Hospital Plans with Limited Day to Day Cover
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.
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IN HOSPITAL BENEFIT |
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200% NHRPL rate |
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No Overall Annual Limit |
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Co-payments apply for certain |
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procedures |
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*30 days Post Hospital Cover |
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*7 days Take Home Medicine |
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*Oral Contraceptives |
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*Emergency Trauma at Out Patients |
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Annual Sub-limits per person: |
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Oncology & Organ |
R 206,000 |
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Transplant |
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Renal Dialysis |
R 206,000 |
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Psychiatric Treatment |
R 17,250 |
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Specialised Medication |
R120, 000 |
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Benefit |
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Internal Prosthesis: |
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See detailed benefits |
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CHRONIC MEDICATION BENEFIT |
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100% Medicine Price |
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27 PMB Chronic Disease Conditions |
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Annual limit: |
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Single |
R 2,415 |
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Per Family |
R 4,828 |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% NHRPL Rate |
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Limits per annum: |
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Member |
R 2,160 |
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Member +Spouse |
R 3,780 |
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Member +Spouse +Child 1 |
R 4,000 |
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Member +Spouse +Child 2 |
R 4,220 |
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Member +Spouse +Child 3 |
R 4,440 |
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Member +Child 1 |
R 2,380 |
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ANNUAL THRESHOLD BENEFIT |
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Principal Member |
R 7,720 |
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Spouse/Adult dependant |
R 5,900 |
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Per Child (Max 3) |
R 2,050 |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,316 |
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Spouse/Adult dependant |
R 1,118 |
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Per Child |
R 395 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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Member |
R1,000,000 |
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Member + 1 |
R1,250,000 |
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Member + 2 |
R1,400,000 |
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Member + 3 |
R1,500,000 |
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Member + 4 + |
R,1600,000 |
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* 3 days Take Home Medicine |
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* Co-payments apply for certain |
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procedures |
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Annual Sub-limits: |
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Physiotherapy |
R 2,200 |
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Psychiatric treatment |
R 6,000 |
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Dialysis (per treatment) |
R 2,000 |
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Internal Prosthesis: |
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See detailed benefit schedule. |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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30 PMB Chronic Disease Conditions |
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Only from Mediscor |
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Subject to scheme formulary. |
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ANNUAL DAY TO DAY BENEFIT |
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(including savings) |
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100% MSR |
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GP's: |
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Member |
4 visits |
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Member + 1 |
6 visits |
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Member + 2 |
7 visits |
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Member + 3 |
8 visits |
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Member + 4 + |
9 visits |
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Specialists: |
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Member |
R 750 |
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Member + 1 |
R 1,000 |
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Member + 2 |
R 1,300 |
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Member + 3 |
R 1,600 |
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Member + 4 + |
R 2,000 |
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Conservative Dentistry: |
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Member |
R 1,400 |
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Member + 1 |
R 2,000 |
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Member + 2 |
R 2,500 |
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Member + 3 |
R 3,000 |
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Member + 4 + |
R 3,700 |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Income p/m |
R0 - R10,500 |
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Principal Member |
R 921 |
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Spouse/Adult dependant |
R 876 |
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Per Child |
R 368 |
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Income p/m |
R10,501 + |
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Principal Member |
R 1,295 |
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Spouse/Adult dependant |
R 1,231 |
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Per Child |
R 519 |
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| RESOLUTION HEALTH |
| PROGRESSIVE |
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IN HOSPITAL BENEFIT |
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100% NHRPL rate |
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R210,000 Single per Annum |
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R420,000 per family per Annum |
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*7 days Take Home Medicine |
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Co-payments apply for certain |
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procedures |
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Emergency Ward treatment which |
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does not result in hospitalisation |
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R1,050 |
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Annual Sub-limts per person: |
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Oncology |
R 210,000 |
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Internal Prosthesis |
R 42,000 |
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Post hospitalisation: R18,350 |
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Rehabilitation, Step-down |
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and terminal care |
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International travel 90 days |
