Topmed in-hospital benefits: 2017

Nov 2, 2016

Click here to compare in-hospital benefits across all schemes, or use the menu bar above for more options. Topmed home page.

Non income-limited plans

Income limited plans

Momentum Ingwe A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R335	R335	R210
Children:	Pay for all children
Income limit:	R0-R650 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Pinnacle 2017: In-hospital Benefits

In brief: 200% 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).

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,328	R4,146	R1,476
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits).
	Main:	Adult:	Child:
(S) Savings:	R12,816	R9,936	R3,528
Extended Fund:	R3,197	R2,488	R886
(SP) Self Payment:	R1,900	R1,416	R460
Threshold (S+SP):	R17,913	R13,840	R4,874
Above Threshold:	R8,700 pb R17,400 pf	17,400 pf

Compare with these plans:

Compcare Pinnacle ED 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

First R2,500 payable from available Savings
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion: R1,000
Gastroscopy, colonoscopy, cystoscopy, nasal/sinus endoscopy, functional nasal surgery, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, joint replacements, conservative back and neck treatment, laminectomy and spinal fusion and nissen fundoplication (reflux surgery), hysterectomy (except for cancer), laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R1,500
Specialised radiology: R2,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Discovery KeyCare Plus A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R914	R914	R331
Children:	Pay for maximum 3 children
Income limit:	R0-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access A 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

If related to approved hospital admission, covered in full
If not, Discovery will pay up to R3,250 per person
No cover for conservative back or neck treatments

4. Supplementary Services: (Physio, etc)

Covered 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Endoscopic procedures: Covered if performed in Day Surgery network

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Fedhealth Maxima EntryZone 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,326	R991	R446
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntrySaver 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a R5,600 co-payment

3. Specialised Radiology:

R2,500 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: PMBs only

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

Colonoscopy, upper GI endoscopy, open hiatus hernia surgery, spinal surgery, back and neck procedures, bunion procedures, cataract surgery, gastritis, dyspepsia, heartburn, hysterectomy, nasal procedures, skin biopsy/excision, tonsil/adenoid procedures, varicose vein procedures, cystoscopy: R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment. Hip or wrist, PMBs only with no co-payment
Laparoscopic procedures: R5,800 co-payment
Elective caesarean: R10,000 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R911	R911	R342
Children:	Pay for all children
Income limit:	R651-R6,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Pinnacle ED 2017: In-hospital Benefits

In brief: 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).

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,452	R3,462	R1,242
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits).
	Main:	Adult:	Child:
(S) Savings:	R10,656	R8,280	R2,952
(SP) Self Payment:	R1,900	R1,416	R460
Threshold (S+SP):	R15,226	R11,774	R4,158
Above Threshold:	R8,700 pb R17,400 pf	17,400 pf

Compare with these plans:

Compcare Pinnacle 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Hospitals

3. Specialised Radiology:

First R2,500 payable from available Savings
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion: R1,000
Gastroscopy, colonoscopy, cystoscopy, nasal/sinus endoscopy, functional nasal surgery, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, joint replacements, conservative back and neck treatment, laminectomy and spinal fusion and nissen fundoplication (reflux surgery), hysterectomy (except for cancer), laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R1,500
Specialised radiology: R2,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Discovery KeyCare Plus B 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,280	R1,280	R358
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access B 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

Covered 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Gomomo A 2017: In-hospital Benefits

In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: maternity. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,666	R1,546	R410
Children:	Pay for all children
Income limit:	R0-R10,112 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:maternity. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Savings Care A 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to protocols

5. Transplants:

Unlimited, at PMB level of care

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Fedhealth Maxima Core 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,907	R1,616	R667
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:post hospitalisation treatment (30 days), casualty visits, GP visit, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima Core Grid 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: PMBs only

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, hysterectomy, open hiatus hernia surgery, varicose vein procedures, wisdom teeth extraction: R3,700 co-payment
Spinal surgery, joint replacements: R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment
Laparoscopic procedures: R5,800 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R1,273	R1,273	R385
Children:	Pay for all children
Income limit:	R6,101-R8,200 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Dynamix 2017: In-hospital Benefits

In brief: 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).

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,014	R3,138	R1,122
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits).
	Main:	Adult:	Child:
(S) Savings:	R7,200	R5,688	R2,016
Extended Fund:	R2,408	R1,883	R673
(SP) Self Payment:	R5,000	R3,878	R1,402
Threshold (S+SP):	R14,608	R11,449	R4,091
Above Threshold:	R5,800 pb R11,600 pf	11,600 pf

Compare with these plans:

Compcare Dynamix ED 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

First R2,500 payable from day-to-day benefit
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion: R1,000
Gastroscopy, colonoscopy, cystoscopy, nasal/sinus endoscopy, functional nasal surgery, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, joint replacements, conservative back and neck treatment, laminectomy and spinal fusion and nissen fundoplication (reflux surgery), hysterectomy (except for cancer), laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R1,500
Specialised radiology: R2,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R330	R330	R330
Children:	Pay for all children
Income limit:	R0-R500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Plus C 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,906	R1,906	R510
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access C 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

Covered 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Gomomo B 2017: In-hospital Benefits

In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,060	R1,623	R420
Children:	Pay for all children
Income limit:	R10,113+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Savings Care B 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to protocols

5. Transplants:

Unlimited, at PMB level of care

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Fedhealth Maxima Core Grid 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,716	R1,454	R600
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:post hospitalisation treatment (30 days), casualty visits, GP visit, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima Core 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a R5,600 co-payment

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: PMBs only

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, hysterectomy, open hiatus hernia surgery, varicose vein procedures, wisdom teeth extraction: R3,700 co-payment
Spinal surgery, joint replacements: R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment
Laparoscopic procedures: R5,800 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R1,734	R1,734	R406
Children:	Pay for all children
Income limit:	R8,201-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network D 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Dynamix ED 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Netcare hospitals. Some co-payments. Comprehensive cover with savings, and limited above threshold benefits that cover most out-of-hospital benefits (with limits).

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,306	R2,580	R930
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive cover with savings, extended fund, and limited above threshold benefits that cover most out-of-hospital benefits (with limits).
	Main:	Adult:	Child:
(S) Savings:	R5,976	R4,680	R1,656
Extended Fund:	R1,984	R1,548	R558
(SP) Self Payment:	R5,000	R3,878	R1,402
Threshold (S+SP):	R12,960	R10,106	R3,616
Above Threshold:	R5,800 pb R11,600 pf	11,600 pf

Compare with these plans:

Compcare Dynamix 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Network

3. Specialised Radiology:

First R2,500 payable from day-to-day benefit
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion: R1,000
Gastroscopy, colonoscopy, cystoscopy, nasal/sinus endoscopy, functional nasal surgery, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, joint replacements, conservative back and neck treatment, laminectomy and spinal fusion and nissen fundoplication (reflux surgery), hysterectomy (except for cancer), laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R1,500
Specialised radiology: R2,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R665	R632	R233
Children:	Pay for all children
Income limit:	R501-R4,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Access A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R644	R644	R281
Children:	Pay for maximum 3 children
Income limit:	R0-R5,050 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Plus A 2017

View this plan in full
.
.

2. Hospital Choice:

Emergencies, trauma, childbirth and care for newborn in KeyCare Access Network
Traumas covered: injuries at work, burns, injuries from a crime, sexual assault, injuries from a car accident, injuries from a fall, loss of arm, leg or foot, near drowning, head injuries, poisoning or serious allergic reaction that may cause death
Other conditions in contracted state facilities

3. Specialised Radiology:

If related to approved hospital admission, covered in full
If not, Discovery will pay up to R3,250 per person
No cover for conservative back or neck treatments

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Savings Care A 2017: In-hospital Benefits

In brief: 100% scheme rate. Scheme pays out-of-hospital claims for: radiology, pathology, maternity. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,015	R1,742	R490
Children:	Pay for all children
Income limit:	R0-R15,052 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medication, radiology, physio, pathology, standard dentistry, optometry, maternity. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,627	R3,136	R882

Compare with these plans:

Sizwe Gomomo A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R23,960 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

R190,420 per family

6. Co-payments:

7. Alternatives to hospitals:

R5,750 per family

View this plan

Fedhealth Maxima EntrySaver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,640	R1,181	R524
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,168	R2,280	R1,008

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

Colonoscopy, upper GI endoscopy, open hiatus hernia surgery, spinal surgery, back and neck procedures, bunion procedures, cataract surgery, gastritis, dyspepsia, heartburn, hysterectomy, nasal procedures, skin biopsy/excision, tonsil/adenoid procedures, varicose vein procedures, cystoscopy: R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment
Laparoscopic procedures: R5,800 co-payment
Elective caesarean: R10,000 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R2,225	R2,225	R646
Children:	Pay for all children
Income limit:	R11,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network E 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Symmetry 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme offers extended fund once savings are depleted, and also pays for: specialised radiology, GPs (unlimited), medical appliances and preventative benefits. Limits apply.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,186	R2,484	R900
Children:	Pay for all children
Day-to-Day Benefit:
Scheme offers extended fund for claims once savings are depleted, and also pays for: specialised radiology, GPs, medical appliances and preventative benefits. Limits apply. All else paid from savings, fund or out of pocket.
	Main:	Adult:	Child:
(S) Savings:	R3,816	R2,952	R1,080
Extended Fund:	R3,816	R2,952	R1,080

Compare with these plans:

Compcare Symmetry ED 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R25,000 per family with first R1,500 paid out of savings
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R7,000 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R2,000
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy : R3,000
laminectomy and spinal fusion: R4,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, functional nasal surgry and septoplasty: R6,150
Joint replacements, conservative back and neck treatment - spinal cord injections, laminectomy and spinal fusion, nissen fundoplication (reflux surgery):R12,600
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R687	R652	R240
Children:	Pay for all children
Income limit:	R4,001-R5,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Access B 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R859	R859	R309
Children:	Pay for maximum 3 children
Income limit:	R5,051-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Plus B 2017

View this plan in full
.
.

2. Hospital Choice:

Emergencies, trauma, childbirth and care for newborn in KeyCare Access Network
Traumas covered: injuries at work, burns, injuries from a crime, sexual assault, injuries from a car accident, injuries from a fall, loss of arm, leg or foot, near drowning, head injuries, poisoning or serious allergic reaction that may cause death
Other conditions in contracted state facilities

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Savings Care B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,800	R2,243	R555
Children:	Pay for all children
Income limit:	R15,053+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R5,040	R4,037	R999

Compare with these plans:

Sizwe Gomomo B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R23,960 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

R190,420 per family

6. Co-payments:

7. Alternatives to hospitals:

R5,750 per family

View this plan

Fedhealth Maxima Saver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,079	R1,693	R600
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,744	R3,048	R1,080

Compare with these plans:

Fedhealth Maxima Saver Grid 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, open hiatus hernia surgery, wisdom teeth extraction: R3,700 co-payment
Spinal surgery, back and neck procedures, bunion procedures, cataract surgery, elective caesarean, gastritis, dyspepsia, heartburn, hysterectomy, nasal procedures, skin biopsy/excision, tonsil/adenoid procedures, varicose vein procedures, cystoscopy, : R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment
Dental admissions, laparoscopic procedures: R5,800 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe Network A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R335	R335	R210
Children:	Pay for all children
Income limit:	R0-R650 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe A 2017

View this plan in full
.
.

2. Hospital Choice:

Ingwe Network

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Symmetry ED 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Netcare hospitals. Some co-payments. Scheme offers extended fund once savings are depleted, and also pays for: specialised radiology, GPs (unlimited), medical appliances and preventative benefits. Limits apply.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,598	R2,022	R732
Children:	Pay for all children
Day-to-Day Benefit:
Scheme offers extended fund for claims once savings are depleted, and also pays for: specialised radiology, GPs, medical appliances and preventative benefits. Limits apply. All else paid from savings, fund or out of pocket.
	Main:	Adult:	Child:
(S) Savings:	R3,118	R2,426	R878
Extended Fund:	R3,118	R2,426	R878

Compare with these plans:

Compcare Symmetry 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Network

3. Specialised Radiology:

R25,000 per family with first R1,500 paid out of savings
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R7,000 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, arthroscopy, diagnostic laparoscopy, dental, laparoscopic inguinal hernia repair, laparoscopic appendicectomy: R2,000
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy : R3,000
laminectomy and spinal fusion: R4,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, functional nasal surgry and septoplasty: R6,150
Joint replacements, conservative back and neck treatment - spinal cord injections, laminectomy and spinal fusion, nissen fundoplication (reflux surgery):R12,600
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R821	R779	R289
Children:	Pay for all children
Income limit:	R5,001-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED Plus D 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Access C 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,241	R1,241	R348
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Plus C 2017

View this plan in full
.
.

