Limited Day To Day Cover

limited day to day cover south africa smiling boy at dentist

Limited Day To Day Cover Hospital Plan – 2020 Comparisons

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 Limited Day To Day benefit does however not carry forward from year to year like savings does.  Any unused benefit falls away at the end of each year.

View our latest 2020 plan updates below.

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Limited Day To Day Cover2020 Comparisons Made Easy!

BONITAS
PRIMARY - Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 2,429
Spouse/Adult Dependant R 1,900
Per Child (Max 3) R 773



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Co-payments apply for certain procedures.
*R390 Take home medicine.
Annual Sub-limits per person:
Psychiatric Treatment
R 15,830
Hospice Care
R 16,880
Oncology
R 165,500




CHRONIC MEDICATION
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 2,660
Member + 1 R 4,760
Member + 2 R 5,590
Member + 3 R 6,010
Member + 4 + R 6,510
Network GP Limit:
Member R 1,900
Member + 1 R 3,490
Member + 2 R 4,130
Member + 3 R 4,440
Member + 4 + R 5,030

Once Annual Day to Day Benefit is exhausted
there is a R1 270 Wellness Extender Benefit
for GP, Physiotherapy, Biokineticist, Dietician visits.
ANNUAL THRESHOLD
Does not apply






BONITAS
STANDARD - Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 3,888
Spouse/Adult Dependant R 3,371
Per Child (Max 3) R 1,140



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
*R465 Take home medicine.



Annual Sub-limits per person:
Psychiatric Treatment
R 40,600
Hospice Care
R 16,880
Oncology
R 344,500




CHRONIC MEDICATION
100% Scheme Rate
27 PMB Chronic Disease Conditions.
(Additional 18 Chronic Disease Conditions)
Annual Limit:
Single R 9,800
Per family R 19,670
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limits per annum:
Member R 5,940
Member + 1 R 9,030
Member + 2 R 10,440
Member + 3 R 11,400
Member + 4 + R 12,420
Network GP Limit:
Member R 4,250
Member + 1 R 6,230
Member + 2 R 6,910
Member + 3 R 7,250
Member + 4 + R 7,870

Once Annual Day to Day Benefit is exhausted
there is a R1 750 Wellness Extender Benefit
for GP, Physiotherapy, Biokineticist, Dietician visits.
ANNUAL THRESHOLD
Does not apply




FEDHEALTH
FLEXIFED 2 ANY - Hospital Plan/Day to Day Cover
Note: Replaced FedHealth Maxima Saver
MONTHLY CONTRIBUTIONS
Principal Member R 2,275
Spouse/Adult Dependant R 1,975
Per Child (Max 3) R 675



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Co-payments are due for certain procedures
(eg: R8 200 for Arthroscopy)
*30 days Post Hospital Cover
*7 days Take Home Medicine
*Emergency Trauma at Out Patients
Psychiatric Treatment
R 24,700
Hospice Care
R 32,300
Oncology (only at DSP)
R 290,400
Internal Prosthesis
PMB
CHRONIC MEDICATION
100% Scheme Rate
27 Chronic Disease Conditions.
Subject to Intermediate Scheme formulary.
Only from Medi-Rite, Clicks, Dis-Chem &
Pharmacy Direct.



ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Member
R 300
Spouse
R 252
Per Child (Max 3)
R 84
MediVault Savings amounts are not pro-rated and can be
transferred to your Wallet at any time and paid back
interest-free over a period of 12 months:
Member
Member + 1
Member + 2
Member + 2 +





ANNUAL THRESHOLD
Member
R 4,500
Member + 1
R 8,400
Member + 2
R 9,600
Member + 2 +
R 11,400
FEDHEALTH
FLEXIFED 3 ANY - Hospital Plan/Day to Day Cover
Note: Replaced FedHealth Maxima Core
MONTHLY CONTRIBUTIONS
Principal Member R 2,545
Spouse/Adult Dependant R 2,296
Per Child (Max 3) R 915



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Co-payments are due for certain procedures
(eg: R8 200 for Arthroscopy)
*30 days Post Hospital Cover
*7 days Take Home Medicine
*Emergency Trauma at Out Patients
Psychiatric Treatment
R 24,700
Hospice Care
R 32,300
Oncology (only at DSP)
R 290,400
Internal Prosthesis
R 26,100
CHRONIC MEDICATION
100% Scheme Rate
27 Chronic Disease Conditions.
Subject to Intermediate Scheme formulary.
Only from Medi-Rite, Clicks, Dis-Chem &
Pharmacy Direct.



ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Member
R 300
Spouse
R 264
Per Child (Max 3)
R 108
MediVault Savings amounts are not pro-rated and can be
transferred to your Wallet at any time and paid back
interest-free over a period of 12 months:
Member
Member + 1
Member + 2
Member + 2 +





ANNUAL THRESHOLD
Member
R 5,400
Member + 1
R 10,200
Member + 2
R 11,700
Member + 2 +
R 13,800
HEALTH SQUARED
FLEX - Limited Day to Day Cover
Note: Old Resolution Progressive Flex Plan
MONTHLY CONTRIBUTIONS
Principal Member R 2,958
Spouse/Adult Dependant R 2,657
Per Child (Max 3) R 920



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Network Hospitals to be used or 30% co-payment will apply.
Co-payments are due for certain procedures
(eg: R4 000 Arthroscopy)
*7 days Take Home Medicine
*Emergency Casualty Annual Limit: R1 844 per family
Annual Sub-limits per person:
Psychiatric Treatment (Network Provider)
PMB
Hospice Care (per family)
12 days
Oncology (Subject to ICON network
R 302,776
and scheme protocols)

Internal Prosthesis: Subject to sub-limits & scheme protocols

CHRONIC MEDICATION
100% Scheme Rate
32 Chronic Disease Conditions.
Subject to scheme formulary.







ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate



GPs Member 4 visits

Member + 1 7 visits

Family 9 visits
Specialists Member 2 visits

Member + 1 3 visits

Family 3 visits
Conservative Dentistry Member R 3,606

Family R 5,798





















ANNUAL THRESHOLD
Does not apply






MEDSHIELD
MEDIVALUE PRIME - Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 2,103
Spouse/Adult Dependant R 1,836
Per Child (Max 3) R 591



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Prime Network hospitals to be used
Co-payments apply for certain procedures.
(eg: 40% co-payment for use of a non-DSP)
*R400 Take home medicine.
Annual Sub-limits per person:
Psychiatric Treatment
PMB
Hospice Care (joint limit)
R 28,000
Oncology
Unlimited PMB
CHRONIC MEDICATION
100% Scheme Rate
26 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 5,380
Member + 1 R 6,390
Member + 2 R 7,190
Member + 3 R 8,360
Member + 4 + R 9,270




















ANNUAL THRESHOLD
Does not apply






MEDSHIELD
MEDIPLUS PRIME - Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 3,453
Spouse/Adult Dependant R 2,466
Per Child (Max 3) R 777



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Prime Network hospitals to be used
Co-payments apply for certain procedures.
(eg: 40% co-payment for use of a non-DSP)
*R500 Take home medicine.
Annual Sub-limits per person:
Psychiatric Treatment
R 29,400
Hospice Care (joint limit)
R 59,850
Oncology
R 240,000
CHRONIC MEDICATION
100% Scheme Rate
26 PMB Chronic Disease Conditions.
Subject to scheme formulary.
Only from Medshield Pharmacy Network
Additional Disease List Annual Limit:
Single R6 325 / Per family R12 650
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limits per annum:
Member R 7,950
Member + 1 R 11,100
Member + 2 R 12,450
Member + 3 R 14,000
Member + 4 + R 15,350




















ANNUAL THRESHOLD
Does not apply




MEDIHELP
PRIME 3 - Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 3,618
Spouse/Adult Dependant R 3,060
Per Child (Max 2) R 1,056



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Co-payments on specified procedures may apply.
(eg. Arthroscopy R2 100 at a Day Clinic and
R3 200 in Hospital)
*Take Home Medicine limited to R350 per admission
*30 days Post Hospital Cover limited to R1 800 single
member and R2 500 per family per annum.
Annual Sub-limits per person:
Psychiatric Treatment (per family)
R 39,300
Hospice Care
Unlimited
Oncology (PMB)
Unlimited
Oncology (non PMB)
R 263,500
CHRONIC MEDICATION
100% Scheme Rate
26 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 2,660
Member + 1 R 4,760
Member + 2 R 5,590
Member + 3 R 6,010
Member + 4 + R 6,510
Network GP Limit:
Member R 1,900
Member + 1 R 3,490
Member + 2 R 4,130
Member + 3 R 4,440
Member + 4 + R 5,030




ANNUAL THRESHOLD
Does not apply






MOMENTUM INCENTIVE OPTION
ASSOCIATED HOSPITAL & ANY FOR CHRONIC
Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 3,301
Spouse/Adult Dependant R 2,656
Per Child (Max 3) R 1,233



IN HOSPITAL BENEFIT
2020 BENEFITS
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 per person:
Psychiatric Treatment
R 37,900
Hospice Care (including Rehab & Step-down)
R 53,000
Oncology R 400 000 thereafter 20% co-payment.

Internal Prostheses: See detailed benefit schedule.

CHRONIC MEDICATION
100% Scheme Rate
26 Chronic Disease Conditions.
Subject to scheme formulary.
6 additional conditions limited to R10 300 per family.



ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate

Limits per annum:
Member R 3,960
Member + Spouse R 7,152
Member + Spouse + Child 1 R 8,628
Member + Spouse + Child 2 R 10,104
Member + Spouse + Child 3 R 11,580
Member + Child 1 R 5,436
Member + Child 2 R 6,912
Member + Child 3 R 8,388



For more savings please enquire about the
Health Saver.

ANNUAL THRESHOLD
Does not apply






MOMENTUM INCENTIVE OPTION
ASSOCIATED HOSPITAL & STATE FOR CHRONIC
Limited Day to Day Cover
MONTHLY CONTRIBUTIONS
Principal Member R 2,141
Spouse/Adult Dependant R 1,690
Per Child (Max 3) R 821



IN HOSPITAL BENEFIT
2020 BENEFITS
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 per person:
Psychiatric Treatment
R 37,900
Hospice Care (including Rehab & Step-down)
R 53,000
Oncology R 400 000 thereafter 20% co-payment
Internal Prosthesis: See detailed benefits
CHRONIC MEDICATION
100% Scheme Rate
26 Chronic Disease Conditions.
Subject to scheme formulary.
6 additional conditions limited to R10 300 per family.
Only from state hospital.
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate

Limits per annum:
Member R 2,568
Member + Spouse R 4,596
Member + Spouse + Child 1 R 5,580
Member + Spouse + Child 2 R 6,564
Member + Spouse + Child 3 R 7,548
Member + Child 1 R 3,552
Member + Child 2 R 4,536
Member + Child 3 R 5,520



For more savings please enquire about the
Health Saver.

ANNUAL THRESHOLD
Does not apply






As additional Hospital Plan with Limited Day To Day Cover comparisons are made 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 Hospital Plan with Limited Day To Day Cover comparisons simply contact us. 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 free 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 Plan with Limited Day To Day Cover comparisons.

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