Hospital Plan with Savings Comparison
These "hospital plans with savings" provide cover for services rendered in hospitals (both hospital and specialists incl.) and further provide a member with a limited savings account (normally available upfront) for day-to-day expenses (eg. GP, medicines, dentist,etc.).
Once the savings account is exhausted, the member needs to pay for their day-to-day expenses from his/her pocket.
In the event of a member not utilising the entire savings available for the year, the remaining balance will be carried forward to the following medical aid year.
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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 per person: |
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Mental Health Benefit |
21 days |
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Terminal Care Benefit |
R 23,400 |
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Alcohol and Drug |
21 days |
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Rehabilitation |
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Internal Prostheses: |
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See detailed benefit schedule |
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Designed for memebers in coastal |
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provinces |
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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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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 3,252 |
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Member+Spouse |
R 5,688 |
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Member+Spouse+Child1 |
R 6,996 |
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Member+Spouse+Child2 |
R 8,304 |
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Member+Spouse+Child3 |
R 9,612 |
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Member+Child 1 |
R 4,560 |
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Add. New Insured Network Benefit |
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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 1,086 |
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Spouse/Adult dependant |
R 813 |
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Per Child (Max 3) |
R 437 |
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IN HOSPITAL BENEFIT |
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200% MSR |
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No Overall Annual Limit |
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Annual Sub-limits per person: |
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Mental Health Benefit |
21 days |
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Terminal Care Benefit |
R 23,400 |
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Alcohol and Drug |
21 days |
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Rehabilitation |
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Internal Prostheses: |
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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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27 MB Chronic Disease Conditions |
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Subject to scheme formulary |
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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 4,212 |
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Member+Spouse |
R 7,524 |
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Member+Spouse+Child1 |
R 9,204 |
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Member+Spouse+Child2 |
R 10.884 |
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Member+Spouse+Child3 |
R 12,564 |
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Member+Child 1 |
R 5,892 |
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Add. New Insured Network Benefit |
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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 1,404 |
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Spouse/Adult dependant |
R 1,105 |
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Per Child (Max 3) |
R 562 |
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| FEDHEALTH |
| MAXIMA STANDARD |
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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 265,000 |
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Transplant |
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Renal Dialysis |
R 265,000 |
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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 3,650 |
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Per Family |
R 7,300 |
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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 4,858 |
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Member +Spouse |
R 8,602 |
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Member +Spouse +Child 1 |
R 9,442 |
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Member +Spouse +Child 2 |
R 10,282 |
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Member +Spouse +Child 3 |
R 11,122 |
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Member +Child 1 |
R 5,698 |
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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 Me mber |
R 1,632 |
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Spouse/Adult dependant |
R 1,388 |
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Per Child |
R 490 |
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IN HOSPITAL BENEFIT |
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150% MSR |
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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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Annual Sub-limits: |
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Oncology |
R 250,000 |
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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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CHRONIC MEDICATION BENEFIT |
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150% 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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150% MSR |
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Limits per annum: |
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Member |
R 2,316 |
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Member +Spouse |
R 4,116 |
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Member +Spouse +Child 1 |
R 4,824 |
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Member +Spouse +Child 2 |
R 5,532 |