2. Hospital Choice:

Emergencies, trauma, childbirth and care for newborn in KeyCare Access Network
Traumas covered: injuries at work, burns, injuries from a crime, sexual assault, injuries from a car accident, injuries from a fall, loss of arm, leg or foot, near drowning, head injuries, poisoning or serious allergic reaction that may cause death
Other conditions in contracted state facilities

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Primary Care A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R407	R407	R407
Children:	Pay for all children
Income limit:	R0-R530 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R17,710 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R4,310 per family

View this plan

Fedhealth Maxima Saver Grid 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,871	R1,524	R540
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,372	R2,748	R972

Compare with these plans:

Fedhealth Maxima Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, open hiatus hernia surgery, wisdom teeth extraction: R3,700 co-payment
Spinal surgery, back and neck procedures, bunion procedures, cataract surgery, elective caesarean, gastritis, dyspepsia, heartburn, hysterectomy, nasal procedures, skin biopsy/excision, tonsil/adenoid procedures, varicose vein procedures, cystoscopy, : R5,300 co-payment
Arthroscopic procedures: R6,900 co-payment
Dental admissions, laparoscopic procedures: R5,800 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: PMBs only

View this plan

Momentum Ingwe Network B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R701	R701	R321
Children:	Pay for all children
Income limit:	R651-R6,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe B 2017

View this plan in full
.
.

2. Hospital Choice:

Ingwe Network

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Mumed 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme offers fund for out-of-hospital claims, incl unlimited GP visits, Scheme also pays for specialised radiology, medical appliances and preventative benefits.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,532	R1,974	R714
Children:	Pay for all children
Day-to-Day Benefit:
Scheme offers fund for out-of-hospital claims, incl unlimited GP visits, Scheme also pays for specialised radiology, medical appliances and preventative benefits.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R5,376	R3,372	R1,338

Compare with these plans:

Compcare Mumed ED 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R22,000 per family
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R6,000 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, diagnostic laparoscopy, dental: R3,300
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy : R4,000
Laminectomy and spinal fusion, : R8,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, arthroscopy, functional nasal surgry and septoplasty: R6,150
Joint replacements, conservative back and neck treatment - spinal cord injections, laminectomy and spinal fusion, nissen fundoplication (reflux surgery):R15,000

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R859	R817	R301
Children:	Pay for all children
Income limit:	R6,001-R8,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Access D 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,863	R1,863	R503
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Plus C 2017

View this plan in full
.
.

2. Hospital Choice:

Emergencies, trauma, childbirth and care for newborn in KeyCare Access Network
Traumas covered: injuries at work, burns, injuries from a crime, sexual assault, injuries from a car accident, injuries from a fall, loss of arm, leg or foot, near drowning, head injuries, poisoning or serious allergic reaction that may cause death
Other conditions in contracted state facilities

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Primary Care B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,907	R1,488	R480
Children:	Pay for all children
Income limit:	R531-R8,766 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R17,710 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R4,310 per family

View this plan

Fedhealth Maxima Basis 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry and maternity, optometry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,501	R2,129	R754
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry and maternity, optometry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,500	R3,828	R1,356

Compare with these plans:

Fedhealth Maxima Basis Grid 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, wisdom teeth extraction, open hernia surgery: R3,700 co-payment
Spinal surgery, joint replacements, : R5,300 co-payment
Laparoscopic procedures: R5,800 co-payment
Arthroscopic procedure: R6,900 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe Network C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R892	R892	R334
Children:	Pay for all children
Income limit:	R6,101-R8,200 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe C 2017

View this plan in full
.
.

2. Hospital Choice:

Ingwe Network

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Mumed ED 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Netcare hospitals. Some co-payments. Scheme offers fund for out-of-hospital claims, incl unlimited GP visits, Scheme also pays for specialised radiology, medical appliances and preventative benefits.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,054	R1,600	R572
Children:	Pay for all children
Day-to-Day Benefit:
Scheme offers fund for out-of-hospital claims, incl unlimited GP visits, Scheme also pays for specialised radiology, medical appliances and preventative benefits.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R5,376	R3,372	R1,338

Compare with these plans:

Compcare Mumed 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Network

3. Specialised Radiology:

R22,000 per family
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R6,000 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, diagnostic laparoscopy, dental: R3,300
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy : R4,000
Laminectomy and spinal fusion, : R8,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, arthroscopy, functional nasal surgry and septoplasty: R6,150
Joint replacements, conservative back and neck treatment - spinal cord injections, laminectomy and spinal fusion, nissen fundoplication (reflux surgery):R15,000

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED F 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R978	R931	R343
Children:	Pay for all children
Income limit:	R8,001-R9,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED Plus F 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Core A 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R731	R731	R190
Children:	Pay for maximum 3 children
Income limit:	R0-R8,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access A 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

If related to approved hospital admission, covered in full
If not, Discovery will pay up to R3,250 per person
No cover for conservative back or neck treatments

4. Supplementary Services: (Physio, etc)

5. Transplants:

Covered

6. Co-payments:

Endoscopic procedures: Covered if performed in Day Surgery network

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Primary Care C 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,326	R1,519	R480
Children:	Pay for all children
Income limit:	R8,767+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R17,710 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R4,310 per family

View this plan

Fedhealth Maxima Basis Grid 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry and maternity, optometry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,251	R1,916	R679
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, GP visits, specialised radiology, contraceptives, some dentistry and maternity, optometry, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,056	R3,444	R1,224

Compare with these plans:

Fedhealth Maxima Basis 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

R250,000 per family
Corneal graft: No benefit

6. Co-payments:

Colonoscopy, upper GI endoscopy, wisdom teeth extraction, open hernia surgery: R3,700 co-payment
Spinal surgery, joint replacements, : R5,300 co-payment
Laparoscopic procedures: R5,800 co-payment
Arthroscopic procedure: R6,900 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe Network D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R1,241	R1,241	R365
Children:	Pay for all children
Income limit:	R8,201-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe D 2017

View this plan in full
.
.

2. Hospital Choice:

Ingwe Network

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Unisave 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments, incl R3,500 for each hospital admission. Over and above the savings fund, scheme pays out-of-hospital claims for): specialised radiology, maternity, appliances, preventative benefits. Limits apply.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,974	R1,680	R594
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, appliances, preventative benefits. Limits apply. . Limits apply. All else paid out of savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R5,904	R5,040	R1,800

Compare with these plans:

Compcare Axis 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R18,000 per family, with first R1,000 paid from available day-to-day benefits
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R6,000 per family

5. Transplants:

PMBs only

6. Co-payments:

All hospitalisation: R3,500
Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, diagnostic laparoscopy, dental: R3,300
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy : R4,000
Laminectomy and spinal fusion, : R8,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, arthroscopy, functional nasal surgry and septoplasty: R6,150
Joint replacements, conservative back and neck treatment - spinal cord injections, laminectomy and spinal fusion, nissen fundoplication (reflux surgery):R15,000

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: Unlimited
Private nursing at home from day-to-day benefit limited to 60 days per family

View this plan

Compcare Networx ED G 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R1,037	R987	R364
Children:	Pay for all children
Income limit:	R9,001-R10,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED Plus G 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Core B 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R912	R912	R224
Children:	Pay for maximum 3 children
Income limit:	R8,101-R11,550 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access B 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Affordable Care A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,733	R2,511	R630
Children:	Pay for all children
Income limit:	R0-R15,052 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R26,920 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R6,430 per family

View this plan

Fedhealth Maxima Standard 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Comprehensive plan with extended fund and threshold benefits (with 20% co-payment) that can be used for most out-of-hospital claims.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,032	R2,583	R907
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive plan with extended fund and threshold benefits (with 20% co-payment) that can be used for most out-of-hospital claims.
	Main:	Adult:	Child:
(S) Savings:	R6,552	R5,580	R1,956
(SP) Self Payment:	R4,648	R3,020	R924
Threshold (S+SP):	R11,200	R8,600	R2,880
Above Threshold:	No limit, with 20% co-payment	No limit, with 20% co-payment	No limit, with 20% co-payment

Compare with these plans:

Fedhealth Maxima Standard Elect 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Audiology, dietetics, genetic counselling, occupational therapy, orthoptics, podiatry, psychologists, speech therapy, social workers and chiropractics: R10,500 per family, from day-to-day benefit for in and out of hospital

5. Transplants:

R400,000 per family
Corneal graft: R18,700 per family

6. Co-payments:

Colonoscopy, upper GI endoscopy, Arthroscopic procedures: R2,100 co-payment
Wisdom teeth extraction, balloon sinuplasty, spinal surgery, joint replacements, all laparoscopic procedures, rhizotomies and facet pain block: R3,700 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Medihelp Dimension Prime 1 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,608	R1,320	R486
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), GP, specialists, physio, medication, maternity, infant paediatrics, medical appliances. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Dimension Prime 1 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Professional services for up to 30 days after discharge following hospital admission: speech therapy, occupational therapy and physiotherapy. M=R1,650yr and M+=R2,200yr

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R10,100 co-payment
In-hospital dentistry for children younger than 5yrs: R2,760 co-payment, with dentist's account paid out of pocket
Gastroscopy and Colonoscopy in doctor's rooms: R900 co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R2,800 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Unify 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments.Scheme pays out-of-hospital claims for: specialised radiology (co-payment). Limits apply. All else paid from savings or from out-of-pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,944	R1,602	R588
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment). Limits apply. All else paid from savings or from out-of-pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R5,832	R4,824	R1,800

Compare with these plans:

Medihelp Dimension Prime 2 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,500 co-payment, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

PMBs only

6. Co-payments:

Back and neck fusion: R9,000 co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R3,400 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Necesse A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Plan aimed at students. 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R438	R438	R438
Children:	Pay for all children
Income limit:	R0-R400 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Unify 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R14,200 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy and occupational therapy: R8,500 per family

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Private nursing and sub-acute care: R19,200 per family, subject to authorisation.

View this plan | Sign up for this plan

Hosmed Essential A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only
Contributions:
Total Cost:	R1,196	R1,092	R410
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Access 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare

3. Specialised Radiology:

2 scans per person, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

7. Alternatives to hospitals:

No benefit

View this plan

Genesis Private Choice 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,000	R1,000	R325
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Genesis Private 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,750 co-payment per scan
Limited to R6,250 per scan, and 2 scans per family
Excludes dentoalveolar procedures and conservative treatment of back and neck

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Limited to R50,000 per person for admissions related to cancer, stroke, motor-neuron disease and organ transplant

6. Co-payments:

Specialised Radiology: R2,750 co-payment per scan
Internal medical appliances or prosthetics: 50% of cost co-payment
External medical appliances 25% of cost co-payment

7. Alternatives to hospitals:

No benefit

View this plan

Bonitas Essential 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,473	R1,127	R432
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bonitas BonFit 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

Colonoscopy,
Conservative back treatment
Cystoscopy,
Facet joint injections,
Flexible sigmoidoscopy,
Functional nasal surgery,
Gastroscopy,
Hysteroscopy,
Myringotomy,
Tonsillectomy and adenoidectomy
Umbilical hernia repair
Varicose vein surgery:
R1,300 co-payment

Arthroscopy,
Diagnostic laparoscopy,
Laparoscopic hysterectomy (except cancer and PMBs),
Laparoscopic appendectomy,
Percutaneous rhizotomies,
R3,300 co-payment

Back surgery including spinal fusion,
Joint replacements,
Laparoscopic pyeloplasty,
Laparoscopic radical prostatectomy,
Nissen fundoplication (reflux surgery),
R6,500 co-payment

7. Alternatives to hospitals:

R14,900 per family

View this plan

Bonitas BonFit 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Over and above the savings fund, scheme pays out-of-hospital claims for: maternity, infant paediatrics, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,789	R1,385	R535
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,228	R2,496	R960

Compare with these plans:

Bonitas Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

Colonoscopy,
Conservative back treatment
Cystoscopy,
Facet joint injections,
Flexible sigmoidoscopy,
Functional nasal surgery,
Gastroscopy,
Hysteroscopy,
Myringotomy,
Tonsillectomy and adenoidectomy
Umbilical hernia repair
Varicose vein surgery:
R1,300 co-payment

Arthroscopy,
Diagnostic laparoscopy,
Laparoscopic hysterectomy (except cancer and PMBs),
Laparoscopic appendectomy,
Percutaneous rhizotomies,
R3,300 co-payment

Back surgery including spinal fusion,
Joint replacements,
Laparoscopic pyeloplasty,
Laparoscopic radical prostatectomy,
Nissen fundoplication (reflux surgery),
R6,500 co-payment

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Momentum Custom (Any provider for chronic) 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,059	R1,653	R735
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom Associate (and any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive (Any provider for chronic) 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,794	R2,270	R389
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,288	R3,288	R2,724

Compare with these plans:

Momentum Incentive Network hospital (and any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender (Any provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,308	R4,235	R1,665
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R15,924	R12,705	R4,995
(SP) Self Payment:	R1,176	R2,095	R105
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender Network hospital (and any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Access 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,842	R1,842	R552
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom (Any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R43,500 per family. paid by scheme.

