Hospital Plans with Limited Day to Day Cover - 2017

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): R23,000  
     
  Oncology                         PMB  
     
       
       
       
       
  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 4 815  
  Member + 1 R 5 240  
  Member + 2 R 5 900  
  Member + 3 R 6 860  
  Member + 4+ R 7 600  
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
       
  does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Member R 1,521  
  Spouse/Adult dependant R 1,323  
  Per Child (Max 3) R 414  
     
     
     
     
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 R32,100  
  Hospice Care (including     R44,000  
   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 8,300 per family  
   Only from state hospitals  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:   
     
  Member R 2,040  
  Member+Spouse R 3,636  
  Member+Spouse+Child1 R 4,428  
  Member+Spouse+Child2 R 5,220  
  Member+Spouse+Child3 R 6,012  
  Member+Child 1 R 2,832  
       
  For more savings, please enquire  
  about the Health Saver  
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,700  
  Spouse/Adult dependant R 1,333  
  Per Child (Max 3) R 659  
       
       
       
       
BONITAS
PRIMARY
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  *R340 Take Home Medicine  
  Annual Sub-limits:  
  Oncology R 149,000  
   Psychiatric Treatment R14,250  
   Hospice Care R14,900  
       
       
       
               
               
               
               
               
               
               
               
  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 1,900  
  Member + 1 R 3,400  
  Member + 2 R 4,000  
  Member + 3 R 4,300  
  Member + 4 + R 4,650  
    Network GP Limit:  
  Member R 1,800  
  Member + 1 R 3,300  
  Member + 2 R3,900  
  Member + 3 R4,200  
  Member + 4 + R4,750  
     
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,924  
  Spouse/Adult dependant R 1,505  
  Per Child R 613  
               
               
               
               
 
 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 27,900
  Oncology (only at DSP) R250,000
     
     
  Internal Prosthesis: PMB
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Only from MED-Rite , Dischem and  
  Pharmacy Direct  
       
       
       
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% Scheme Rate
 
  Limits per annum:  
  Member R 3,744  
  Member + Spouse R 6,792  
  Member + Spouse + Child 1 R 7,872  
  Member + Spouse + Child 2 R 8,952  
  Member + Spouse + Child 3 R 10,032  
  Member + Child 1 R 4,824  
       
  Unlimited Network GP benefit    
       
       
       
  ANNUAL THRESHOLD BENEFIT  
              Does not Apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,079  
  Spouse/Adult dependant R 1,693  
  Per Child R 600  
       
       
RESOLUTION HEALTH
PROGRESSIVE FLEX
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
  Network hospitals to be used,  
  otherwise R3,657 co-payment  
  Co-payments are due for certain  
  procedures (eg. R3,751 Arthroscopy)  
     
  *7 day take home medication  
  Emergency Casualty Annual
 
  Limit: R1,502 per family  
     
  Annual Sub-limts per person:  
  Psychiatric Treatment PMB  
  Hospice Care 12 Days  
  Oncology (subject to ICON R261,555  
   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 R3,116  
   Dentistry Family R5,009  
         
         
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R2,154  
   Spouse/Adult dependant  R2,017  
   Per Child (max 3) R666  
               
     
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 R32,100  
   Hospice Care (including R44,000  
    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 8, 300 per family  
               
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate   
  Limits per annum:  
 
 
  Member R 3,036  
  Member+Spouse R 5,472  
  Member+Spouse+Child1 R 6,600  
  Member+Spouse+Child2 R 7,728  
  Member+Spouse+Child3 R 8,856  
  Member+Child 1 R 4,164  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,529  
  Spouse/Adult dependant R 2,034  
  Per Child (Max 3) R 944  
       
     
 
 
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     R26,000  
   (per family)  
   Hospice Care R47,000  
   (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: R5,385  
  Family                                R10,775  
     
               
   
 
 
  100% Scheme Rate  
   Limits per Annum  
   Member R6,750  
   Member + 1 R9,420  
   Member + 2 R10,610  
   Member + 3 R11,910  
   Member + 4+ R13,050  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
     
  Does not apply   
     
     
   Member R2,544  
   Spouse/Adult dependant R1,797  
   Per Child (Max 3)                     R558  
       
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 22,600  
  Hospice care R 27,900   
  Oncology (only at DSP) R250,000  
  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% Scheme Rate
 
  Limits  per annum:  
  Member R 4,500  
  Member +Spouse R 8,328  
  Member +Spouse +Child 1 R 9,684  
  Member +Spouse +Child 2 R 11,040  
  Member +Spouse +Child 3 R 12,396  
  Member +Child 1 R 5,856  
       
  Unlimied GP Network    
   benefit    
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
             Does not apply    
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,501  
  Spouse/Adult dependant R 2,129  
  Per Child R 754  
       
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 R2 120 per family  
  Annual Sub-limits per person:  
  Psychiatric Treatment R33,700  
    (per family)    
  Hospice Care Unlimited  
  Oncology (PMB) Unlimited  
       
       
   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 5,700  
  Member + 1 R 9,550  
  Member + 2 R 11,700  
  Member + 3 R 12, 600  
       
    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 two years  
  - 1 Extra oral xray per person every  
     three years  
       
     
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
       
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,730  
  Spouse/Adult dependant R 2,316  
  Per Child (Max 2) R 798  
     
 
 BONITAS
STANDARD
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
  *R400 Take home medicine   
     
     
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R 36,550
  Hospice Care R 14,900
  Oncology R 310,150
     
     
     
     
     
     
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Additional 17 Chronic Disease  
  Conditions  
  Annual limit:  
  Single R 8,650  
  Per Family R 17,350  
               
  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  
       
     
       
       
       
       
       
       
     
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
   Does not apply    
       
       
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 2,998  
  Spouse/Adult dependant R 2,600  
  Per Child R 880  
       
       
               
               
               
               
               
               
               
               
               
               
               
               
               
               

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.