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Member +Spouse +Child 3 |
R 6,240 |
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Member +Child 1 |
R 3,024 |
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Plus Basic and Advanced Dental |
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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 1,049 |
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Spouse/Adult dependant |
R 813 |
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Per Child |
R 316 |
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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 per person: |
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Mental Health Benefit |
21 days |
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Terminal Care Benefit |
R 23,400 |
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Alcohol and Drug |
21 days |
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Rehabilitation |
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Internal Prostheses: |
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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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27 MB Chronic Disease Conditions |
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Subject to scheme formulary |
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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 2,004 |
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Member+Spouse |
R 3,504 |
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Member+Spouse+Child1 |
R 4,296 |
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Member+Spouse+Child2 |
R 5.088 |
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Member+Spouse+Child3 |
R 5,880 |
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Member+Child 1 |
R 2,796 |
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Add. New Insured Network Benefit |
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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 1,116 |
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Spouse/Adult dependant |
R 836 |
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Per Child (Max 3) |
R 445 |
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IN HOSPITAL BENEFIT |
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200% MSR |
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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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Annual Sub-limits per person: |
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Mental Health Benefit |
21 days |
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Terminal Care Benefit |
R 23,400 |
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Alcohol and Drug |
21 days |
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Rehabilitation |
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Internal Prostheses: |
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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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27 MB Chronic Disease Conditions |
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Subject to scheme formulary |
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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 4,716 |
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Member+Spouse |
R 8,424 |
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Member+Spouse+Child1 |
R 10,308 |
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Member+Spouse+Child2 |
R 12.192 |
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Member+Spouse+Child3 |
R 14,076 |
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Member+Child 1 |
R 6,600 |
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Add. New Insured Network Benefit |
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ANNUAL THRESHOLD BENEFIT |
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Principal Member |
R 6,800 |
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Spouse/Adult dependant |
R 5,070 |
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Per Child (Max 3) |
R 2,250 |
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MONTHLY CONTRIBUTIONS |
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Principal Member |
R 1,574 |
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Spouse/Adult dependant |
R 1,238 |
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Per Child (Max 3) |
R 630 |
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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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* 5 days Take Home Medicine |
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Annual Sub-limits |
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Acute Dialysis |
R 2,400 |
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(per treatment) |
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Haemodialysis |
R 110,000 |
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Peritoneal Dialysis |
R 95,000 |
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Neo-natal intensive care |
15 days |
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Oncology |
R 100,000 |
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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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Only from Network Provider |
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ANNUAL DAY TO DAY BENEFIT
(including savings) |
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100% MSR |
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Member |
R 3,500 |
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Member +Spouse |
R 6,500 |
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Member +Spouse +1 Child |
R 7,100 |
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Member +Spouse +2 Child |
R 7,700 |
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Member +Spouse +3 Child |
R 8,300 |
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Dental Sub-limit |
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Single |
R 2,500 |
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Per family |
R 5,000 |
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ANNUAL THRESHOLD BENEFIT |
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Does not apply |
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MONTHLY CONTRIBUTIONS |
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Member |
R 1,153 |
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Spouse/Adult dependant |
R 981 |
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Per Child |
R 461 |
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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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Network Hospitals to be used |