View this plan | Sign up for this plan

Keyhealth Essence 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,278	R1,013	R427
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, medical appliances, oncology, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Keyhealth Equilibrium 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare or Life or State

3. Specialised Radiology:

MRI and CT scans: R13,900 per family with R1,400 co-payment, in and out of hospital
PET scans: No benefit

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Unlimited, subject to use of DSP

6. Co-payments:

Sigmoidoscopy and Cystoscopy: R2,000 co-payment in hospital
Hysteroscopy: R2,800 co-payment
Arthroscopy and Laparoscopy: R3,500 co-payment
Specialised radiology: R1,400 co-payment

7. Alternatives to hospitals:

Hospice, private nursing, rehab, step-down and wound care: PMB only

View this plan

Discovery Executive 2017: In-hospital Benefits

In brief: 300% 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 300% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,544	R5,544	R1,055
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers 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.
	Main:	Adult:	Child:
(S) Savings:	R16,632	R16,632	R3,156
(SP) Self Payment:	R28	R28	R
Threshold (S+SP):	R16,660	R16,660	R3,150
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Classic Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, with a R1,750 cover per day for private ward

3. Specialised Radiology:

Paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

n/a

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Comprehensive 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,506	R4,264	R898
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers 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.
	Main:	Adult:	Child:
(S) Savings:	R13,512	R12,792	R2,688
(SP) Self Payment:	R1,988	R2,708	R262
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Classic Delta Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Priority 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Comprehensive cover with savings, extended fund, and limited 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,968	R2,337	R1,187
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits) with limited above threshold benefit. Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R8,904	R7,008	R3,552
(SP) Self Payment:	R4,246	R2,842	R748
Threshold (S+SP):	R13,150	R9,850	R4,300
Above Threshold:	11,150	7,950	3,850

Compare with these plans:

Discovery Essential Priority 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: you pay the first R2,800 of the hospital account. Also, the first R2,750 of scan is paid from day-to-day benefit.

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit
Conservative back and neck treatment, adenoidectomy, myringotomy (grommets), tonsillectomy: R2,800 co-payment
Arthroscopy, functional nasal procedures, hysterectomy, laparoscopy, hysteroscopy, endometrial ablation: R6,750 co-payment
Reflux surgery, spinal surgery, joint replacements: R13,850 co-payment
No co-payment is procedure can and is done out-of-hospital

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Saver 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,577	R2,029	R1,031
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,728	R6,084	R3,084

Compare with these plans:

Discovery Classic Delta Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Smart 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: GP consults, acute meds, eye and dental check up and sport related injuries, specialised radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,535	R1,209	R612
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, acute meds, eye and dental check up and sport related injuries, specialised radiology. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Essential Smart 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Smart Network
Otherwise, R8,200 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: R2,750 co-payment

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Core 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Most day-to-day claims paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,918	R1,510	R767
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Classic Delta Core 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Topmed Essential 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate
Specialists and clinical procedures: 70% scheme rate if not DSP

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,458	R1,174	R592
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Active Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

In-hospital scopes: R2,500 co-payment
Specialised radiology: R2,500 co-payment per scan

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: R131,676 per person

View this plan

Topmed Network A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R319	R319	R319
Children:	Pay for all children
Income limit:	R0-R1,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: scopes, medicine, dentistry, optometry, supplementary services, radiology, pathology. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Hysterectomy: R3,500
Cholecystectomy: R2,500
Tonsils, adenoids, grommets: R500
Specialised radiology: R2,500 per scan

7. Alternatives to hospitals:

PMBs only

View this plan

Medimed Alpha 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays in and out of hospital benefits, but with a 25% or 40% co-payment from member for most claims. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

PMBs: 100% scheme rate
non-PMBs: 75% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,020	R1,020	R400
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: out-of-hospital claims but with a 25% or 40% co-payment from member. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medimed Essential A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

25% co-payment for non-PMBs

4. Supplementary Services: (Physio, etc)

40% co-payment for non-PMBs
R4,500 per family, for in and out-of-hospital

5. Transplants:

R100,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

Member pays 25% or 40% co-payment to providers for in-hospital treatment of non-PMBs conditions. No co-payment for PMBs.

7. Alternatives to hospitals:

R5,000 per family

View this plan

Medimed Essential A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,110	R1,110	R380
Children:	Pay for all children
Income limit:	R0-R7,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,332	R1,332	R456

Compare with these plans:

Medimed Standard A 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a 20% co-payment applies

3. Specialised Radiology:

3 scans per family, up to R10,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R2,000 per person

5. Transplants:

R50,000 per family
Benefit is shared with Dialysis and Oncology Benefit

6. Co-payments:

7. Alternatives to hospitals:

R6,000 per person

View this plan

Medimed Standard A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Income based plan. Over and above the savings and extended fund, scheme pays out-of-hospital claims for: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R9,000 per family) or out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,660	R1,660	R390
Children:	Pay for all children
Income limit:	R0-R8,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R9,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R9,480	R9,480	R1,170
Extended Fund:	R4,500 pp	R9,000 pf	R

Compare with these plans:

Medimed Essential A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

3 scans per family, up to R15,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R3,000 per family

5. Transplants:

R100,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R10,000 per person

View this plan

Medimed Max A 2017: In-hospital Benefits

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,810	R2,810	R500
Children:	Pay for all children
Income limit:	R0-R10,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R10,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R13,430	R13,430	R1,500
Extended Fund:	R5,000 pp	R10,000 pf	R

Compare with these plans:

Medimed Standard A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

4 scans per family, up to R20,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R4,000 per family

5. Transplants:

R200,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R15,000 per person

View this plan

Bestmed Beat 1 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R1,257	R976	R529
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bestmed Beat 1 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Private hospital: R3,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital
Specialised radiology: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pace 1 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,055	R2,145	R711
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative dentistry, optometry, maternity, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,332	R5,148	R1,848
Extended Fund:	R8,500 (main)	R17,000 (family)	R

Compare with these plans:

Bestmed Pace 2 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pulse 1 A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,131	R1,075	R679
Children:	Pay for maximum 4 children
Income limit:	R0-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bestmed Pulse 2 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R10,000 co-payment

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Private hospital endoscopic procedures: R2,950 co-payment
Laparoscopic procedures: R2,950 co-payment
Prostate Procedures: R2,950 co-payment
Procedures for prolapse/incontinence: R2,950 co-payment
Arthroscopy, other than acute trauma: R2,950 co-payment

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Aqua 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,208	R1,099	R427
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Spectramed Capri 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

Physio: R2,250 per family

5. Transplants:

PMBs only

6. Co-payments:

Dental in-hospital: R2,500 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy and reflux surgery: R3,000 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,500 co-payment
Procedural arthroscopy: R2,000 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

No benefit

View this plan

Fedhealth Blue Door A: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate, limited to R2,000 per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R776	R644	R369
Children:	Pay for all children
Income limit:	R0-R5,200 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or R10,000 co-payment

3. Specialised Radiology:

R12,100 per person and R24,400 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

7. Alternatives to hospitals:

PMBs only, excludes hospice

View this plan

Resolution Hospital 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,565	R1,335	R585
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Fundation D 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

R7,502 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

Excision nail bed, skin lesions, tympanoplasty:R1,881 co-payment
Myringotomy, tonsillectomy, adenoidectomy: R2,193 co-payment
Dental admissions, circumcision, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, gastroscopy: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment, hernia repair, hysterectomy: R3,751 co-payment
Nasal surgery: R5,632 co-payment
Joint replacements, rotator cuff surgery: R7,157 co-payment
Spinal surgery: R7,824 co-payment
Reflux surgery: R10,752 co-payment

7. Alternatives to hospitals:

Home nursing: no benefit, unless in lieu of hospitalisation
Hospice, rehab and step down facility: 10 days per family

View this plan

Resolution Fundation A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R907	R907	R273
Children:	Pay for all children
Income limit:	R0-R4,600 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Hospital 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

Co-payments might apply, depending on scheme protocols and alternative available treatment

7. Alternatives to hospitals:

Home nursing: no benefit, unless in lieu of hospitalisation
Hospice, rehab and step down facility: no benefit

View this plan

Cape Medical Premium 2017: In-hospital Benefits

In brief:

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,548	R1,548	R271
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Cape Medical Silver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited for non PMBs
PMBs: State or simialar facility, nominated by scheme

3. Specialised Radiology:

R10,220 per person with a R1,500 co-payment, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMB level of care

6. Co-payments:

Arthroscopy, appendectomy, inguinal hernia repair, gynaecological procedures, urology procedures, umbilical hernia repair, incisional hernia repair, ventral hernia repair, colectomy, colonoscopy, gastroscopy, hysteroscopy, sympathectomy, vaginal hysterectomy, cystoscopy: R1,000 co-payment

7. Alternatives to hospitals:

PMBs only

View this plan

Suremed Shuttle 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,320	R980	R540
Children:	Pay for all children
Day-to-Day Benefit:
Scheme pays out-of-hospital claims for: specialised radiology, preventative care, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Explorer D 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

3 scans per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R5,000 per person

5. Transplants:

PMBs only

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R14,000 per family
Hospice: R20,000 per family

View this plan

Suremed Explorer A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: medication, appliances, dentistry, GPs and specialists, maternity, optometry, pathology, radiology, specialised radiology, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R860	R770	R400
Children:	Pay for all children
Income limit:	R0-R7,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: medication, appliances, dentistry, GPs and specialists, maternity, optometry, pathology, radiology, specialised radiology, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Shuttle 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

2 scans per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R3,300 per family

5. Transplants:

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R12,500 per family
Hospice: R20,000 per family

View this plan

Medshield MediPhila 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. R1,000,000 per family limit. Scheme pays out-of-hospital claims for: specialised radiology, maternity, optometry, some non-surgical procedures including scopes, preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R500,000 per person, R1 million per family for non-PMB
Contributions:
Total Cost:	R1,041	R1.041	R261
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, optometry, preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,500 per family	R	R

Compare with these plans:

Medshield MediValue 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

1 scan per family, with 10% co-payment and subject to overall hospital limit

4. Supplementary Services: (Physio, etc)

Subject to Overall Annual Limit (see above)

5. Transplants:

PMBs only

6. Co-payments:

Endoscopic procedures: R1,500 co-payment if done in hospital

7. Alternatives to hospitals:

PMBs only

View this plan

Commed Roots A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some-co-payments. Network hospitals. Annual limit of R400k per person and R800k per family. Scheme pays out-of-hospital claims for:GPs, specialits, dentistry, medicine, optometry, radiology, pathology, external applianes, alternative to hopitalisation. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R400k per person, R800k per family
Contributions:
Total Cost:	R822	R822	R342
Children:	Pay for all children
Income limit:	R0-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:GPs, specialits, dentistry, medicine, optometry, radiology, pathology, external applianes, alternative to hopitalisation. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Commed Shina A 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Shina A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some-co-payments. Network hospitals. Annual limit of R600,000 per person and R1,200,000 per family. Scheme pays out-of-hospital claims for: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R600k per person, R1,200,000 per family
Contributions:
Total Cost:	R1,498	R1,274	R300
Children:	Pay for all children
Income limit:	R0-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,798	R1,529	R360

Compare with these plans:

Commed Roots A 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R6,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Standard A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some-co-payments. Network hospitals. Annual limit of R760,000 per person and R1,460,000 per family. Scheme pays out-of-hospital claims for: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R730k per person, R1,460,000 per family
Contributions:
Total Cost:	R2,946	R2,413	R591
Children:	Pay for all children
Income limit:	R0-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,419	R3,620	R887

Compare with these plans:

Commed Shina A 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R8,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R2,500 co-payment
Circumcision (elective): R1,500 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,000 co-payment
Cystoscopy: R1,500 co-payment
Dental admissions: R1,500 co-payment
Excision nail bed: R1,500 co-payment
Gastroscopy: R2,000 co-payment
Hernia repair: R2,000 co-payment
Hysterectomy: R3,000 co-payment
Hysteroscopy: R3,000 co-payment
Joint Replacements: R5,500 co-payment
Laparoscopic procedures: R3,000 co-payment
Myringotomy: R1,500 co-payment
Nasal Surgery: R2,000 co-payment
Reflux surgery: R3,000 co-payment
Skin lesions: R1,500 co-payment
Spinal surgery: R5,500 co-payment
Urinary incontinence repair: R3,500 co-payment
Varicose veins: R3,500 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Deluxe 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Comprehensive cover with savings, self-payment gap and limited above threshold benefits that cover most out-of-hospital benefits (with limits).

