Hospital Plans with Limited Day to Day Cover - 2012

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:
Spectramed Cyan Bonitas Primary Momentum Incentive Opt 1
Momentum Access Network Resolution Progressive Flex Momentum Incentive Opt 2
FedHealth Maxima Basis Bonitas Standard Discovery Classic Priority
     
 
SPECTRAMED
SPECTRA CYAN
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  Member R1,000,000  
  Member + 1 R1,250,000  
  Member + 2 R1,400,000  
  Member + 3 R1,500,000  
  Member + 4 + R1,600,000  
  * 3 days Take Home Medicine  
  * Co-payments apply for certain  
  procedures  
  Annual Sub-limits:  
  Psychiatric Treatment R6,000  
   (subject to PMB)    
  Hospice care n/a  
  Oncology R100,000  
       
       
       
       
       
       
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from Mediscor  
  Subject to scheme formulary.  
  (Add. 3 Chronic Disease Conditions)   
       
       
  ANNUAL DAY TO DAY BENEFIT  
  (including savings)  
  100% Scheme Rate  
  Income p/m              R0 - R10,500     
  Member R1,956  
  Member+Spouse R3,816  
  Member+Spouse+Child 1 R4,596  
  Member+Spouse+Child 2 R5,376  
  Member+Spouse+Child 3 R6,156  
  Member+Child 1 R2,736  
       
  Income p/m  R10,501+   
  Member R2,748  
  Member+Spouse R5,352  
  Member+Spouse+Child 1 R6,456  
  Member+Spouse+Child 2 R7,560  
  Member+Spouse+Child 3 R8,664  
  Member+Child 1 R3,852  
       
       
       
       
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m R0 - R10,500  
  Principal Member R 1,084  
  Spouse/Adult dependant R 1,032  
  Per Child R 433  
       
  Income p/m R10,501 +  
  Principal Member R 1,524  
  Spouse/Adult dependant R 1,448  
  Per Child R 611  
     
     
     
     
BONITAS
PRIMARY
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  R1,000,000 per family per annum  
  Co-payments apply for certain  
  procedures  
  Annual Sub-limits:  
  Oncology R 115,000  
  Physical Rehabilitation R 34,000  
  (per family)    
  Take home medicine R 250  
  (per admission)    
       
       
       
               
               
               
               
               
               
               
               
               
               
  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 1,400  
  Member + 1 R 2,600  
  Member + 2 R 3,000  
  Member + 3 R 3,300  
  Member + 4 + R 3,600  
    Network GP Limit:  
  Member R 1,400  
  Member + 1 R 2,700  
  Member + 2 R3, 100  
  Member + 3 R3, 400  
  Member + 4 + R3, 800  
  Plus basic Dentistry  
  and Optometry  
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,159  
  Spouse/Adult dependant R 907  
  Per Child R 369  
       
       
       
       
       
       
       
       
       
       
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  
     
  Surgical Appliances R4,250  
  (eg. support stockings)    
  Mental Health R 24,300  
  Rehabilitation, Private R 35, 500  
  nursing, Hospice and    
  step-down facilities    
  Oncology R365,000  
   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 6,600 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 1,416  
  Member+Spouse R 2,520  
  Member+Spouse+Child1 R 3,072  
  Member+Spouse+Child2 R 3,624  
  Member+Spouse+Child3 R 4,176  
  Member+Child 1 R 1,968  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,179  
  Spouse/Adult dependant R 924  
  Per Child (Max 3) R 458  
               
               
               
               
               
               
               
               
               
               
.
MOMENTUM ACCESS OPTION
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
     
     
  Annual Sub-limits :
 
     
  High and Intensive Care 12 days  
  (per admission)    
  Medical and Surgical R 4,250  
  Appliances (per family)    
  Rehabilitation and Step- R 33,500  
  down facilities    
  Internal Prosthesis:    
  See detailed benefits     
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
   CareCross, Medicross or Prime Cure.  
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% NHRPL Rate  
  CareCross, Medicross or    
   Prime Cure    
  GP's:   
  10 visits per person per annum  
  thereafter R500  co-payment  
   applies.   
     
