Medical aid plans that cost R1,200-R1,500 for main member

(Please note that only plans for 2017 are shown below, and more will be added as they are released by the medical schemes. We anticipate all plans should be on this site by Nov 5 2016)

CONTRIBUTIONS: MAIN MEMBER BENEFITS:
Main Adult Child Savings Extended Fund Self payment Above Threshold
Spectramed Aqua 2017 R1,208 R1,099 R427 R R R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children.


Discovery KeyCare Access C 2017 R1,241 R1,241 R348 R R R

Unlimited cover in state facilities, or Access network for some procedures. Scheme pays out-of-hospital claims for: maternity, specialists. All else paid from out of pocket, unless PMB. Pay for maximum 3 children. Income-limited plan: R8,101-R11,550pm only


Momentum Ingwe Network D 2017 R1,241 R1,241 R365 R R R

100% scheme rate for specialists. Network hospitals. R1,190,000 per family limit. Income based plan. Scheme pays out-of-hospital claims for: dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Income-limited plan: R8,201-R11,000pm only


Bestmed Beat 1 2017 R1,257 R976 R529 R R R

100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 4 children.


Medihelp Dimension Prime 1 Network R1,260 R1,026 R378 R R R

100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), GP, specialists, physio, medication, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 2 children under 18yrs. Child rates apply for under 26yr olds.


Compcare Axis ED 2017 R1,260 R1,260 R396 R R R

100% scheme rate for specialists. Netcare hospitals. Some exclusions apply. Most out-of-hospital benefits covered only if PMBs. Pay for all children.


Momentum Custom Associate (and State provider for chronic) 2017 R1,266 R957 R448 R R R

100% scheme rate for specialists. State hospitals. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children.


Momentum Ingwe C 2017 R1,273 R1,273 R385 R R R

100% scheme rate for specialists. R1,190,000 per family limit. Income based plan. Scheme pays out-of-hospital claims for: dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Income-limited plan: R6,101-R8,200pm only


Keyhealth Essence 2017 R1,278 R1,013 R427 R R R

100% scheme rate for specialists. Network hospitals. Some co-payments. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, medical appliances, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children.


Discovery KeyCare Plus B 2017 R1,280 R1,280 R358 R R R

Unlimited cover in KeyCare networks. Scheme pays out-of-hospital claims for: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children. Income-limited plan: R8,101-R11,550pm only


Topmed Network C 2017 R1,282 R1,282 R359 R R R

100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: scopes, medicine, dentistry, optometry, supplementary services, radiology, pathology. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Income-limited plan: R8,001-R11,000pm only


Momentum Ingwe State E 2017 R1,291 R1,291 R389 R R R

100% scheme rate for specialists. State hospitals. Network hospitals. R1,190,000 per family limit. Income based plan. Scheme pays out-of-hospital claims for: dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Income-limited plan: R11,001+pm only


Discovery Essential Delta Core 2017 R1,317 R989 R528 R R R

100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB. Pay for maximum 3 children.


Compcare Networx ED H 2017 R1,318 R1,186 R585 R R2,800 (main) R

100% scheme rate for specialists. Some exclusions apply. Private and public Network hospitals. Annual limit of R1,100,000 per family. Scheme pays for: GPs, medicine, radiology, pathology, maternity and preventative benefits. Limits apply. All else paid from out of fund or from out of pocket, unless PMB. Pay for all children. Income-limited plan: R10,001+pm only


Suremed Shuttle 2017 R1,320 R980 R540 R R R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: specialised radiology, preventative care, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB. Pay for all children.


Medshield MediValue 2017 R1,521 R1,323 R414 R RM= R4,815
M1= R5,240
M2= R5,900
M3= R6,660
M4+ =R7,600
R

100% scheme rate. Scheme pays out-of-hospital claims for: specialised radiology, maternity, alternative to hospitalisation, optometry, some non-surgical procedures including scopes,preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB. Pay for three children only.


Fedhealth Maxima EntryZone 2017 R1,326 R991 R446 R R R

100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children.


Resolution Fundation C 2017 R1,338 R1,338 R427 R R R

Pay for all children. Income-limited plan: R7,101-R9,700pm only


Bestmed Pulse 1 B 2017 R1,357 R1,290 R814 R R R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: GP and specialist consults, dentistry, optometry, maternity, radiology and pathology, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 4 children. Income-limited plan: R6,001-R10,000pm only


Fedhealth Blue Door C R1,380 R1,145 R522 R R R

100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Income-limited plan: R8,501-R10,500pm only


Medimed Essential C 2017 R1,390 R1,390 R400 R1,668 R R

100% scheme rate for specialists. Network hospitals. Income based plan. Over and above the savings, scheme pays out-of-hospital claims for: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB. Pay for all children. Income-limited plan: R8,501-R13,000pm only


Bestmed Beat 2 Network 2017 R1,399 R1,087 R589 R2,856 R R

100% scheme rate for specialists. Network hospitals. Some co-payments. Scheme pays out-of-hospital claims for: preventative dentistry, wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB. Pay for maximum 4 children.


Medihelp Necesse B R1,404 R1,110 R600 R R R

100% scheme rate for specialists. Network hospitals only. Income based plan. Scheme pays out-of-hospital claims for: specialised radiology, maternity, GPs, specialists, supplementary health and medication, dentistry, optometry, medical appliances, radiology and pathology. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Child rates apply for under 21yr olds. Income-limited plan: R401-R5,000pm only


Discovery KeyCare Core C 2017 R1,408 R1,408 R318 R R R

Unlimited cover in KeyCare networks. Scheme pays out-of-hospital claims for: maternity, GP consults, specialists, casualty visits, acute meds, pathology and radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children. Income-limited plan: R11,551+pm only


Topmed Essential 2017 R1,458 R1,174 R592 R R R

100% scheme rate for specialists. Hospital plan. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, scopes, alternatives to hospital, extended rehab benefits, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children.


Hosmed Essential B R1,460 R1,333 R368 R R R

100% scheme rate for specialists. In-hospital, PMBs only. Scheme pays out-of-hospital claims for: GPs, specialists, medicine, pathology, radiology, specialised radiology, optometry, dentistry, appliances, maternity benefits, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children.


Medihelp Necesse C R1,464 R1,170 R660 R R R

100% scheme rate for specialists. Network hospitals only. Income based plan. Scheme pays out-of-hospital claims for: specialised radiology, maternity, GPs, specialists, supplementary health and medication, dentistry, optometry, medical appliances, radiology and pathology. Limits apply. All else paid from out of pocket, unless PMB. Pay for all children. Child rates apply for under 21yr olds. Income-limited plan: R5,001-R7,000pm only


Makoti Comprehensive A 2017 R1,469 R1,266 R488 R R R

Pay for all children. Income-limited plan: R0-R9,250pm only


Bonitas Essential 2017 R1,473 R1,127 R432 R R R

100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: maternity and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children .


Momentum Custom (Network for chronic) 2017 R1,483 R1,483 R689 R R R

100% scheme rate for specialists. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB. Pay for maximum 3 children.


Discovery Coastal Core 2017 R1,496 R1,122 R596 R R R

100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB. Pay for maximum 3 children.


Genesis Private: 2017 R1,500 R1,500 R365 R R R

100% scheme rate for specialists. R50,000 in-hospital limit for cancer, stroke, motor-neuron disease and organ transplant. Scheme pays out-of-hospital claims for: dentistry. Limits apply. All else paid out of pocket, unless PMB. Pay for all children.