 4,776  
  Member+Spouse+Child2 R 5,628  
  Member+Spouse+Child3 R 6,480  
  Member+Child 1 R 3,048  
  Member+Child 2 R 3,900  
  Member+Child 3 R 4,752  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,834  
  Spouse/Adult dependant R 1,439  
  Per Child (Max 3) R 711  
       
       
BONITAS
PRIMARY
  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 157,600  
   Psychiatric Treatment R15,080  
   Hospice Care R15,760  
       
       
       
       
               
               
               
               
               
               
               
  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)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 2,010  
  Member + 1 R 3,600  
  Member + 2 R 4,230  
  Member + 3 R 4,550  
  Member + 4 + R 4,920  
    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 R1,210 Wellness  
  Extender Benefit for GP, Physiotherapy  
  Biokineticist, Dietician visits  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,076  
  Spouse/Adult dependant R 1,624  
  Per Child R 661  
               
               
 
 FEDHEALTH
MAXIMA SAVER
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments are due for certain  
  procedures(eg: R6,900 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 22,600
  Hospice Care R 29,500
  Oncology (only at DSP) R264,500
     
     
  Internal Prosthesis: PMB
     
     
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite , Dischem, Clicks &  
  Pharmacy Direct  
       
       
       
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 4,068  
  Member + Spouse R 7,464  
  Member + Spouse + Child 1 R 8,652  
  Member + Spouse + Child 2 R 9,840  
  Member + Spouse + Child 3 R 11,028  
  Member + Child 1 R 5,256  
  Member + Child 2 R 6,444  
  Member + Child 3 R 7,632  
       
   Unlimited Network GP benefit    
       
       
       
  ANNUAL THRESHOLD BENEFIT  
              Does not Apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,259  
  Spouse/Adult dependant R 1,887  
  Per Child R 657  
       
RESOLUTION HEALTH
PROGRESSIVE FLEX
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used,  
  otherwise R4,110 co-payment  
  Co-payments are due for certain  
  procedures (eg. R3,957 Arthroscopy)  
     
  *7 day take home medication  
  Emergency Casualty Annual
 
  Limit: R1,680 per family  
     
  Annual Sub-limts per person:  
  Psychiatric Treatment PMB  
  Hospice Care 12 Days  
  Oncology (subject to ICON R275,941  
   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 R3,287  
   Dentistry Family R5,284  
         
         
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R2,365  
   Spouse/Adult dependant  R2,190  
   Per Child (max 3) R 725  
       
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 R34,400  
   Hospice Care (including R46,400  
    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, 300 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 3,288  
  Member+Spouse R 5,928  
  Member+Spouse+Child1 R 7,152  
  Member+Spouse+Child2 R 8,376  
  Member+Spouse+Child3 R 9,600  
  Member+Child 1 R 4,512  
  Member+Child 2 R 5,736  
  Member+Child 3 R 6,960  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,737  
  Spouse/Adult dependant R 2,202  
  Per Child (Max 3) R 1,022  
       
 
 
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           R27,560  
   (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: R5,710  
  Family                                R11,420  
     
               
   
 
 
  100% Scheme Rate  
   Limits per Annum  
   Member R7,155  
   Member + 1 R9,985  
   Member + 2 R11,235  
   Member + 3 R12,625  
   Member + 4+ R13,830  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
     
       
       
  does not apply   
     
     
   Member R2,817  
   Spouse/Adult dependant R2,004  
   Per Child (Max 3)                     R618  
     
FEDHEALTH
MAXIMA BASIS
  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) R264,500  
  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)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 4,896  
  Member +Spouse R 9,168  
  Member +Spouse +Child 1 R 10,656  
  Member +Spouse +Child 2 R 12,144  
  Member +Spouse +Child 3 R 13,632  
  Member +Child 1 R 6,384  
  Member +Child 2 R 7,872  
  Member +Child 3 R 9,360  
       
  Unlimied GP Network    
   benefit    
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
             Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,722  
  Spouse/Adult dependant R 2,374  
  Per Child R 826  
       
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 R1,700 single member  
  R2 300 per family per annum  
  Annual Sub-limits per person:  
  Psychiatric Treatment R35,600  
    (per family)    
  Hospice Care Unlimited  
  Oncology (PMB) Unlimited  
  Oncology (non PMB) R150,000  
       
       
       
   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 8,600  
  Member + 1 R 13,700  
  Member + 2 R 16,000  
  Member + 3 + R 17, 000  
       
    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 2,940  
  Spouse/Adult dependant R 2,490  
  Per Child (Max 2) R 858  
       
 
 BONITAS
STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *R445 Take home medicine   
     
     
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R 38,670
  Hospice Care R 15,760
  Oncology R 328,100
     
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 18 Chronic Disease  
  Conditions  
  Annual limit:  
  Single R 9,150  
  Per Family R 18,360  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Day to Day benefits
 
  Member R 5,232  
  Member + 1 R 7,970  
  Member + 2 R 9,214  
  Member + 3 R 10,062  
  Member + 4 + R 10,966  
       
  Network GP limit
 
  Member R 3,750  
  Member + 1 R 5,500  
  Member + 2 R 6,100  
  Member + 3 R 6,400  
  Member + 4 + R 6,950  
       
  Once Annual Day to Day Benefit is   
   exhausted, there is R1,670 Wellness  
  Extender Benefit for GP, Physiotherapy  
   Biokineticist, Dietician visits  
     
     
       
       
       
     
       
       
  ANNUAL THRESHOLD BENEFIT  
   Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,265  
  Spouse/Adult dependant R 2,831  
  Per Child R 958  
       
               
               
               
               
               
               
               
               
               
               
               
               
               
               

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.