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Annual Sub-limits per person: |
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Mental Health Benefit |
21 days |
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Terminal Care Benefit |
R 23,400 |
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Alcohol and Drug |
21 days |
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Rehabilitation |
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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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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 3,360 |
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Member+Spouse |
R 6,012 |
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Member+Spouse+Child1 |
R 7,356 |
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Member+Spouse+Child2 |
R 8,700 |
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Member+Spouse+Child3 |
R 10,044 |
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Member+Child 1 |
R 4,704 |
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Add. New Insured Network Benefit |
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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 1,122 |
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Spouse /Adult |
R 884 |
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dependant |
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Per Child (Max 3) |
R 449 |
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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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Advanced Network Hospitals |
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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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Rehabilitation benefit |
R 40,000 |
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Jaw Surgery |
R 15,000 |
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Wisdom Teeth Removal |
R 5,500 |
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Oncology Medicines |
R 200,000 |
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Internal Prosthesis |
R 25,000 |
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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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Member |
R 261 |
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Member + Spouse |
R 485 |
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Member+Spouse+Child 1 |
R 602 |
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Member+Spouse+Child 2 |
R 602 |
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Member+Spouse+Child 3 |
R 602 |
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Member + Child 1 |
R 378 |
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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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Principal Member |
R 1,308 |
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Spouse/Adult dependant |
R 1,122 |
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1st Child Only |
R 586 |
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IN HOSPITAL BENEFIT |
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Private Provider Rates |
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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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Annual Sub-limits per person: |
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Rehabilitation Benefit |
R 45,000 |
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Jaw Surgery |
R 15, 000 |
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Wisdom Teeth Removal |
R 5,500 |
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Oncology Medicines |
R 200,000 |
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Internal Prosthesis |
R27,000 |
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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) |
|
| |
100% MSR |
|
| |
Monthly Savings Amounts: |
|
| |
Member |
R 531 |
|
| |
Member + Spouse |
R 1,028 |
|
| |
Member+Spouse+Child 1 |
R 1,217 |
|
| |
Member+Spouse+Child 2 |
R 1,217 |
|
| |
Member+Spouse+Child 3 |
R 1,217 |
|
| |
Member + Child 1 |
R 720 |
|
| |
|
|
|
| |
|
|
|
| |
Savings Advance on a monthly basis |
|
| |
|
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Does not apply |
|
| |
|
|
| |
|
|
| |
|
|
|
|
|
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 2,123 |
|
| |
Spouse /Adult dependant |
R 1,989 |
|
| |
1st Child Only |
R 754 |
|
| |
|
|
| |
|
|
|
|
|
|
| |
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 |
|
|
| |
Cochlear implants |
R 10, 000 |
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to formulary at State facilities |
|
| |
36 additional conditions limited to |
|
| |
R 6, 000 per family |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
|
|
| |
Member |
R 5,496 |
|
| |
Member+Spouse |
R 9,360 |
|
| |
Member+Spouse+Child1 |
R 11,172 |
|
| |
Member+Spouse+Child2 |
R 12,984 |
|
| |
Member+Spouse+Child3 |
R 14,796 |
|
| |
Member+Child 1 |
R 7,308 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 8,500 |
|
| |
Spouse/Adult dependant |
R 7,100 |
|
| |
Per Child (Max 3) |
R 2,500 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 1,833 |
|
| |
Spouse/Adult dependant |
R 1,287 |
|
| |
Per Child (Max 3) |
R 605 |
|
| |
|
|
|
| |
|
|
|
|
|
|
| |
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 |
|
|
| |
Cochlear Implants |
R 10, 000 |
|
| |
Internal Prostheses: |
R 47, 500 |
|
| |
|
|
|
| |
|
|
|
|
|
|
|
|
| |
CHRONIC MEDICATION BENEFIT |
|
| |
100% MSR |
|
| |
26 Chronic Disease Conditions |
|
| |
Subject to reference price list |
|
| |
36 additional conditions limited to |
|
| |
R 6, 000 per family |
|
| |
|
|
|
|
|
|
|
|
| |
ANNUAL DAY TO DAY BENEFIT
(including savings) |
|
| |
100% MSR |
|
| |
|
|
| |
Member |
R 6,552 |
|
| |
Member+Spouse |
R 11,532 |
|
| |
Member+Spouse+Child1 |
R 13,692 |
|
| |
Member+Spouse+Child2 |
R 15,852 |
|
| |
Member+Spouse+Child3 |
R18,012 |
|
| |
Member+Child 1 |
R 8,712 |
|
| |
|
|
|
| |
For more savings, please enquire |
|
| |
about the Health Saver |
|
| |
|
|
|
|
| |
ANNUAL THRESHOLD BENEFIT |
|
| |
Principal Member |
R 8,500 |
|
| |
Spouse/Adult dependant |
R 7,100 |
|
| |
Per Child (Max 3) |
R 2,500 |
|
| |
|
|
|
| |
MONTHLY CONTRIBUTIONS |
|
| |
Principal Member |
R 2,183 |
|
| |
Spouse/Adult dependant |
R 1,659 |
|
| |
Per Child (Max 3) |
R 720 |
|
| |
|
|
|
| |
|
|
|
|
|
|
As additional Hospital Plans with saving accounts 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 savings accounts.
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