Medihelp Medical Aid Comparisons – 2021 Plans
Medihelp Medical Aid Comparisons: Medihelp offers a range of good quality simple plans for corporate and individual clients. The products offer cost-effective and efficient financial cover for health care services.
You can compare Medihelp Medical Aid Comparisons and options side by side to find out which suit you the best. Some plans might require that you use a specific GP or hospital network. If you prefer to having the choice to use any provider’s services, you should choose a non-network option instead.
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Compare Medihelp’s latest 2021 plan updates in the tables below.
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Medihelp Health PlansCompare 4 Medical Aid Plans - 2021 Updates
| MEDIHELP | ||
| PRIME 1 - Hospital Plan | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 2,202 | |
| Spouse/Adult Dependant | R 1,818 | |
| Per Child (Max 2) | R 672 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 100% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments on specified procedures may apply. | ||
| (eg. Arthroscopy R4 200 in Hospital + a further 35% co-payment | ||
| will apply if services performed out of Day Surgery Network) | ||
| No co-payment if done in doctors room | ||
| *30 days Post Hospital Cover limited to R1 870 single | ||
| member and R2 600 per family per annum. | ||
| Annual Sub-limits per person: | ||
| Psychiatric Treatment (per family) | R 30,400 | |
| Hospice Care | Unlimited | |
| Oncology (PMB) | Unlimited | |
| Oncology (non PMB) | R 220,000 | |
| CHRONIC MEDICATION | ||
| 100% Scheme Rate | ||
| 26 Chronic Disease Conditions. | ||
| Subject to scheme formulary. | ||
| Only from a DSP. | ||
| ANNUAL DAY TO DAY BENEFIT | ||
| (including Savings) | ||
| Does not apply | ||
| GP's | ||
| Single | R 1,250 | |
| Family | R 2,500 | |
| Shared limit with Acute / Prescribed Medication | ||
| Specialists | ||
| Shared limit with GP Consultations. | ||
| Conservative Dentistry | ||
| Removal of impacted wisdom teeth only. | ||
| ANNUAL THRESHOLD | ||
| Does not apply | ||
| MEDIHELP | ||
| PRIME 2 - Hospital Plan with Savings | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 2,934 | |
| Spouse/Adult Dependant | R 2,412 | |
| Per Child (Max 2) | R 882 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 100% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments on specified procedures may apply. | ||
| (eg. Arthroscopy R4 050 in Hospital + a further 35% co-payment | ||
| will apply if services performed out of Day Surgery Network) | ||
| No co-payment if done in doctors room | ||
| *30 days Post Hospital Cover limited to R1 870 single | ||
| member and R2 600 per family per annum. | ||
| Annual Sub-limits per person: | ||
| Psychiatric Treatment (per family) | R 34,800 | |
| Hospice Care | Unlimited | |
| Oncology (PMB) | Unlimited | |
| Oncology (non PMB) | R 240,840 | |
| CHRONIC MEDICATION | ||
| 100% Scheme Rate | ||
| 26 Chronic Disease Conditions. | ||
| Subject to scheme formulary. | ||
| Only from a DSP. | ||
| ANNUAL DAY TO DAY BENEFIT | ||
| (including Savings) | ||
| 100% Scheme Rate | ||
| Limits per annum: | ||
| Member | R 5,256 | |
| Member + Spouse | R 9,576 | |
| Member + Spouse + Child 1 | R 11,160 | |
| Member + Spouse + Child 2 | R 12,744 | |
| Member + Spouse + Child 3 | R 14,328 | |
| Member + Child 1 | R 6,840 | |
| Member + Child 2 | R 8,424 | |
| Member + Child 3 | R 10,008 | |
| ANNUAL THRESHOLD | ||
| Does not apply | ||
| MEDIHELP | ||
| PRIME 3 - Limited Day to Day Cover | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 3,828 | |
| Spouse/Adult Dependant | R 3,240 | |
| Per Child (Max 2) | R 1,116 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 100% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments on specified procedures may apply. | ||
| (eg. Arthroscopy R3 350 in Hospital + a further 35% co-payment | ||
| will apply if services performed out of Day Surgery Network) | ||
| No co-payment if done in doctors room | ||
| *Take Home Medicine limited to R450 per admission | ||
| *30 days Post Hospital Cover limited to R1 870 single | ||
| member and R2 600 per family per annum. | ||
| Annual Sub-limits per person: | ||
| Psychiatric Treatment (per family) | R 40,800 | |
| Hospice Care | Unlimited | |
| Oncology (PMB) | Unlimited | |
| Oncology (non PMB) | R 273,700 | |
| 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 4,608 | |
| Member + Spouse | R 8,496 | |
| Member + Spouse + Child 1 | R 9,864 | |
| Member + Spouse + Child 2 | R 11,232 | |
| Member + Spouse + Child 3 | R 12,600 | |
| Member + Child 1 | R 5,976 | |
| Member + Child 2 | R 7,344 | |
| Member + Child 3 | R 8,712 | |
| Network GP Limit: | ||
| Singlel | R 6,000 | |
| Family | R 11,000 | |
| ANNUAL THRESHOLD | ||
| Does not apply | ||
| MEDIHELP | ||
| UNIFY - Hospital Plan with Savings | ||
| MONTHLY CONTRIBUTIONS | ||
| Principal Member | R 2,748 | |
| Spouse/Adult Dependant | R 2,256 | |
| Per Child (Max 2) | R 828 | |
| IN HOSPITAL BENEFIT | ||
| 2021 BENEFITS | ||
| 100% Scheme Rate | ||
| No Overall Annual Limit | ||
| Co-payments on specified procedures may apply. | ||
| (eg. Arthroscopy R4 050 in Hospital + a further 35% co-payment | ||
| will apply if services performed out of Day Surgery Network) | ||
| No co-payment if done in doctors room | ||
| *Take Home Medicine limited to R350 per admission | ||
| *30 days Post Hospital Cover limited to R1 870 single | ||
| member and R2 600 per family per annum. | ||
| Annual Sub-limits per person: | ||
| Psychiatric Treatment (per family) | R 34,800 | |
| Hospice Care | Unlimited | |
| Oncology (PMB) | Unlimited | |
| Oncology (non PMB) | R 240,840 | |
| 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 8,208 | |
| Member + Spouse | R 14,976 | |
| Member + Spouse + Child 1 | R 17,424 | |
| Member + Spouse + Child 2 | R 19,872 | |
| Member + Spouse + Child 3 | R 22,320 | |
| Member + Child 1 | R 10,656 | |
| Member + Child 2 | R 13,104 | |
| Member + Child 3 | R 15,552 | |
| ANNUAL THRESHOLD | ||
| Does not apply | ||
More Information About Medihelp
For more detailed information on any of the above Medihelp Medical Aid Comparisons, please feel free to give us a call 021 712 8866.
Applying For Medihelp Medical Aid
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.
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 Medihelp Medical Aid Comparisons. Visit Medihelp.