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,802	R4,742	R1,158
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive cover with savings, self-payment gap and limited above threshold benefits that cover most out-of-hospital benefits (with limits).
	Main:	Adult:	Child:
(S) Savings:	R10,440	R8,532	R2,088
(SP) Self Payment:	R7,830	R6,399	R1,566
Threshold (S+SP):	R18,270	R14,931	R3,654
Above Threshold:	2,610	2,133	522

Compare with these plans:

Commed Shina C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R10,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R2,000 co-payment
Circumcision (elective): R1,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R1500 co-payment
Cystoscopy: R1,000 co-payment
Dental admissions: R1,000 co-payment
Gastroscopy: R1,500 co-payment
Hernia repair: R1,500 co-payment
Hysterectomy: R2,500 co-payment
Hysteroscopy: R2,500 co-payment
Joint Replacements: R5,000 co-payment
Laparoscopic procedures: R2,500 co-payment
Myringotomy: R1,000 co-payment
Nasal Surgery: R1,500 co-payment
Reflux surgery: R2,500 co-payment
Skin lesions: R1,000 co-payment
Spinal surgery: R5,000 co-payment
Urinary incontinence repair: R3,000 co-payment
Varicose veins: R3,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Makoti Primary A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R225	R225	R147
Children:	Pay for all children
Income limit:	R0-R3,000 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive A 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Makoti Comprehensive A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in private hospitals
Contributions:
Total Cost:	R1,469	R1,266	R488
Children:	Pay for all children
Income limit:	R0-R9,250 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Primary A 2017

View this plan in full
.
.

2. Hospital Choice:

Private hospitals

3. Specialised Radiology:

PMBs only, in private hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in private hospitals

5. Transplants:

PMBs only, in private hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Selfmed Selfnet Essential 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R850	R850	R300
Children:	Pay for maximum 3 children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Selfmed Selfnet 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

PMBs only

5. Transplants:

Heart, lung, bone-marrow, kidney and liver transplants only. Donor costs covered up to limits only if recipient is part of the scheme

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Momentum Ingwe Network E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R1,758	R1,758	R518
Children:	Pay for all children
Income limit:	R11,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe E 2017

View this plan in full
.
.

2. Hospital Choice:

Ingwe Network

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Axis 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some exclusions apply. Most out-of-hospital benefits covered only if PMBs.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,734	R1,734	R534
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Compcare Axis ED 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R20,000 per family
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R6,500 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, diagnostic laparoscopy, dental: R3,300
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy : R4,000
Laminectomy and spinal fusion, : R8,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, arthroscopy, functional nasal surgry and septoplasty: R6,150

7. Alternatives to hospitals:

PMBs only

View this plan

Compcare Networx ED H 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R1,908	R1,718	R669
Children:	Pay for all children
Income limit:	R10,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED Plus H 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private and State)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Discovery KeyCare Core C 2017: In-hospital Benefits

1. Payout Rate:

Covered in full at network hospitals

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,408	R1,408	R318
Children:	Pay for maximum 3 children
Income limit:	R11,551+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery KeyCare Access C 2017

View this plan in full
.
.

2. Hospital Choice:

KeyCare Hospital Network or KeyCare day surgery network

3. Specialised Radiology:

4. Supplementary Services: (Physio, etc)

5. Transplants:

Covered

6. Co-payments:

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R37,350 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Sizwe Affordable Care B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,843	R2,610	R660
Children:	Pay for all children
Income limit:	R15,053-R18,444 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R26,920 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R6,430 per family

View this plan

Fedhealth Maxima Standard Elect 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Comprehensive plan with extended fund and threshold benefits (with 20% co-payment) that can be used for most out-of-hospital claims.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,316	R1,974	R694
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive plan with extended fund and threshold benefits (with 20% co-payment) that can be used for most out-of-hospital claims.
	Main:	Adult:	Child:
(S) Savings:	R5,004	R4,260	R1,500
(SP) Self Payment:	R6,196	R4,340	R1,380
Threshold (S+SP):	R11,200	R8,600	R2,880
Above Threshold:	No limit, with 20% co-payment	No limit, with 20% co-payment	No limit, with 20% co-payment

Compare with these plans:

Fedhealth Maxima Standard 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Audiology, dietetics, genetic counselling, occupational therapy, orthoptics, podiatry, psychologists, speech therapy, social workers and chiropractics: R10,500 per family, from day-to-day benefit for in and out of hospital

5. Transplants:

R400,000 per family
Corneal graft: R18,700 per family

6. Co-payments:

Colonoscopy, upper GI endoscopy, Arthroscopic procedures: R2,100 co-payment
Wisdom teeth extraction, balloon sinuplasty, spinal surgery, joint replacements, all laparoscopic procedures, rhizotomies and facet pain block: R3,700 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe State A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R335	R335	R210
Children:	Pay for all children
Income limit:	R0-R650 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network A 2017

View this plan in full
.
.

2. Hospital Choice:

State Hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Axis ED 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Netcare hospitals. Some exclusions apply. Most out-of-hospital benefits covered only if PMBs.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,260	R1,260	R396
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Compcare Axis 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Network

3. Specialised Radiology:

R20,000 per family
No benefit for screening purposes

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physiotherapy: R6,500 per family

5. Transplants:

PMBs only

6. Co-payments:

Excision lesion:R1,000
Gastroscopy, colonoscopy, cystoscopy, proctoscopy, nasal/sinus endoscopy, hysteroscopy, flexible sigmoidoscopy, diagnostic laparoscopy, dental: R3,300
Adenoidectomy, myringotomy, grommets, tonsillectomy: R2,550
Laparoscopic hemicolectomy, laparoscopic inguinal hernia repair, laparoscopic appendicectomy : R4,000
Laminectomy and spinal fusion, : R8,000
Hysterectomy (except for cancer), laparoscopy, hysteroscopy, endometrial ablation, arthroscopy, functional nasal surgry and septoplasty: R6,150

7. Alternatives to hospitals:

PMBs only

View this plan

Compcare Networx ED Plus A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some exclusions apply. Private 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R283	R279	R154
Children:	Pay for all children
Income limit:	R0-R500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED A 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Sizwe Affordable Care C 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,657	R3,251	R730
Children:	Pay for all children
Income limit:	R18,445+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Gomomo B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R26,920 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R6,430 per family

View this plan

Fedhealth Maxima Advanced 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: post hospitalisation treatment (30 days), casualty visits, specialised radiology, contraceptives, some medication, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,251	R2,756	R968
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: post hospitalisation treatment (30 days), casualty visits, specialised radiology, contraceptives, some medication, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,900	R3,312	R1,164

Compare with these plans:

Fedhealth Maxima Standard 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Physio and biokinetics: 100% scheme rate
Audiology, dietetics, genetic counselling, occupational therapy, orthoptics, podiatry, psychologists, speech therapy, social workers and chiropractics: from day-to-day benefit for in and out of hospital

5. Transplants:

R400,000 per family
Corneal graft: R18,700 per family

6. Co-payments:

Colonoscopy, upper GI endoscopy, Arthroscopic procedures: R2,100 co-payment
Wisdom teeth extraction, balloon sinuplasty, spinal surgery, joint replacements, all laparoscopic procedures, rhizotomies and facet pain block: R3,700 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe State B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R560	R560	R302
Children:	Pay for all children
Income limit:	R651-R6,100 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network B 2017

View this plan in full
.
.

2. Hospital Choice:

State Hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Networx ED Plus B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R413	R405	R204
Children:	Pay for all children
Income limit:	R501-R4,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED B 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Sizwe Full Benefit A 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,210	R3,825	R860
Children:	Pay for all children
Income limit:	R0-R18,879 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Affordable Care A 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R35,422 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R8,610 per family

View this plan

Fedhealth Maxima Exec 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 200% scheme rate for specialists and 100% scheme rate for GPs

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,302	R3,666	R1,284
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive plan with extended fund and threshold benefits that can be used for most out-of-hospital plans.
	Main:	Adult:	Child:
(S) Savings:	R3,768	R3,216	R1,128
Extended Fund:	R5,390	R4,200	R700
(SP) Self Payment:	R2,042	R1,184	R1,052
Threshold (S+SP):	R11,200	R8,600	R2,880
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Fedhealth Maxima Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R1,900 co-payment

4. Supplementary Services: (Physio, etc)

Dietetics, occupational therapy, speech therapy: from day-to-day benefit

5. Transplants:

R500,000 per family
Corneal graft: R18,700 per family

6. Co-payments:

Colonoscopy, upper GI endoscopy, Arthroscopic procedures: R2,100 co-payment
Wisdom teeth extraction, balloon sinuplasty, spinal surgery, joint replacements, all laparoscopic procedures, rhizotomies and facet pain block: R3,700 co-payment

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe State C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R641	R1,282	R950
Children:	Pay for all children
Income limit:	R6,101-R8,200 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network C 2017

View this plan in full
.
.

2. Hospital Choice:

State Hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Sizwe Full Benefit B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,885	R4,441	R960
Children:	Pay for all children
Income limit:	R18,880+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Sizwe Affordable Care C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R35,422 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Dietician, speech therapy, occupational therapy: subject to PMBs

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

R8,610 per family

View this plan

Fedhealth Maxima Plus 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 200% scheme rate for specialists and 100% scheme rate for GPs

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,740	R5,733	R2,021
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive plan with extended fund and threshold benefits that can be used for most out-of-hospital plans.
	Main:	Adult:	Child:
(S) Savings:	R4,452	R3,780	R1,332
Extended Fund:	R7,850	R5,670	R1,740
(SP) Self Payment:	R736	R578	R405
Threshold (S+SP):	R13,038	R10,028	R3,477
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Fedhealth Maxima Exec 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited

4. Supplementary Services: (Physio, etc)

Dietetics, occupational therapy, speech therapy, physiotherapy, biokinetics: 200% scheme tariff

5. Transplants:

Unlimited
Corneal graft: R18,700 per family

6. Co-payments:

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe State D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R748	R748	R324
Children:	Pay for all children
Income limit:	R8,201-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network D 2017

View this plan in full
.
.

2. Hospital Choice:

State Hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Networx ED Plus D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R529	R502	R251
Children:	Pay for all children
Income limit:	R5,001-R6,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED D 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Fedhealth Ultimax 2017: In-hospital Benefits

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

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 300% scheme rate for specialists and 100% scheme rate for GPs

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R9,215	R7,829	R2,765
Children:	Pay for all children
Day-to-Day Benefit:
Comprehensive plan with extended fund and threshold benefits that can be used for most out-of-hospital plans.
	Main:	Adult:	Child:
(S) Savings:	R5,748	R4,884	R1,728
Extended Fund:	R2560 (main)	R4,010 (family)	R
(SP) Self Payment:	R4,942	R3,747	R
Threshold (S+SP):	R13,250	R10,081	R3,360
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Fedhealth Maxima Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited

4. Supplementary Services: (Physio, etc)

Dietetics, occupational therapy, speech therapy, physiotherapy, biokinetics: 300% scheme tariff

5. Transplants:

Unlimited
Corneal graft: R18,700 per family

6. Co-payments:

7. Alternatives to hospitals:

Terminal care: R27,900 per family
Physical rehabilitation, sub-acute facilities, nursing services: Unlimited and paid by scheme

View this plan

Momentum Ingwe State E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,190,000 per family
Contributions:
Total Cost:	R1,291	R1,291	R389
Children:	Pay for all children
Income limit:	R11,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: std dentistry, GPs, specialists, optometry, pathology, std radiology, medicine, maternity, alternatives to hospitalistion, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Ingwe Network E 2017

View this plan in full
.
.

2. Hospital Choice:

State Hospitals

3. Specialised Radiology:

PMBs only, at state facilities

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only, at state facilities

6. Co-payments:

n/a

7. Alternatives to hospitals:

Medical rehabilitation and step-down facilities: R11,260 per family
Private nursing and hospice: no benefit

View this plan | Sign up for this plan

Compcare Networx ED Plus F 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R631	R599	R300
Children:	Pay for all children
Income limit:	R8,001-R9,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED F 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Compcare Networx ED Plus G 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R668	R636	R318
Children:	Pay for all children
Income limit:	R9,001-R10,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED G 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Compcare Networx ED Plus H 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,100,000 per family
Contributions:
Total Cost:	R1,318	R1,186	R585
Children:	Pay for all children
Income limit:	R10,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, medicine, radiology, pathology, maternity and preventative benefits. All else paid from out of fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R2,800 (main)	R4,170 (family)	R

Compare with these plans:

Compcare Networx ED H 2017

View this plan in full
.
.