  Specialists:  
  3 visits per person limited to  
  5 visits per family per annum  
                    
  Conservative Dentistry:  
  No Limit from Network Providers   
         
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
       
  Principal Member R 1,188  
  Spouse/Adult Dependant R 1,129  
  Per Child R 356  
       
RESOLUTION HEALTH
PROGRESSIVE FLEX
  IN HOSPITAL BENEFIT  
  150% Scheme Rate  
  No overall annual limit  
  *7 day take home medication  
  Co-payments apply for  certain  
  procedures  
     
  Emergency Casualty Annual Limit:  
  R1,200 per family  
     
     
  Annual Sub-limts per person:  
  Prosthesis R45,000  
   (subject to prosthesis sub-    
   limits)    
  Hospice,Rehab & Step down R20,600   
       
       
       
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
     
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% NHRPL Rate  
  GP's: Member 4 visits  
    Member + 1 7 visits  
    Family 9 visits  
  Specialists: Member 3 visits  
    Member + 1 4 visits  
    Family 5 visits  
         
  Conservative & Specialised Dentistry  
     
     
     
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R1,224  
   Spouse/Adult dependant  R1,164  
   Per Child R362  
       
     
     
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 :  
  Surgical Appliances R 4,250  
  (eg. support stockings)    
  Mental Health R 24,300  
  Rehabilitation, Private R 33, 500  
  nursing, Hospice and    
  step-down facilities    
  Oncology R 365,00  
   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 6, 300 per family  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 1,836  
  Member+Spouse R 3,312  
  Member+Spouse+Child1 R 3,996  
  Member+Spouse+Child2 R 4,680  
  Member+Spouse+Child3 R5,364  
  Member+Child 1 R2,520  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,528  
  Spouse/Adult dependant R 1,230  
  Per Child (Max 3) R 571  
     
     
     
     
     
.
 
FEDHEALTH
MAXIMA BASIS
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  (e.g R1,700 Anthroscopy)  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral contraceptives  
  *Emergency Trauma at Out Patients  
  Psychiatric Treatment R 18,200  
  Hospice care R 13,700   
  Oncology (only at DSP) R230,000  
  Internal Prosthesis:     
  See detailed benefits    
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite Pharmacies  
               
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% NHRPL Rate
 
  Limits  per annum:  
  Member R 2,340  
  Member +Spouse R 4,100  
  Member +Spouse +Child 1 R 4,340  
  Member +Spouse +Child 2 R 4,580  
  Member +Spouse +Child 3 R 4,820  
  Member +Child 1 R 2,580  
       
  Unlimied GP Network    
   benefit    
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 9,290  
  Spouse/Adult dependant R 7,070  
  Per Child (Max 3) R 2,380  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,547  
  Spouse/Adult dependant R 1,317  
  Per Child R 466  
       
BONITAS
STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Annual Sub-limits:  
  Oncology R 250,000  
  Physical Rehabilitation R 34,000  
  (per family)    
  Take home medicine R 320  
  (per admission)    
  Internal Prosthesis: R 30,500  
       
       
       
       
       
       
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 PMB Chronic Disease Conditions  
  Add. 16 Chronic Disease Conditions  
  Annual limit:  
  Single R 6,900  
  Per Family R 13,800  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits  per annum:  
  Member R 3,100  
  Member + 1 R 4,700  
  Member + 2 R 5,100  
  Member + 3 R 5,500  
  Member + 4 + R 5,900  
  Network GP Limit:  
  Member R3, 000  
  Member + 1 R 4, 500  
  Member + 2 R 4, 900  
  Member + 3 R 5,200  
  Member + 4 + R 5, 600  
  Plus basic and advanced Dentistry  
  and Optometry  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,795  
  Spouse/Adult dependant R 1,533  
  Per Child R 525  
     
DISCOVERY HEALTH
  IN HOSPITAL BENEFIT  
  200% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  Annual Sub-limits per person:  
  Mental Health Benefit 21 days  
  Terminal Care Benefit R 28,000  
  Alcohol and Drug 21 days  
  Rehabilitation    
  Internal Prostheses:    
  See detailed benefit schedule  
               
               
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% Scheme Rate  
  27 MB Chronic Disease Conditions  
  Subject to scheme formulary  
     
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member R 5,544  
  Member+Spouse R 9,912  
  Member+Spouse+Child1 R 12,132  
  Member+Spouse+Child2 R 14.352  
  Member+Spouse+Child3 R 16,572  
  Member+Child 1 R 7,764  
       
  Insured Network Benefit  
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 8,200  
  Spouse/Adult dependant R 6,150  
  Per Child (Max 3) R 2,690  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,850  
  Spouse/Adult dependant R 1,457  
  Per Child (Max 3) R 740  
     

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.