R5 million |
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per trip |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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27 PMB Chronic Disease Conditions |
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Subject to Progressive formulary |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% NHRPL Rate |
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GP's: |
Member |
R 850 |
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Member + 1 |
R 1,500 |
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FamilyM+2+ |
R 1,900 |
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Specialists: |
Member |
R 500 |
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Member + 1 |
R 750 |
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FamilyM+2+ |
R 1,250 |
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OAL |
Member |
R1,600 |
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Member +1 |
R2,200 |
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FamilyM+2+ |
R2,500 |
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MSA |
Member |
R576 |
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Member +1 |
R1152 |
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FamilyM+2+ |
R1,728 |
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Medical |
Member |
R2,600 |
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Appliances |
Member +1 |
R2,600 |
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FamilyM+2+ |
R2,600 |
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Plus: Dentistry, Optometry & |
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Preventative Care benefits as per |
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schedule |
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Additional benefits paid from risk |
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Maternity: Out of hospital |
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7 Gynae Consultations |
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2 2D Scans |
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R500 Ante-Natal classes once |
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registered on ResoBaby |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,011 |
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Spouse/Adult dependant |
R 963 |
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Per Child |
R 309 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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R500,000 Per Family per annum |
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Primary Network Hospitals to be used |
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Co-payments apply for certain |
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procedures |
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Annual Sub-limits per person: |
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Oncology Medicines |
R 200,000 |
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Wisdom Teeth Removal |
R 1,750 |
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Internal Prostheses: |
R 20,000 |
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Organ Transplants |
R 200,000 |
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Psychiatric treatment |
R 10,000 |
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CHRONIC MEDICATION BENEFIT |
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100% Medicine Price |
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27 PMB Chronic Disease Conditions |
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Subject to Basic formulary |
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Only from Oxygen Pharmacy |
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Network |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% MSR |
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Monthly Savings Amounts: |
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Income p/m |
R0-R7,000 |
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Member |
R 116 |
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Member + Spouse |
R 222 |
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Member+Spouse+Child 1 |
R 272 |
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Member+Spouse+Child 2 |
R 272 |
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Member+Spouse+Child 3 |
R 272 |
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Member + Child 1 |
R 166 |
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Income p/m |
R7,001+ |
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Member |
R171 |
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Member + Spouse |
R 321 |
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Member+Spouse+Child 1 |
R 376 |
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Member+Spouse+Child 2 |
R 376 |
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Member+Spouse+Child 3 |
R 376 |
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Member + Child 1 |
R 226 |
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Savings Advance on a monthly basis |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Income p/m |
R0 - R7,000 |
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Principal Member |
R 776 |
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Spouse/Adult dependant |
R 707 |
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1st Child Only |
R 333 |
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Income p/m |
R7,001 + |
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Principal Member |
R 1,143 |
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Spouse /Adult dependant |
R 1,003 |
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1st Child Only |
R 368 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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No Overall Annual Limit |
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Annual Sub-limits: |
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Oncology |
R 200,000 |
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Physical Rehabilitation |
R 30,000 |
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(per family) |
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Take home medicine |
R 250 |
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(per admission) |
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Internal Prosthesis: |
R 27,000 |
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Organ Transplants |
R 250,000 |
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Renal Dialysis |
R 200,000 |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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45 PMB Chronic Disease Conditions |
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Annual limit: |
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Single |
R 6,500 |
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Per Family |
R 13,000 |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% MSR |
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Limits per annum: |
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Member |
R 2,500 |
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Member + 1 |
R 3,800 |
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Member + 2 |
R 4,100 |
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Member + 3 |
R 4,400 |
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Member + 4 + |
R 4,700 |
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Seperate Network GP Limit: |
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Member |
R3, 000 |
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Member + 1 |
R 4, 500 |
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Member + 2 |
R 4, 900 |
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Member + 3 |
R 5,200 |
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Member + 4 + |
R 5, 600 |
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Plus Dentistry, Radiology, Pathology |
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and Optometry |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,514 |
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Spouse/Adult dependant |