2. Hospital Choice:

Network (Private)

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Step down nursing facilities, hospice and rehabilitation: subject to OAL
Private nursing at home: PMBs only

View this plan

Medihelp Dimension Prime 1 Network 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,260	R1,026	R378
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), GP, specialists, physio, medication, maternity, infant paediatrics, medical appliances. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Dimension Prime 1 2017

View this plan in full
.
.

2. Hospital Choice:

Network (106 facilities)

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R10,100 co-payment
In-hospital dentistry for children younger than 5yrs: R2,760 co-payment, with dentist's account paid out of pocket
Gastroscopy and Colonoscopy in doctor's rooms: R900 co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R2,800 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Plus 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: radiology, pathology, GPs, specialists, supplementary services, psychologists, medicine, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,936	R6,936	R1,728
Children:	Pay for all children.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, medical appliances, GPs, specialists, psychologists, supplementary health, medication, radiology and pathology, dentistry and optometry. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Dimension Elite 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

MRI, CT and Angiography: unlimited, in and out of hospital
PET Scans: R19,100 per case (non-PMB)

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

None

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Necesse B 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,404	R1,110	R600
Children:	Pay for all children
Income limit:	R401-R5,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Unify 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R14,200 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy and occupational therapy: R8,500 per family

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Private nursing and sub-acute care: R19,200 per family, subject to authorisation.

View this plan | Sign up for this plan

Hosmed Essential B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only
Contributions:
Total Cost:	R1,460	R1,333	R368
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Access 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare

3. Specialised Radiology:

2 scans per person, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

7. Alternatives to hospitals:

No benefit

View this plan

Genesis Private 2017: In-hospital Benefits

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,500	R1,500	R365
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Genesis Private Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Scans related to conservative treatment of back and neck covered up to 50% scheme rate, and limited to R6,000 per person

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Limited to R550,000 per person for admissions related to cancer, stroke, motor-neuron disease and organ transplant
Cost of immunosuppressants: R84,000

6. Co-payments:

External medical appliances: 25% of cost copayment

7. Alternatives to hospitals:

Hospice: 100% of cost
Home care visits: R200 per day
Home visits by medical practitioner: 100% scheme rate

View this plan

Bonitas Primary 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Over and above the fund, scheme pays out-of-hospital claims for: GPs, mental health, specialised radiology, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,924	R1,505	R613
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, mental health, specialised radiology, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bonitas BonSave 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

R11,700 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

PMBs only

6. Co-payments:

Colonoscopy,
Conservative back treatment
Cystoscopy,
Facet joint injections,
Flexible sigmoidoscopy,
Functional nasal surgery,
Gastroscopy,
Hysteroscopy,
Myringotomy,
Tonsillectomy and adenoidectomy
Umbilical hernia repair
Varicose vein surgery:
R1,300 co-payment

Arthroscopy,
Diagnostic laparoscopy,
Laparoscopic hysterectomy (except cancer and PMBs),
Laparoscopic appendectomy,
Percutaneous rhizotomies,
R3,300 co-payment

Back surgery including spinal fusion,
Joint replacements,
Laparoscopic pyeloplasty,
Laparoscopic radical prostatectomy,
Nissen fundoplication (reflux surgery),
R6,500 co-payment

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Bonitas BonSave 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Over and above the savings fund, scheme pays out-of-hospital claims for: specialised radiology, mental health, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

150% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,135	R1,654	R640
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, mental health, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,104	R3,180	R1,236

Compare with these plans:

Bonitas Primary 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

R21,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

Colonoscopy,
Conservative back treatment
Cystoscopy,
Facet joint injections,
Flexible sigmoidoscopy,
Functional nasal surgery,
Gastroscopy,
Hysteroscopy,
Myringotomy,
Tonsillectomy and adenoidectomy
Umbilical hernia repair
Varicose vein surgery:
R1,300 co-payment

Arthroscopy,
Diagnostic laparoscopy,
Laparoscopic hysterectomy (except cancer and PMBs),
Laparoscopic appendectomy,
Percutaneous rhizotomies,
R3,300 co-payment

Back surgery including spinal fusion,
Joint replacements,
Laparoscopic pyeloplasty,
Laparoscopic radical prostatectomy,
Nissen fundoplication (reflux surgery),
R6,500 co-payment

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Momentum Custom Associate (and any provider for chronic) 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,742	R1,374	R614
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom (Any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive Network hospital (and any provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at any provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,529	R2,034	R826
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,035	R3,035	R2,441

Compare with these plans:

Momentum Incentive (Any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender Network hospital (and any provider for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,671	R3,728	R1,465
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R14,013	R11,184	R4,395
(SP) Self Payment:	R3,087	R3,616	R705
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender (Any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Summit 2017: In-hospital Benefits

In brief: 300% scheme rate. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

300% Scheme Rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R7,637	R6,108	R1,754
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R22,300	R22,300	R22,300

Compare with these plans:

Momentum Extender (Any provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Keyhealth Equilibrium 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,817	R1,096	R556
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, medical appliances, preventative benefits. Limits apply. All else paid from savings, from fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,584	R960	R480
Extended Fund:	R2,070	R1,150	R625

Compare with these plans:

Keyhealth Silver 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare or Life or State

3. Specialised Radiology:

MRI and CT scans: R13,900 per family with R1,400 co-payment, in and out of hospital
PET scans: No benefit

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Unlimited, subject to use of DSP

6. Co-payments:

Sigmoidoscopy and Cystoscopy: R2,000 co-payment in hospital
Hysteroscopy: R2,800 co-payment
Arthroscopy and Laparoscopy: R3,500 co-payment
Specialised radiology: R1,400 co-payment

7. Alternatives to hospitals:

Hospice, private nursing, rehab, step-down and wound care: PMB only

View this plan

Discovery Classic Delta Comprehensive 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,059	R3,842	R807
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers 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.
	Main:	Adult:	Child:
(S) Savings:	R12,168	R11,520	R2,412
(SP) Self Payment:	R3,332	R3,980	R538
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Classic Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Priority 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Comprehensive cover with savings, extended fund, and limited 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,551	R2,004	R1,012
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers most out-of-hospital benefits (with sub limits) with limited above threshold benefit. Extended benefit covers some claims while in self-payment gap. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,584	R3,600	R1,824
(SP) Self Payment:	R8,566	R6,250	R2,476
Threshold (S+SP):	R13,150	R9,850	R4,300
Above Threshold:	11,150	7,950	3,850

Compare with these plans:

Discovery Classic Priority 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: you pay the first R2,800 of the hospital account. Also, the first R2,750 of scan is paid from day-to-day benefit.

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit
Conservative back and neck treatment, adenoidectomy, myringotomy (grommets), tonsillectomy: R2,800 co-payment
Arthroscopy, functional nasal procedures, hysterectomy, laparoscopy, hysteroscopy, endometrial ablation: R6,750 co-payment
Reflux surgery, spinal surgery, joint replacements: R13,850 co-payment
No co-payment is procedure can and is done out-of-hospital

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Delta Saver 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network Hospitals. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,058	R1,623	R826
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, maternity, kids' casualty if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,168	R4,860	R2,472

Compare with these plans:

Discovery Classic Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Smart 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Scheme pays out-of-hospital claims for: GP consults, eye and dental check up. Limits and co-payments apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,100	R1,100	R1,100
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults, eye and dental check up. Limits and co-payments apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Classic Smart 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Smart Network
Otherwise, R8,200 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Classic Delta Core 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,535	R1,209	R612
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Classic Core 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Topmed Active Saver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: maternity, scopes, extended rehab benefits, birth control, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Specialists and clinical procedures: 70% scheme rate if not DSP

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,512	R1,512	R500
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, scopes, extended rehab benefits, birth control, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,904	R2,904	R960

Compare with these plans:

Topmed Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Hysterectomy: R3,500
Cholecystectomy, specialised radiology, scopes (in-hospital): R2,500
Tonsils, adenoids, grommets: R500

7. Alternatives to hospitals:

PMBs only

View this plan

Topmed Network B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R915	R915	R331
Children:	Pay for all children
Income limit:	R1,000-R8,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: scopes, medicine, dentistry, optometry, supplementary services, radiology, pathology. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Hysterectomy: R3,500
Cholecystectomy: R2,500
Tonsils, adenoids, grommets: R500
Specialised radiology: R2,500 per scan

7. Alternatives to hospitals:

PMBs only

View this plan

Medimed Essential B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,200	R1,200	R390
Children:	Pay for all children
Income limit:	R7,001-R8,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,440	R1,440	R468

Compare with these plans:

Medimed Standard B 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a 20% co-payment applies

3. Specialised Radiology:

3 scans per family, up to R10,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R2,000 per person

5. Transplants:

R50,000 per family
Benefit is shared with Dialysis and Oncology Benefit

6. Co-payments:

7. Alternatives to hospitals:

R6,000 per person

View this plan

Medimed Standard B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,760	R1,760	R410
Children:	Pay for all children
Income limit:	R8,501-R13,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R9,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R9,780	R9,780	R1,230
Extended Fund:	R4,500 pp	R9,000 pf	R

Compare with these plans:

Medimed Essential B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

3 scans per family, up to R15,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R3,000 per family

5. Transplants:

R100,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R10,000 per person

View this plan

Medimed Max B 2017: In-hospital Benefits

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,050	R3,050	R530
Children:	Pay for all children
Income limit:	R10,001-R17,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R10,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R14,150	R14,150	R1,590
Extended Fund:	R5,000 pp	R10,000 pf	R

Compare with these plans:

Medimed Standard B 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

4 scans per family, up to R20,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R4,000 per family

5. Transplants:

R200,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R15,000 per person

View this plan

Bestmed Beat 1 Network 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R1,131	R879	R476
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bestmed Beat 1 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Hospitals, or up to R10,000 co-payment if you voluntarily choose another hospital

3. Specialised Radiology:

Private hospital: R3,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital
Specialised radiology: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pace 2 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,315	R4,231	R951
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, specialised radiology, contraceptives, medicine, trauma rehab and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,764	R7,620	R1,716
Extended Fund:	R12,000 (main)	R24,000 (family)	R

Compare with these plans:

Bestmed Pace 1 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

100% scheme rate

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pulse 1 B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,357	R1,290	R814
Children:	Pay for maximum 4 children
Income limit:	R6,001-R10,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bestmed Pulse 2 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R10,000 co-payment

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Private hospital endoscopic procedures: R2,950 co-payment
Laparoscopic procedures: R2,950 co-payment
Prostate Procedures: R2,950 co-payment
Procedures for prolapse/incontinence: R2,950 co-payment
Arthroscopy, other than acute trauma: R2,950 co-payment

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Cyan A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,730	R1,669	R692
Children:	Pay for maximum 3 children
Income limit:	R0-R8,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,904	R2,808	R1,164

Compare with these plans:

Spectramed Aqua 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-payment and limited to R4,500 per family

4. Supplementary Services: (Physio, etc)

Physio: R2,780 per family

5. Transplants:

R200,000 per family

6. Co-payments:

Dental in-hospital: R2,500 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy and reflux surgery: R3,000 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,500 co-payment
Procedural arthroscopy: R2,000 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

No benefit

View this plan

Fedhealth Blue Door B: In-hospital Benefits

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate, limited to R2,000 per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R984	R813	R475
Children:	Pay for all children
Income limit:	R5,201-R8,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or R10,000 co-payment

3. Specialised Radiology:

R12,100 per person and R24,400 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

7. Alternatives to hospitals:

PMBs only, excludes hospice

View this plan

Resolution Progressive Flex 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,154	R2,017	R666
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Progressive Flex Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

R9,438 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

R112,524 per family

6. Co-payments:

Excision nail bed, skin lesions, tympanoplasty:R1,881 co-payment
Myringotomy, tonsillectomy, adenoidectomy: R2,193 co-payment
Dental admissions, circumcision, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, gastroscopy: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment, hernia repair, hysterectomy: R3,751 co-payment
Nasal surgery: R5,632 co-payment
Joint replacements, rotator cuff surgery: R7,157 co-payment
Spinal surgery: R7,824 co-payment
Reflux surgery: R10,752 co-payment

7. Alternatives to hospitals:

Home nursing: 5 days per family
Hospice, rehab and step down facility: 12 days per family

View this plan

Resolution Fundation B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,056	R1,056	R364
Children:	Pay for all children
Income limit:	R4,601-R7,100 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Hospital 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

Co-payments might apply, depending on scheme protocols and alternative available treatment

7. Alternatives to hospitals:

Home nursing: no benefit, unless in lieu of hospitalisation

View this plan

Cape Medical Silver 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,704	R1,704	R258
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R3,000	R3,000	R456

Compare with these plans:

Cape Medical Select 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited for non PMBs
PMBs: State or simialar facility, nominated by scheme

3. Specialised Radiology:

R10,220 per person with a R1,500 co-payment in and out of hospital
Thereafter, from day-to-day benefit

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMB level of care

6. Co-payments:

Arthroscopy, appendectomy, inguinal hernia repair, gynaecological procedures, urology procedures, umbilical hernia repair, incisional hernia repair, ventral hernia repair, colectomy, colonoscopy, gastroscopy, hysteroscopy, sympathectomy, vaginal hysterectomy, cystoscopy: R1,000 co-payment

7. Alternatives to hospitals:

Hospice and registered nurses: up to 15 days per person

View this plan

Suremed Navigator 2017: In-hospital Benefits

In brief: 125% 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 savings or out of pocket, unless PMB.

