Medical aid plans that cost R4,001-R5,000 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
Suremed Challanger 2017 R4,000 R3,000 R800 R R R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: medication, appliances, dentistry, GPs and specialists, maternity, non surgical procedures, optometry, supplementary services, pathology, radiology, specialised radiology, preventative care, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB. Pay for all children.


Compcare Dynamix 2017 R4,014 R3,138 R1,122 R7,200 R2,408 R5,000 R5,800 pb
R11,600 pf

100% scheme rate for specialists. Some co-payments. Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits). Pay for all children.


Discovery Classic Delta Comprehensive 2017 R4,059 R3,842 R807 R12,168 R R3,332 unlimited

200% scheme rate for specialists. Network hospitals. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB. Pay for maximum 3 children.


Medshield MediBonus 2017 R4,119 R2,829 R819 R RM =R9,300
M1 = R13,040
M2 =R14,460
M3 = R15,930
M4 = R17,240
R

Up to 200% 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.


Keyhealth Gold 2017 R4,143 R2,802 R812 R4,968 R4,190 R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), dentistry, medicine, optometry, maternity, medical appliances, hearing aids, preventative benefits. Limits apply. All else paid from savings, from fund or from out of pocket, unless PMB. Pay for all children.


Hosmed Plus R4,184 R3,115 R700 R R R

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


Resolution Millennium 2017 R4,200 R3,598 R979 R10,092 R R3,479 5,544

Pay for all children.


Sizwe Full Benefit A 2017 R4,210 R3,825 R860 R R R

Pay for all children. Income-limited plan: R0-R18,879pm only


Bestmed Pace 3 A 2017 R4,243 R3,394 R725 R7,632 R15,000 (main) R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative dentistry, optometry, maternity, specialised radiology, contraceptives, some medicine, trauma rehab and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB. Pay for maximum 4 children. Income-limited plan: R0-R8,208pmpm only


Medshield Premium Plus 2017 R4,284 R3,909 R792 R12,852 R R 4,280

Up to 200% scheme rate. Scheme pays out-of-hospital claims for: specialised radiology, maternity, alternative to hospitalisation, some non-surgical procedures including scopes, preventative benefits. Limits apply. All else paid from savings, from threshold benefit or from out of pocket, unless PMB. Pay for three children only.


Fedhealth Maxima Exec 2017 R4,302 R3,666 R1,284 R3,768 R5,390 R2,042 unlimited

100% scheme rate for specialists. Comprehensive plan with extended fund and threshold benefits that can be used for most out-of-hospital claims. Pay for all children.


Momentum Extender Network hospital (and Network provider for chronic) 2017 R4,304 R3,433 R1,352 R12,912 R R4,188 Unlimited

200% scheme rate for specialists. Network hospitals. Chronic benefits from Network provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid. Pay for maximum 3 children.


Momentum Extender (State provider for chronic) 2017 R4,309 R3,507 R1,323 R12,927 R R4,173 Unlimited

00% scheme rate. Chronic benefits from State provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid. Pay for maximum 3 children.


Bestmed Pace 2 2017 R4,315 R4,231 R951 R7,764 R12,000 (main) R

100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative dentistry, optometry, maternity, specialised radiology, contraceptives, some medicine, trauma rehab and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB. Pay for maximum 4 children.


Compcare Pinnacle ED 2017 R4,452 R3,462 R1,242 R10,656 R R1,900 R8,700 pb
R17,400 pf

200% scheme rate for specialists. Netcare hospitals. Some co-payments. Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits). Pay for all children.


Topmed Executive 2017 R4,453 R3,554 R1,355 R12,356 R R

200% scheme rate fro specialists. Scheme pays most out-of-hospital claims for: maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. All else paid for from day-to-day benefits, which include an unlimited above threshold benefit or out-of-pocket unless PMB. Sub-limits apply. Pay for all children.


Discovery Classic Comprehensive 2017 R4,506 R4,264 R898 R13,512 R R1,988 unlimited

200% scheme rate for specialists. Comprehensive cover with savings, extended fund, and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB. Pay for maximum 3 children.


Resolution Supreme 2017 R4,565 R4,345 R1,130 R R R

Pay for all children.


Momentum Extender Network hospital (and any provider for chronic) 2017 R4,671 R3,728 R1,465 R14,013 R R3,087 Unlimited

200% scheme rate for specialists. Network hospitals. Chronic benefits from any provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid. Pay for maximum 3 children.


Momentum Extender (Network provider for chronic) 2017 R4,776 R3,813 R1,495 R14,328 R R2,772 Unlimited

200% scheme rate for specialists. Chronic benefits from Network provider. Comprehensive plan, with out of hospital benefits paid by scheme from threshold (with sub-limits), once savings run out and self payment gap has been paid. Pay for maximum 3 children.


Sizwe Full Benefit B 2017 R4,885 R4,441 R960 R R R

Pay for all children. Income-limited plan: R18,880+pm only


Cape Medical Select 2017 R4,998 R4,998 R809 R3,600 R4,800 R

Pay for all children.