Resolution Medical Aid Comparison - 2016 Plans

Resolution Health is a medium sized medical aid with about 150,000 lives covered. It was registered in 1998 and has the second highest Global Credit Rating of A+, for claims paying ability with claims being processed within 48 hours. Their range of products includes a hospital plan with the rest being traditional in structure.

 
Resolution: Hospital Plan  Progressive Flex
 Classic
  Millenium  Supreme   
 
RESOLUTION HEALTH
HOSPITAL PLAN
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (e.g. R3,539 Arthroscopy)  
     
  *7 days Take Home Medicine  
     
     
     
  Annual Sub-limits per person:  
  Psychiatric Treatment PMB  
  Hospice Care 10 days  
  Oncology (subject to ICON R161,031  
   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)
 
     
  Does not apply  
   GP and Specialist consultations  
    subject to PMB and    
    pre-authorisation only at    
    contracted providers    
       
       
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 1 375  
  Spouse/Adult dependant R 1 170  
  Per Child (max 3) R 513  
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
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. R3,539 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 R246,750  
   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 R2,940  
   Dentistry Family R4,725  
         
         
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R1 910  
   Spouse/Adult dependant  R1,788  
   Per Child (max 3) R590  
               
     
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
RESOLUTION HEALTH
CLASSIC
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No overall annual limit  
     
     
  Co-payments are due for certain  
  procedures (eg. R3,539 Arthroscopy)  
  Contracted Specialist paid at  
   150% Scheme Rate  
     
  *7 day take home medication   
     
     
     
  Annual Sub-limts per person:  
  Psychiatric Treatment R14,238  
  Hospice Care 15 Days  
  Oncology (subject to ICON Unlimited  
   network & scheme    
   protocols    
   Internal Prosthesis    
     (see detailed benefits)    
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  (Add. 3 Chronic Disease Conditions)  
  Annual Limit:  
     
  Single    R 1 948  
  Per family    R 3 896  
     
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
  Limits per annum:  
  Member   R4,740  
  Member + Spouse R8,952  
  Member+ Spouse+ 1 Child R10,692  
  Member+ Spouse+ 2 Child R12,432  
  Member+ Spouse+ 3 Child R12,432  
         
         
         
     
     
     
     
  ANNUAL THRESHOLD BENEFIT  
  Does not apply  
               
  MONTHLY CONTRIBUTIONS  
   Principal Member R2,633  
   Spouse/Adult dependant  R2,337  
   Per Child (max 3) R964  
       
       
       
               
               
               
               
               
               
               
               
               
               
               
               
               
               

 

RESOLUTION HEALTH
MILLENIUM
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (eg R3,539 Arthroscopy)  
  *7 days Take Home Medicine  
  *Contracted Specialists paid at  
   150% Scheme Rate  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R17 693  
  Hospice Care 18 days  
  Oncology (subject to ICON Unlimited  
   network & scheme    
   protocols    
    Internal Prosthesis    
     (see detailed benefits)    
       
       
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  (Additional 7 Chronic disease  
  conditions)  
     
  Annual Limit  
       
   Single R2,499  
   Family R5,009  
       
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
     
  Limits per annum  
       
       
  Member R8,628  
  Member + Spouse R16,008  
  Member+ Spouse +Child 1 R18,012  
  Member+ Spouse +Child 2 R20,016  
  Member+ Spouse +Child 3 R20,016  
       
       
       
       
       
       
  ANNUAL THRESHOLD BENEFIT  
     
  Principal Member                  R11,791  
  Spouse/Adult dependant        R9,770  
  Per Child                              R2,579  
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,592  
  Spouse/Adult dependant R 3,078  
  Per Child (max 3) R 838  
       
       
       
       
     
RESOLUTION HEALTH
SUPREME
  IN HOSPITAL BENEFIT  
  100% Scheme Rate  
  No Overall Annual Limit  
     
  Co-payments are due for certain  
  procedures (eg R3,539 Arthroscopy)  
  *7 days Take Home Medicine  
  Contracted Specialist paid 220%  
  Scheme rate  
  Emergency Casualty Annual   
   Limit: R1,430 per family  
     
  Annual Sub-limits per person:  
  Psychiatric Treatment R28,266  
  Hospice Care 21 days  
  Oncology (subject to ICON Unlimited  
   network & scheme    
   protocols    
    Internal Prosthesis    
     (see detailed benefits)    
       
       
  CHRONIC MEDICATION BENEFIT  
  100% Medicine Price  
  27 PMB Chronic Disease Conditions  
  (Additional 25 Chronic disease  
  conditions)  
     
  Annual Limit  
       
   Single R5,177  
   Family R10,343  
       
  ANNUAL DAY TO DAY BENEFIT
(including savings)
 
  100% Scheme Rate  
     
  Out of Hospital Annual Limit  
       
       
  Member R13,356  
  Member + Spouse R23,373  
  Member+ Spouse + 1 Child R24,770  
  Member+ Spouse+ 2 Child. R26,167  
  Member+ Spouse+ 3 Child. R27,564  
       
  Additional Out of Hospital Benefit  
  Principal Member R7,004  
  Member + 1 R12,327  
  Family R13,388  
       
  ANNUAL THRESHOLD BENEFIT  
     
     
   Does not apply  
     
               
  MONTHLY CONTRIBUTIONS  
  Principal Member R 3,907  
  Spouse/Adult dependant R 3,715  
  Per Child (max 3) R 966  
     
     
     
     
     
 
 
     
     
     
     
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
     
     
     
     
     
     
     
     
     
     
               
     
     
     
     
     
     
     
     
     
     
     
     
     
       
       
     
     
       
     
     
     
     
     
               
     
       
     
     
     
       
     
     
       

For more detailed information on any of the above Resolution plans, just click on the name of the relevant 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 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/or 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 the Resolution Medical Aids.