R 1,310 |
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Per Child |
R 442 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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R600,000 per family per annum |
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Annual Sub-limits: |
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Oncology |
R 100,000 |
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Physical Rehabilitation |
R 30,000 |
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(per family) |
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Take home medicine |
R 250 |
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(per admission) |
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Internal Prosthesis: |
R 16,500 |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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27 PMB Chronic Disease Conditions |
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Subject to scheme formulary, |
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only from Pharmacy Direct |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% NHRPL Rate |
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Limits per annum: |
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Member |
R 1,200 |
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Member + 1 |
R 2,300 |
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Member + 2 |
R 2,600 |
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Member + 3 |
R 2,900 |
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Member + 4 + |
R 3,200 |
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Seperate Network GP Limit: |
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Member |
R 1,400 |
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Member + 1 |
R 2,700 |
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Member + 2 |
R3, 100 |
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Member + 3 |
R3, 400 |
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Member + 4 + |
R3, 800 |
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Plus Dentistry, Radiology, Pathology |
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and Optometry |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 977 |
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Spouse/Adult dependant |
R 765 |
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Per Child |
R 311 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*R800 co-payment except for |
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MVA's and maternity |
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Annual Sub-limits : |
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Surgical Appliances |
R 3,850 |
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(eg. support stockings) |
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Mental Health |
R 22,000 |
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Rehabilitation, Private |
R 30, 300 |
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nursing, Hospice and |
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step-down facilities |
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Internal Prostheses: |
R 47, 500 |
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CHRONIC MEDICATION BENEFIT |
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100% MSR |
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26 Chronic Disease Conditions |
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Subject to formulary at State facilities |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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Member |
R 696 |
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Member+Spouse |
R 1,200 |
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Member+Spouse+Child1 |
R 1,464 |
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Member+Spouse+Child2 |
R 1,728 |
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Member+Spouse+Child3 |
R1,992 |
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Member+Child 1 |
R 960 |
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For more savings, please enquire |
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about the Health Saver |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 774 |
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Spouse/Adult dependant |
R 558 |
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Per Child (Max 3) |
R 289 |
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IN HOSPITAL BENEFIT |
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100% MSR |
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No Overall Annual Limit |
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*7 days Take Home Medicine |
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*R800 co-payment except for |
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MVA's and maternity |
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Annual Sub-limits : |
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Surgical Appliances |
R 3,850 |
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(eg. support stockings) |
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Mental Health |
R 22,000 |
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| |
Rehabilitation, Private |
R 30, 300 |
|
| |
nursing, Hospice and |
|
|
| |
step-down facilities |
|
|
| |
|
|
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to reference price list |
|
| |
|
|
| |
|
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
|
|
| |
|
|
| |
Member |
R 864 |
|
| |
Member+Spouse |
R 1,512 |
|
| |
Member+Spouse+Child1 |
R 1,836 |
|
| |
Member+Spouse+Child2 |
R 2,160 |
|
| |
Member+Spouse+Child3 |
R 2,484 |
|
| |
Member+Child 1 |
R 1,188 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 959 |
|
| |
Spouse/Adult dependant |
R 720 |
|
| |
Per Child (Max 3) |
R 357 |
|
| |
|
|
|
|
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
*7 days Take Home Medicine |
|
| |
*Co-payments apply for certain |
|
| |
procedures if not referred |
|
| |
Annual Sub-limits : |
|
| |
Surgical Appliances |
R 3,850 |
|
| |
(eg. support stockings) |
|
|
| |
Mental Health |
R 22,000 |
|
| |
Rehabilitation, Private |
R 30, 300 |
|
| |
nursing, Hospice and |
|
|
| |
step-down facilities |
|
|
| |
|
|
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to formulary at State facilities |
|
| |
6 additional conditions limited to |
|
| |
R 6,000 per family |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
|
|
| |
|
|
| |
Member |
R 1,236 |
|
| |
Member+Spouse |
R 2,160 |
|
| |
Member+Spouse+Child1 |
R 2,664 |
|
| |
Member+Spouse+Child2 |
R 3,168 |
|
| |
Member+Spouse+Child3 |
R 3,672 |
|
| |
Member+Child 1 |
R 1,740 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,033 |
|
| |
Spouse/Adult dependant |
R 771 |
|
| |
Per Child (Max 3) |
R 422 |
|
| |
|
|
|
|
|
|
| . |
|
|
|
| |
IN HOSPITAL BENEFIT |
|
| |
200% MSR |
|
| |
No Overall Annual Limit |
|
| |
*7 days Take Home Medicine |
|
| |
*Co-payments apply for certain |
|
| |
procedures if not referred |
|
| |
Annual Sub-limits : |
|
| |
Surgical Appliances |
R 3,850 |
|
| |
(eg. support stockings) |
|
|
| |
Mental Health |
R 22,000 |
|
| |
Rehabilitation, Private |
R 30, 300 |
|
| |
nursing, Hospice and |
|
|
| |
step-down facilities |
|
|
| |
|
|
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to reference price list |
|
| |
6 additional conditions limited to |
|
| |
R 6, 000 per family |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
|
|
| |
|
|
| |
Member |
R 1,500 |
|
| |
Member+Spouse |
R 2,652 |
|
| |
Member+Spouse+Child1 |
R 3,240 |
|
| |
Member+Spouse+Child2 |
R 3,828 |
|
| |
Member+Spouse+Child3 |
R4,416 |
|
| |
Member+Child 1 |
R2,088 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,253 |
|
| |
Spouse/Adult dependant |
R 960 |
|
| |
Per Child (Max 3) |
R 493 |
|
| |
|
|
|
|
|
|
|
|
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 021 712 6626. 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 21 712-6686 at any point in your decision making process for further information on these Hospital Plans with limited day to day cover.
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