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.

 
 
Hospital
Plans:
FedHealth Maxima Basis Spectramed Alliance Resolution Health Progressive
Oxygen Essential Bonitas Standard Bonitas Primary
Momentum Custom Option 1
Momentum Custom Option 2
Momentum Incentive Option 1
Momentum Incentive Option 2
   
 
FEDHEALTH
MAXIMA BASIS
  IN HOSPITAL BENEFIT  
  200% NHRPL rate  
  No Overall Annual Limit  
  Co-payments apply for certain  
  procedures  
  *30 days Post Hospital Cover  
  *7 days Take Home Medicine  
  *Oral Contraceptives  
  *Emergency Trauma at Out Patients  
  Annual Sub-limits per person:  
  Oncology & Organ R 206,000  
  Transplant    
  Renal Dialysis R 206,000  
  Psychiatric Treatment R 17,250  
  Specialised Medication R120, 000  
  Benefit    
  Internal Prosthesis:    
  See detailed benefits    
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Annual limit:  
  Single R 2,415  
  Per Family R 4,828  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% NHRPL Rate
 
  Limits  per annum:  
  Member R 2,160  
  Member +Spouse R 3,780  
  Member +Spouse +Child 1 R 4,000  
  Member +Spouse +Child 2 R 4,220  
  Member +Spouse +Child 3 R 4,440  
  Member +Child 1 R 2,380  
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Principal Member R 7,720  
  Spouse/Adult dependant R 5,900  
  Per Child (Max 3) R 2,050  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,316  
  Spouse/Adult dependant R 1,118  
  Per Child R 395  
     
     
     
     
     
     
     
SPECTRAMED
ALLIANCE PLAN
  IN HOSPITAL BENEFIT  
  100% MSR  
  Member R1,000,000  
  Member + 1 R1,250,000  
  Member + 2 R1,400,000  
  Member + 3 R1,500,000  
  Member + 4 + R,1600,000  
  * 3 days Take Home Medicine  
  * Co-payments apply for certain  
  procedures  
  Annual Sub-limits:  
  Physiotherapy R 2,200  
  Psychiatric treatment R 6,000  
  Dialysis (per treatment) R 2,000  
  Internal Prosthesis:  
  See detailed benefit schedule.  
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% MSR  
  30 PMB Chronic Disease Conditions  
  Only from Mediscor  
  Subject to scheme formulary.  
       
       
       
  ANNUAL DAY TO DAY BENEFIT  
  (including savings)  
  100% MSR   
  GP's:    
  Member 4 visits  
  Member + 1 6 visits  
  Member + 2 7 visits  
  Member + 3 8 visits  
  Member + 4 + 9 visits  
  Specialists:    
  Member R 750  
  Member + 1 R 1,000  
  Member + 2 R 1,300  
  Member + 3 R 1,600  
  Member + 4 + R 2,000  
  Conservative Dentistry:    
  Member R 1,400  
  Member + 1 R 2,000  
  Member + 2 R 2,500  
  Member + 3 R 3,000  
  Member + 4 + R 3,700  
               
               
               
               
               
               
               
               
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Income p/m R0 - R10,500  
  Principal Member R 921  
  Spouse/Adult dependant R 876  
  Per Child R 368  
       
  Income p/m R10,501 +  
  Principal Member R 1,295  
  Spouse/Adult dependant R 1,231  
  Per Child R 519  
       
RESOLUTION HEALTH
PROGRESSIVE
  IN HOSPITAL BENEFIT  
  100% NHRPL rate  
  R210,000 Single per Annum  
  R420,000 per family per Annum  
  *7 days Take Home Medicine  
  Co-payments apply for certain  
  procedures  
  Emergency Ward treatment which  
  does not result in hospitalisation  
  R1,050  
  Annual Sub-limts per person:  
  Oncology R 210,000  
  Internal Prosthesis R 42,000  
  Post hospitalisation:              R18,350  
  Rehabilitation, Step-down  
  and terminal care    
  International travel 90 days R5 million  
  per trip    
       
  CHRONIC MEDICATION BENEFIT  
  100% MSR  
  27 PMB Chronic Disease Conditions  
  Subject to Progressive formulary  
     
     
     
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% NHRPL Rate  
  GP's: Member R 850  
    Member + 1 R 1,500  
    FamilyM+2+ R 1,900  
  Specialists: Member R 500  
    Member + 1 R 750  
    FamilyM+2+ R 1,250  
  OAL Member R1,600  
    Member +1 R2,200  
    FamilyM+2+ R2,500  
  MSA Member R576  
    Member +1 R1152  
    FamilyM+2+ R1,728  
  Medical Member R2,600  
  Appliances Member +1 R2,600  
    FamilyM+2+ R2,600  
  Plus: Dentistry, Optometry &  
  Preventative Care benefits as per  
  schedule  
     