1. Payout Rate:

125% scheme rate for GPs and Specialists

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,400	R1,900	R720
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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 savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,960	R3,180	R1,200
Extended Fund:	R8,500 pp	R17,680 pf	R

Compare with these plans:

Suremed Challanger 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R14,800 per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R5,000 per person

5. Transplants:

In and out of hospital: R140,000 per family

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R20,000 per family
Hospice: R20,000 per family

View this plan

Suremed Explorer B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,080	R960	R480
Children:	Pay for all children
Income limit:	R7,501-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: medication, appliances, dentistry, GPs and specialists, maternity, optometry, pathology, radiology, specialised radiology, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Shuttle 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

2 scans per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R3,300 per family

5. Transplants:

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R12,500 per family
Hospice: R20,000 per family

View this plan

Medshield MediValue 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,521	R1,323	R414
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	RM= R4,815 M1= R5,240 M2= R5,900 M3= R6,660 M4+ =R7,600	R	R

Compare with these plans:

Medshield MediCore 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R5,560 per family, with 8% co-payment in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R23,000 per family

View this plan

Commed Roots B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R400k per person, R800k per family
Contributions:
Total Cost:	R950	R950	R458
Children:	Pay for all children
Income limit:	R6,001-R18,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:GPs, specialits, dentistry, medicine, optometry, radiology, pathology, external applianes, alternative to hopitalisation. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Commed Shina B 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Shina B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R600k per person, R1,200,000 per family
Contributions:
Total Cost:	R1,803	R1,532	R361
Children:	Pay for all children
Income limit:	R6,001-R18,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,164	R1,838	R433

Compare with these plans:

Commed Roots B 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R6,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Standard B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R730k per person, R1,460,000 per family
Contributions:
Total Cost:	R3,181	R2,607	R638
Children:	Pay for all children
Income limit:	R6,001-R7,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,772	R3,911	R957

Compare with these plans:

Commed Shina B 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R8,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R2,500 co-payment
Circumcision (elective): R1,500 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,000 co-payment
Cystoscopy: R1,500 co-payment
Dental admissions: R1,500 co-payment
Excision nail bed: R1,500 co-payment
Gastroscopy: R2,000 co-payment
Hernia repair: R2,000 co-payment
Hysterectomy: R3,000 co-payment
Hysteroscopy: R3,000 co-payment
Joint Replacements: R5,500 co-payment
Laparoscopic procedures: R3,000 co-payment
Myringotomy: R1,500 co-payment
Nasal Surgery: R2,000 co-payment
Reflux surgery: R3,000 co-payment
Skin lesions: R1,500 co-payment
Spinal surgery: R5,500 co-payment
Urinary incontinence repair: R3,500 co-payment
Varicose veins: R3,500 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Makoti Primary B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R239	R239	R159
Children:	Pay for all children
Income limit:	R3,001-R6,450 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive B 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Makoti Comprehensive B 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in private hospitals
Contributions:
Total Cost:	R1,699	R1,415	R554
Children:	Pay for all children
Income limit:	R9,251-R12,250 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Primary B 2017

View this plan in full
.
.

2. Hospital Choice:

Private hospitals

3. Specialised Radiology:

PMBs only, in private hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in private hospitals

5. Transplants:

PMBs only, in private hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Selfmed Selfnet 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,185	R1,185	R418
Children:	Pay for maximum 3 children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Selfmed Selfnet Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

PMBs only

5. Transplants:

Heart, lung, bone-marrow, kidney and liver transplants only. Donor costs covered up to limits only if recipient is part of the scheme

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Medihelp Dimension Prime 2 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), GPs, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,136	R1,746	R642
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), GPs, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,096	R2,520	R936

Compare with these plans:

Medihelp Dimension Prime 2 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R9,000 co-payment
In-hospital dentistry for children younger than 5yrs: R1,810 co-payment, with dentist's account paid out of savings account
Gastroscopy and Colonoscopy in doctor's rooms: no co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R3,400 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Necesse C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,464	R1,170	R660
Children:	Pay for all children
Income limit:	R5,001-R7,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Unify 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R14,200 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy and occupational therapy: R8,500 per family

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Private nursing and sub-acute care: R19,200 per family, subject to authorisation.

View this plan | Sign up for this plan

Hosmed Essential C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only
Contributions:
Total Cost:	R1,826	R1,666	R707
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Access 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare

3. Specialised Radiology:

2 scans per person, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

7. Alternatives to hospitals:

No benefit

View this plan

Genesis Private Plus 2017: In-hospital Benefits

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,900	R1,900	R365
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,140	R4,140	R

Compare with these plans:

Genesis Private Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Scans related to conservative treatment of back and neck covered up to 50% scheme rate, and limited to R6,000 per person

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Limited to R550,000 per person for admissions related to cancer, stroke, motor-neuron disease and organ transplant
Cost of immunosuppressants: R84,000

6. Co-payments:

External medical appliances: 25% of cost copayment

7. Alternatives to hospitals:

Hospice: 100% of cost
Home care visits: R200 per day
Home visits by medical practitioner: 100% scheme rate

View this plan

Bonitas BonComplete 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Over and above the savings/threshold fund, scheme pays out-of-hospital claims for: specialised radiology, mental health, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings, or from above threshold benefit or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,923	R2,340	R794
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, mental health, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings, or from above threshold benefit or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R5,256	R4,200	R1,428
(SP) Self Payment:	R1,568	R1,326	R336
Threshold (S+SP):	R6,824	R5,526	R1,764
Above Threshold:	R4,150	R2,450	R1,060

Compare with these plans:

Bonitas Standard 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

R21,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Bonitas Standard 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Over and above the fund, scheme pays out-of-hospital claims for: GPs, specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,998	R2,600	R880
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bonitas Standard Select 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

R23,500 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Momentum Custom (Network for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,899	R1,483	R689
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom Associate (and Network provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive (Network provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,506	R2,010	R1,089
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,007	R3,007	R2,412

Compare with these plans:

Momentum Incentive Network hospital (and Network provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender (Network provider for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,776	R3,813	R1,495
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R14,328	R11,439	R4,485
(SP) Self Payment:	R2,772	R3,361	R615
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender Network hospital (and Network provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Keyhealth Silver 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,977	R1,601	R620
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), dentistry, medicine, optometry, maternity, medical appliances, preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R6,485	R4,710	R1,305

Compare with these plans:

Keyhealth Gold 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare or State

3. Specialised Radiology:

MRI and CT scans: R13,900 per family with R1,400 co-payment, in and out of hospital
PET scans: No benefit

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Unlimited, subject to use of DSP

6. Co-payments:

Sigmoidoscopy and Cystoscopy: R2,000 co-payment in hospital
Hysteroscopy: R2,800 co-payment
Arthroscopy and Laparoscopy: R3,500 co-payment
Specialised radiology: R1,400 co-payment

7. Alternatives to hospitals:

Hospice, private nursing, rehab, step-down and wound care: R25,100 per family in and out of hospital
Wound care sublimit: R8,050

View this plan

Discovery Classic Comprehensive Zero MSA 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Comprehensive cover with no savings, a self-payment gap and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). All else paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,380	R3,199	R674
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Comprehensive cover with no savings, a self-payment gap and unlimited above threshold benefits that cover most out-of-hospital benefits (with sub limits). All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
(SP) Self Payment:	R#VALUE!	R#VALUE!	R#VALUE!
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Classic Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Only covered once Annual Threshold is reached

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 200% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Saver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,047	R1,536	R819
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,684	R2,760	R1,464

Compare with these plans:

Discovery Essential Delta Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Core 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Most day-to-day claims paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,648	R1,234	R661
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Essential Delta Core 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Topmed Limited 2017: In-hospital Benefits

In brief: R1,000,000 limit per person in private hospitals. Unlimited in public hospitals. Co-payment for private hospital stays, and 20% co-payment for all healthcare providers. Scheme pays most out-of-hospital benefits with 20% co-payment. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate, with co-payment

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,000,000 per person
Contributions:
Total Cost:	R2,245	R600	R260
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: most out-of-hospital claims, with 20% co-payment. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Savings 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Subject to Overall Annual Limit and 20% co-payment

4. Supplementary Services: (Physio, etc)

Subject to Overall Annual Limit and 20% co-payment

5. Transplants:

Subject to Overall Annual Limit and 20% co-payment

6. Co-payments:

Hospital account at private hospital: 50% of the first R4,950, then 10% of remainder up to a maximum of R10,650
All other accounts: 20% co-payment

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: 21 days per person

View this plan

Topmed Network C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,282	R1,282	R359
Children:	Pay for all children
Income limit:	R8,001-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: scopes, medicine, dentistry, optometry, supplementary services, radiology, pathology. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Hysterectomy: R3,500
Cholecystectomy: R2,500
Tonsils, adenoids, grommets: R500
Specialised radiology: R2,500 per scan

7. Alternatives to hospitals:

PMBs only

View this plan

Medimed Essential C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,390	R1,390	R400
Children:	Pay for all children
Income limit:	R8,501-R13,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,668	R1,668	R480

Compare with these plans:

Medimed Standard C 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a 20% co-payment applies

3. Specialised Radiology:

3 scans per family, up to R10,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R2,000 per person

5. Transplants:

R50,000 per family
Benefit is shared with Dialysis and Oncology Benefit

6. Co-payments:

7. Alternatives to hospitals:

R6,000 per person

View this plan

Medimed Standard C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,050	R2,050	R440
Children:	Pay for all children
Income limit:	R13,001-R17,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R9,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R10,650	R10,650	R1,320
Extended Fund:	R4,500 pp	R9,000 pf	R

Compare with these plans:

Medimed Essential C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

3 scans per family, up to R15,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R3,000 per family

5. Transplants:

R100,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R10,000 per person

View this plan

Medimed Max C 2017: In-hospital Benefits

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,210	R3,210	R560
Children:	Pay for all children
Income limit:	R17,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R10,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R14,630	R14,630	R1,680
Extended Fund:	R5,000 pp	R10,000 pf	R

Compare with these plans:

Medimed Standard C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

4 scans per family, up to R20,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R4,000 per family

5. Transplants:

R200,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R15,000 per person

View this plan

Bestmed Beat 2 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R1,554	R1,208	R655
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R3,168	R2,460	R1,332

Compare with these plans:

Bestmed Beat 2 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Private hospital: R3,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital
Specialised radiology: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pace 3 A 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,243	R3,394	R725
Children:	Pay for maximum 4 children
Income limit:	R0-R8,208 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, specialised radiology, contraceptives, medicine, trauma rehab and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,632	R6,108	R1,416
Extended Fund:	R15,000 (main)	R31,000 (family)	R

Compare with these plans:

Bestmed Pace 2 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

100% scheme rate

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pulse 1 C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,630	R1,466	R814
Children:	Pay for maximum 4 children
Income limit:	R10,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bestmed Pulse 2 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R10,000 co-payment

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Private hospital endoscopic procedures: R2,950 co-payment
Laparoscopic procedures: R2,950 co-payment
Prostate Procedures: R2,950 co-payment
Procedures for prolapse/incontinence: R2,950 co-payment
Arthroscopy, other than acute trauma: R2,950 co-payment

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Cyan B 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,396	R2,296	R960
Children:	Pay for maximum 3 children
Income limit:	R8,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,020	R3,852	R1,608

Compare with these plans:

Spectramed Aqua 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-payment and limited to R4,500 per family

4. Supplementary Services: (Physio, etc)

Physio: R2,780 per family

5. Transplants:

R200,000 per family

6. Co-payments:

Dental in-hospital: R2,500 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy and reflux surgery: R3,000 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,500 co-payment
Procedural arthroscopy: R2,000 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