  Additional benefits paid from risk  
  Maternity: Out of hospital  
   7 Gynae Consultations  
   2 2D Scans    
   R500 Ante-Natal classes once  
    registered on ResoBaby  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
               
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,011  
  Spouse/Adult dependant R 963  
  Per Child R 309  
               
               
               
               
               
               
               
.
OXYGEN
ESSENTIAL
  IN HOSPITAL BENEFIT  
  100% MSR  
  R500,000 Per Family per annum  
  Primary Network Hospitals to be used  
  Co-payments apply for certain  
  procedures  
  Annual Sub-limits per person:  
  Oncology Medicines R 200,000  
  Wisdom Teeth Removal R 1,750  
  Internal Prostheses: R 20,000  
  Organ Transplants R 200,000  
  Psychiatric treatment R 10,000  
       
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  Subject to Basic formulary  
   Only from Oxygen Pharmacy  
  Network  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% MSR  
  Monthly Savings Amounts:  
  Income p/m R0-R7,000  
  Member R 116  
  Member + Spouse R 222  
  Member+Spouse+Child 1 R 272  
  Member+Spouse+Child 2 R 272  
  Member+Spouse+Child 3 R 272  
  Member + Child 1 R 166  
       
  Income p/m R7,001+  
  Member R171  
  Member + Spouse R 321  
  Member+Spouse+Child 1 R 376  
  Member+Spouse+Child 2 R 376  
  Member+Spouse+Child 3 R 376  
  Member + Child 1 R 226  
       
  Savings Advance on a monthly basis  
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Income p/m R0 - R7,000  
  Principal Member R 776  
  Spouse/Adult dependant R 707  
  1st Child Only R 333  
       
  Income p/m R7,001 +  
  Principal Member R 1,143  
  Spouse /Adult dependant R 1,003  
  1st Child Only R 368  
       
BONITAS
STANDARD
  IN HOSPITAL BENEFIT  
  100% MSR  
  No Overall Annual Limit  
     
  Annual Sub-limits:  
  Oncology R 200,000  
  Physical Rehabilitation R 30,000  
  (per family)    
  Take home medicine R 250  
  (per admission)    
  Internal Prosthesis: R 27,000  
  Organ Transplants R 250,000  
  Renal Dialysis R 200,000  
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% MSR  
  45 PMB Chronic Disease Conditions  
  Annual limit:  
  Single R 6,500  
  Per Family R 13,000  
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% MSR
 
  Limits  per annum:  
  Member R 2,500  
  Member + 1 R 3,800  
  Member + 2 R 4,100  
  Member + 3 R 4,400  
  Member + 4 + R 4,700  
  Seperate 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 Dentistry, Radiology, Pathology  
  and Optometry  
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1,514  
  Spouse/Adult dependant R 1,310  
  Per Child R 442  
     
     
     
     
     
     
     
BONITAS
PRIMARY
  IN HOSPITAL BENEFIT  
  100% MSR  
  R600,000 per family per annum  
     
  Annual Sub-limits:  
  Oncology R 100,000  
  Physical Rehabilitation R 30,000  
  (per family)    
  Take home medicine R 250  
  (per admission)    
  Internal Prosthesis: R 16,500  
               
               
               
               
               
  CHRONIC MEDICATION BENEFIT  
  100% MSR  
  27 PMB Chronic Disease Conditions  
  Subject to scheme formulary,  
  only from Pharmacy Direct  
               
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
 
100% NHRPL Rate
 
  Limits  per annum:  
  Member R 1,200  
  Member + 1 R 2,300  
  Member + 2 R 2,600  
  Member + 3 R 2,900  
  Member + 4 + R 3,200  
    Seperate 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 Dentistry, Radiology, Pathology  
  and Optometry  
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
     
  MONTHLY CONTRIBUTIONS  
  Principal Member R 977  
  Spouse/Adult dependant R 765  
  Per Child R 311  
     
     
     
     
     
     
     
 
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% MSR  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R800 co-payment except for  
  MVA's and maternity  
  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  
     
     
               
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
     
 
 
  Member R 696  
  Member+Spouse R 1,200  
  Member+Spouse+Child1 R 1,464  
  Member+Spouse+Child2 R 1,728  
  Member+Spouse+Child3 R1,992  
  Member+Child 1 R 960  
       
  For more savings, please enquire  
  about the Health Saver  
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 774  
  Spouse/Adult dependant R 558  
  Per Child (Max 3) R 289  
       
MOMENTUM CUSTOM OPTION
  IN HOSPITAL BENEFIT  
  100% MSR  
  No Overall Annual Limit  
  *7 days Take Home Medicine  
  *R800 co-payment except for  
  MVA's and maternity  
  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  
     
     
               
  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  
       
MOMENTUM INCENTIVE OPTION
  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  
       
.
 
MOMENTUM INCENTIVE OPTION
  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.