No benefit

View this plan

Fedhealth Blue Door C: In-hospital Benefits

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate, limited to R2,000 per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,380	R1,145	R522
Children:	Pay for all children
Income limit:	R8,501-R10,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or R10,000 co-payment

3. Specialised Radiology:

R12,100 per person and R24,400 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

7. Alternatives to hospitals:

PMBs only, excludes hospice

View this plan

Resolution Progressive Flex Plus 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,369	R2,219	R733
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Progressive Flex 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R9,438 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

R112,524 per family

6. Co-payments:

Excision nail bed, skin lesions, tympanoplasty:R1,881 co-payment
Myringotomy, tonsillectomy, adenoidectomy: R2,193 co-payment
Dental admissions, circumcision, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, gastroscopy: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment, hernia repair, hysterectomy: R3,751 co-payment
Nasal surgery: R5,632 co-payment
Joint replacements, rotator cuff surgery: R7,157 co-payment
Spinal surgery: R7,824 co-payment
Reflux surgery: R10,752 co-payment

7. Alternatives to hospitals:

Home nursing: 5 days per family
Hospice, rehab and step down facility: 12 days per family

View this plan

Resolution Fundation C 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,338	R1,338	R427
Children:	Pay for all children
Income limit:	R7,101-R9,700 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Hospital 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

Co-payments might apply, depending on scheme protocols and alternative available treatment

7. Alternatives to hospitals:

Home nursing: no benefit, unless in lieu of hospitalisation

View this plan

Cape Medical Select 2017: In-hospital Benefits

In brief:

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,998	R4,998	R809
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R3,600	R3,600	R586
Extended Fund:	R4,800	R4,800	R1,200

Compare with these plans:

Cape Medical Silver 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited for non PMBs
PMBs: State or simialar facility, nominated by scheme

3. Specialised Radiology:

R10,220 per person with a R1,500 co-payment in and out of hospital
Thereafter, from day-to-day benefit

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMB level of care

6. Co-payments:

Arthroscopy, appendectomy, inguinal hernia repair, gynaecological procedures, urology procedures, umbilical hernia repair, incisional hernia repair, ventral hernia repair, colectomy, colonoscopy, gastroscopy, hysteroscopy, sympathectomy, vaginal hysterectomy, cystoscopy: R1,000 co-payment

7. Alternatives to hospitals:

Hospice and registered nurses: up to 15 days per person

View this plan

Suremed Challanger 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,000	R3,000	R800
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Navigator 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R16,900 per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R5,000 per person

5. Transplants:

In and out of hospital: R170,000 per family

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R20,000 per family
Hospice: R20,000 per family

View this plan

Suremed Explorer C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,720	R1,720	R500
Children:	Pay for all children
Income limit:	R11,001-R15,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: medication, appliances, dentistry, GPs and specialists, maternity, optometry, pathology, radiology, specialised radiology, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Shuttle 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

2 scans per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R3,300 per family

5. Transplants:

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R12,500 per family
Hospice: R20,000 per family

View this plan

Medshield MediCore 2017: In-hospital Benefits

In brief: Up to 200% scheme rate for specialists. This is hospital plan. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), alternatives to hospitalisation, some non-surgical procedures including scopes, maternity, preventative benefits, in-hospital dentistry for under 6yr olds. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,926	R1,623	R438
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, optometry, some non-surgical procedures including scopes, preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medshield MediValue 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

1 scan per family, with 10% co-payment

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

PMBs only

6. Co-payments:

Hernia repair: R3,000
Diagnostic laparoscopy: R2,000
Reflux: R5,000
Hysterectomy: R5,000
Functional nasal surgery: R5,000
Back surgery: R5,000
Scopes: R1,500, in hospital

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R30,000 per family

View this plan

Commed Roots C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R400k per person, R800k per family
Contributions:
Total Cost:	R1,454	R1,454	R620
Children:	Pay for all children
Income limit:	R18,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some:GPs, specialits, dentistry, medicine, optometry, radiology, pathology, external applianes, alternative to hopitalisation. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Commed Shina C 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Shina C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R600k per person, R1,200,000 per family
Contributions:
Total Cost:	R2,441	R2,075	R488
Children:	Pay for all children
Income limit:	R18,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,929	R2,490	R586

Compare with these plans:

Commed Roots C 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R6,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R3,000 co-payment
Circumcision (elective): R2,000 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,500 co-payment
Cystoscopy: R2,000 co-payment
Dental admissions: R2,000 co-payment
Excision nail bed: R2,000 co-payment
Gastroscopy: R2,500 co-payment
Hernia repair: R2,500 co-payment
Hysterectomy: R3,500 co-payment
Hysteroscopy: R3,500 co-payment
Joint Replacements: R6,000 co-payment
Laparoscopic procedures: R3,500 co-payment
Myringotomy: R2,000 co-payment
Nasal Surgery: R2,500 co-payment
Reflux surgery: R3,500 co-payment
Skin lesions: R2,000 co-payment
Spinal surgery: R6,000 co-payment
Urinary incontinence repair: R4,000 co-payment
Varicose veins: R4,000 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Commed Standard C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R730k per person, R1,460,000 per family
Contributions:
Total Cost:	R3,434	R2,815	R690
Children:	Pay for all children
Income limit:	R7,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Alternative to hopitalisation, mammogram and external appliances. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R5,151	R4,223	R1,035

Compare with these plans:

Commed Shina C 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R8,000 per person with a R2,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

6. Co-payments:

Arthroscopy: R2,500 co-payment
Circumcision (elective): R1,500 co-payment
Colonoscopy, sigmoidoscopy, proctoscopy: R2,000 co-payment
Cystoscopy: R1,500 co-payment
Dental admissions: R1,500 co-payment
Excision nail bed: R1,500 co-payment
Gastroscopy: R2,000 co-payment
Hernia repair: R2,000 co-payment
Hysterectomy: R3,000 co-payment
Hysteroscopy: R3,000 co-payment
Joint Replacements: R5,500 co-payment
Laparoscopic procedures: R3,000 co-payment
Myringotomy: R1,500 co-payment
Nasal Surgery: R2,000 co-payment
Reflux surgery: R3,000 co-payment
Skin lesions: R1,500 co-payment
Spinal surgery: R5,500 co-payment
Urinary incontinence repair: R3,500 co-payment
Varicose veins: R3,500 co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: 14 days per person

View this plan

Makoti Primary C 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R530	R438	R195
Children:	Pay for all children
Income limit:	R6,451-R9,000 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive C 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Makoti Comprehensive C 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in private hospitals
Contributions:
Total Cost:	R1,832	R1,537	R594
Children:	Pay for all children
Income limit:	R12,251-R16,250 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Primary C 2017

View this plan in full
.
.

2. Hospital Choice:

Private hospitals

3. Specialised Radiology:

PMBs only, in private hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in private hospitals

5. Transplants:

PMBs only, in private hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Selfmed MexXXI 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,599	R1,592	R818
Children:	Pay for maximum 3 children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Selfmed Selfnet Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R1,600 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme tariff

5. Transplants:

Donor costs covered up to limits only if recipient is part of the scheme

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Medihelp Dimension Prime 2 Network 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Some co-payments. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), GPs, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,668	R1,368	R498
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), GPs, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,448	R2,016	R720

Compare with these plans:

Medihelp Dimension Prime 2 2017

View this plan in full
.
.

2. Hospital Choice:

Network (106 facilities)

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R9,000 co-payment
In-hospital dentistry for children younger than 5yrs: R1,810 co-payment, with dentist's account paid out of savings account
Gastroscopy and Colonoscopy in doctor's rooms: no co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R3,400 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Necesse D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,656	R1,290	R726
Children:	Pay for all children
Income limit:	R7,001-R11,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Unify 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R14,200 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy and occupational therapy: R8,500 per family

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Private nursing and sub-acute care: R19,200 per family, subject to authorisation.

View this plan | Sign up for this plan

Hosmed Access 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. R1,250,000 per family limit. Scheme pays out-of-hospital claims for: GPs, specialists, medicine, pathology, radiology, specialised radiology, optometry, dentistry, appliances, supplementary services, maternity benefits, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
R1,250,000
Contributions:
Total Cost:	R2,124	R1,829	R413
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medicine, pathology, radiology, specialised radiology, optometry, dentistry, appliances, supplementary services, maternity benefits, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Value 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare

3. Specialised Radiology:

2 scans per person, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

Some co-payments apply

7. Alternatives to hospitals:

No benefit

View this plan

Genesis Private Comprehensive 2017: In-hospital Benefits

In brief: 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, consults, medicine. Limits apply. All else paid out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,200	R2,200	R365
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: dentistry, consults and medicine. Limits apply. All else paid from out of savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,740	R1,740	R

Compare with these plans:

Genesis Private Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Scans related to conservative treatment of back and neck covered up to 50% scheme rate, and limited to R6,000 per person

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Limited to R550,000 per person for admissions related to cancer, stroke, motor-neuron disease and organ transplant
Cost of immunosuppressants: R84,000

6. Co-payments:

External medical appliances: 25% of cost copayment

7. Alternatives to hospitals:

Hospice: 100% of cost
Home care visits: R200 per day
Home visits by medical practitioner: 100% scheme rate

View this plan

Bonitas Standard Select 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Over and above the fund, scheme pays out-of-hospital claims for: GPs, specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,597	R2,247	R760
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Bonitas Standard 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R23,500 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Bonitas BonClassic 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Over and above the savings fund, scheme pays out-of-hospital claims for: specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,648	R3,132	R900
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, mental health, medical appliances, hearing aids, optometry, dentistry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,192	R5,316	R1,524

Compare with these plans:

Bonitas BonComprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

R26,100 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

n/a

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Momentum Custom Associate (and Network provider for chronic) 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. 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.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,573	R1,219	R556
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom (Network for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive Network hospital (and Network provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at Network provider. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,323	R1,848	R949
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,788	R2,788	R2,218

Compare with these plans:

Momentum Incentive (Network provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender Network hospital (and Network provider for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,304	R3,433	R1,352
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R12,912	R10,299	R4,056
(SP) Self Payment:	R4,188	R4,501	R1,044
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender (Network provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Keyhealth Gold 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,143	R2,802	R812
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R4,968	R3,360	R972
Extended Fund:	R4,190	R3,120	R1,000

Compare with these plans:

Keyhealth Platinum 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

MRI and CT scans: R13,900 per family with R1,400 co-payment, in and out of hospital
PET scans: R30,800 per person. Maximum R15,400 per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Unlimited, subject to use of DSP

6. Co-payments:

Specialised radiology: R1,400 co-payment

7. Alternatives to hospitals:

Hospice, private nursing, rehab, step-down and wound care: R34,100 per family in and out of hospital
Wound care sublimit: R11,200

View this plan

Discovery Essential Comprehensive 2017: In-hospital Benefits

In brief: 100% 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,787	R3,580	R762
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers 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.
	Main:	Adult:	Child:
(S) Savings:	R6,816	R6,444	R1,368
(SP) Self Payment:	R8,684	R9,056	R1,582
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Essential Delta Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Delta Saver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Over and above the savings fund, scheme pays out-of-hospital claims for: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,634	R1,230	R655
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,940	R2,208	R1,176

Compare with these plans:

Discovery Essential Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Essential Delta Core 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,317	R989	R528
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Essential Core 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Topmed Savings 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,317	R1,850	R698
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,452	R3,552	R1,344

Compare with these plans:

Topmed Limited 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate
Stomatherapy: R18,900 per family

5. Transplants:

PMBs only

6. Co-payments:

In-hospital scopes: R2,500 co-payment
Specialised radiology: R2,500 co-payment per scan

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: R131,676 per person

View this plan

Topmed Network D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,734	R1,734	R464
Children:	Pay for all children
Income limit:	R11,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: scopes, medicine, dentistry, optometry, supplementary services, radiology, pathology. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Essential 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Hysterectomy: R3,500
Cholecystectomy: R2,500
Tonsils, adenoids, grommets: R500
Specialised radiology: R2,500 per scan

7. Alternatives to hospitals:

PMBs only

View this plan

Medimed Essential D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,660	R1,660	R420
Children:	Pay for all children
Income limit:	R13,001-R17,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R1,992	R1,992	R504

Compare with these plans:

Medimed Standard D 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a 20% co-payment applies

3. Specialised Radiology:

3 scans per family, up to R10,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R2,000 per person

5. Transplants:

R50,000 per family
Benefit is shared with Dialysis and Oncology Benefit

6. Co-payments:

7. Alternatives to hospitals:

R6,000 per person

View this plan

Medimed Standard D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,230	R2,230	R470
Children:	Pay for all children
Income limit:	R17,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, preventative benefits, some medication. Limits apply. All else paid from savings, extended fund (max R9,000 per family) or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R11,190	R11,190	R1,410
Extended Fund:	R4,500 pp	R9,000 pf	R

Compare with these plans:

Medimed Essential D 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

3 scans per family, up to R15,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R3,000 per family

5. Transplants:

R100,000 per family
Benefit is shared with Dialysis Benefit

6. Co-payments:

7. Alternatives to hospitals:

R10,000 per person

View this plan

Bestmed Beat 2 Network 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R1,399	R1,087	R589
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, wound care, specialised radiology, contraceptives and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,856	R2,220	R1,220

Compare with these plans:

Bestmed Beat 2 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Hospitals, or up to R10,000 co-payment if you voluntarily choose another hospital

3. Specialised Radiology:

Private hospital: R3,000 co-payment

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital
Specialised radiology: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pace 3 B 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,097	R4,066	R853
Children:	Pay for maximum 4 children
Income limit:	R8,209+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, specialised radiology, contraceptives, medicine, trauma rehab and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R9,180	R7,320	R1,536
Extended Fund:	R28,000 (main)	R45,100 (family)	R

Compare with these plans:

Bestmed Pace 2 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

100% scheme rate

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pulse 2 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: GP and specialist consults, dentistry, optometry, appliances, wound care, maternity, radiology and pathology, specialised radiology, some medication, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,902	R3,902	R927
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP and specialist consults, dentistry, optometry, appliances, wound care, maternity, radiology and pathology, specialised radiology, medication, contraceptives and preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R11,350 (main)	R22,550 (family)	R

Compare with these plans:

Bestmed Pulse 1 C 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R10,000 co-payment

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

None

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Capri 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,003	R1,609	R909
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,400	R1,932	R1,092

Compare with these plans:

Spectramed Cobalt 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-payment and limited to R8,900 per family

4. Supplementary Services: (Physio, etc)

Physio: R3,900 per family

5. Transplants:

R350,000 per family

6. Co-payments:

Dental in-hospital: R2,500 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy: R2,500 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,500 co-payment
Arthroscopy: R1,000 co-payment
Reflux surgery: R3,000 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

No benefit

View this plan

Fedhealth Blue Door D: In-hospital Benefits

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate, limited to R2,000 per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,754	R1,375	R677
Children:	Pay for all children
Income limit:	R10,501-R12,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or R10,000 co-payment

3. Specialised Radiology:

R12,100 per person and R24,400 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

7. Alternatives to hospitals:

PMBs only, excludes hospice

View this plan

Resolution Millennium 2017: In-hospital Benefits

In brief:

1. Payout Rate:

150% scheme rate for contracted providers, otherwise 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,200	R3,598	R979
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R10,092	R8,628	R2,340
(SP) Self Payment:	R3,479	R2,629	R633
Threshold (S+SP):	R13,571	R11,257	R2,973
Above Threshold:	5,544	4,728	774

Compare with these plans:

Resolution Millennium Select 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R15,003 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

Unlimited

6. Co-payments:

Excision nail bed, skin lesions:R1,881 co-payment
Dental admissions, circumcision, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, gastroscopy: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment, hernia repair, hysterectomy: R3,751 co-payment
Nasal surgery: R5,632 co-payment
Joint replacements, rotator cuff surgery: R7,157 co-payment
Spinal surgery: R7,824 co-payment
Reflux surgery: R10,752 co-payment

7. Alternatives to hospitals:

Home nursing: 10 days per family
Hospice, rehab and step down facility: 18 days per family

View this plan

Resolution Fundation D 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,022	R2,022	R694
Children:	Pay for all children
Income limit:	R9,701+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Resolution Hospital 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

PMBs only

4. Supplementary Services: (Physio, etc)

5. Transplants:

PMBs only

6. Co-payments:

Co-payments might apply, depending on scheme protocols and alternative available treatment

7. Alternatives to hospitals:

Home nursing: no benefit, unless in lieu of hospitalisation

View this plan

Suremed Explorer D 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,920	R1,920	R600
Children:	Pay for all children
Income limit:	R15,000+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: medication, appliances, dentistry, GPs and specialists, maternity, optometry, pathology, radiology, specialised radiology, alternative to hospitals. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Suremed Shuttle 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

2 scans per family,in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: R3,300 per family

5. Transplants:

6. Co-payments:

none

7. Alternatives to hospitals:

Private nursing and step down facilities: R12,500 per family
Hospice: R20,000 per family

View this plan

Medshield MediPlus 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,544	R1,797	R558
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	RM=R6,750 M1 =R9,420 M2 =R10,600 M3 = R11,910 M4+ +R13,050	R	R

Compare with these plans:

Medshield MediSaver 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R10,200 per family, with 10% co-payment in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

R140,000 per family

6. Co-payments:

non-PMBs internal prostheses and devices: 25% co-payment
non-PMBs PET and PET-CT scan: 10% co-payment

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R47,000 per family

View this plan

Makoti Primary D 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R569	R461	R210
Children:	Pay for all children
Income limit:	R9,001-R12,000 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive D 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Makoti Comprehensive D 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in private hospitals
Contributions:
Total Cost:	R2,008	R1,722	R653
Children:	Pay for all children
Income limit:	R16,251+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Primary D 2017

View this plan in full
.
.

2. Hospital Choice:

Private hospitals

3. Specialised Radiology:

PMBs only, in private hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in private hospitals

5. Transplants:

PMBs only, in private hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Selfmed Selfsure 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,456	R2,451	R836
Children:	Pay for maximum 3 children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Selfmed MexXXI 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R1,600 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme tariff

5. Transplants:

Donor costs covered up to limits only if recipient is part of the scheme

6. Co-payments:

7. Alternatives to hospitals:

View this plan

Medihelp Dimension Prime 3 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: radiology (co-payment), pathology, GPs, specialists, supplementary services, medicine, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,730	R2,316	R798
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, GPs, specialists, supplementary health and medication, dentistry, optometry, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Dimension Prime 3 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R7,850 co-payment
In-hospital dentistry for children younger than 5yrs: R780 co-payment
Gastroscopy and Colonoscopy in doctor's rooms: no co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R2,800 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Medihelp Necesse E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,932	R1,506	R834
Children:	Pay for all children
Income limit:	R11,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Unify 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R14,200 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy and occupational therapy: R8,500 per family

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, PMBs only

6. Co-payments:

7. Alternatives to hospitals:

Private nursing and sub-acute care: R19,200 per family, subject to authorisation.

View this plan | Sign up for this plan

Hosmed Value 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,964	R2,144	R482
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GPs, specialists, medicine, pathology, radiology, specialised radiology, optometry, dentistry, appliances, mental health, supplementary services, maternity benefits, preventative benefits. Limits apply. All else paid out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

n/a

7. Alternatives to hospitals:

No benefit

View this plan

Bonitas BonComprehensive 2017: In-hospital Benefits

In brief: 300% scheme rate. Over and above the savings/threshold benefit, scheme pays out-of-hospital claims for: specialised radiology, mental health, refractive surgery, medical appliances, hearing aids, optometry, maternity, infant paediatrics and preventative benefits. Limits apply. Unlimited threshold with a self payment gap and sub-limits. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

300% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,254	R4,956	R1,069
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, mental health, refractive surgery, medical appliances, hearing aids, optometry, maternity, infant paediatrics and preventative benefits. Limits apply. All else paid from savings, above threshold or from out of pocket.
	Main:	Adult:	Child:
(S) Savings:	R11,892	R11,220	R2,424
(SP) Self Payment:	R3,600	R2,980	R1,370
Threshold (S+SP):	R15,492	R14,200	R3,794
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Bonitas BonClassic 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a co-payment may apply for admission to certain hospitals. Speak to scheme.

3. Specialised Radiology:

Unlimited

4. Supplementary Services: (Physio, etc)

100% scheme rate
Physical rehabilitation: R44,650 per family

5. Transplants:

Unlimited

6. Co-payments:

n/a

7. Alternatives to hospitals:

R14,900 per family

View this plan | Sign up for this plan

Momentum Custom (State for chronic) 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. 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.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,610	R1,215	R590
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom Associate (and State provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive (State provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,088	R1,646	R984
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,506	R2,506	R1,975

Compare with these plans:

Momentum Incentive Network hospital (and State provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender (State provider for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,309	R3,507	R1,323
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R12,927	R10,521	R3,969
(SP) Self Payment:	R4,173	R4,279	R1,131
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender Network hospital (and State provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Keyhealth Platinum 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. This is a comprehensive plan. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), dentistry, medicine, optometry, maternity, medical appliances, hearing aids, oncology, sub-acute facilities, preventative benefits. Limits apply. All else paid from fund, from above threshold benefit or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,796	R4,764	R1,433
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), dentistry, medicine, optometry, maternity, medical appliances, sub-acute facilities, preventative benefits. Limits apply. All else paid from fund, from above threshold benefit or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	R9,115	R8,840	R2,160
(SP) Self Payment:	R3,190	R2,840	R1,045
Threshold (S+SP):	R12,305	R11,680	R3,205
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

MRI and CT scans: R20,800 per family with R1,400 co-payment, in and out of hospital
PET scans: R30,800 per person. Maximum R15,400 per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

Unlimited, subject to use of DSP

6. Co-payments:

Specialised radiology: R1,400 co-payment

7. Alternatives to hospitals:

Hospice, private nursing, rehab, step-down and wound care: R41,600 per family in and out of hospital
Wound care sublimit: R14,500

View this plan

Discovery Essential Delta Comprehensive 2017: In-hospital Benefits

In brief: 100% 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.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,410	R3,221	R684
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Comprehensive cover that covers 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.
	Main:	Adult:	Child:
(S) Savings:	R6,132	R5,796	R1,224
(SP) Self Payment:	R9,368	R9,704	R1,726
Threshold (S+SP):	R15,500	R15,500	R2,950
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Discovery Essential Comprehensive 2017

View this plan in full
.
.

2. Hospital Choice:

Hospitals in Delta Network
Otherwise, R7,100 co-payment

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: First R3,150 co-payment paid from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Coastal Saver 2017: In-hospital Benefits

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,007	R1,506	R808
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: GP consults if savings run out. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,812	R3,612	R1,932

Compare with these plans:

Discovery Essential Saver 2017

View this plan in full
.
.

2. Hospital Choice:

Selected private hospitals in coastal provinces
Otherwise, no payment if a non-selected hospital is used in coastal province, or a 70% payment if a hospital is used outside the coastal provinces.

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: the first R2,750 paid from day-to-day benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Discovery Coastal Core 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Most day-to-day claims paid from out of pocket, unless PMB.

1. Payout Rate:

Covered in full for specialists with payment arrangement with Discovery
Otherwise, 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,496	R1,122	R596
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Most claims paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Discovery Coastal Core 2017

View this plan in full
.
.

2. Hospital Choice:

Selected private hospitals in coastal provinces
Otherwise, no payment if a non-selected hospital is used in coastal province, or a 70% payment if a hospital is used outside the coastal provinces.

3. Specialised Radiology:

If not related to admission or for conservative back or neck treatment: no benefit

4. Supplementary Services: (Physio, etc)

Covered in full for professionals with payment arrangement with Discovery
Otherwise, 100% scheme rate

5. Transplants:

Covered

6. Co-payments:

Scopes: R3,900 co-payment from day-to-day benefit. No co-payment if done in doctor's rooms.

7. Alternatives to hospitals:

Administration of IV, iron treatments, steroids and immunoglobulins when a hospital admission is not required: covered
Care for venous ulcers, diabetic foot ulcers, pressure sores and other moderate to severe wounds for patients who do not require hospital admission: covered
End of life care: R52,750 per person, per lifetime
Cancer: Unlimited palliative care cover for approved care at home

View this plan | Sign up for this plan

Topmed Family 2017: In-hospital Benefits

In brief: 150% scheme rate. Scheme pays out-of-hospital claims for: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. In addition, there is a limited above threshold benefit. Limits apply. All else paid from savings, or from above threshold(limited) or from out of pocket, unless PMB.

1. Payout Rate:

150% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,490	R2,790	R954
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. Limits apply. All else paid from savings, or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R8,376	R6,696	R2,292

Compare with these plans:

Topmed Executive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate
Stomatherapy: R18,900 per family

5. Transplants:

R230,400

6. Co-payments:

Joint replacement, spinal surgery, hiatus hernia repair: R7,500
Hysterectomy: R3,500
Laparoscopic surgery: R3,000
Cholecystectomy: R2,500
In-hospital scopes: R2,500 co-payment
Specialised radiology: R2,500 co-payment per scan
Sinus and nasal surgery: R2,000
Dentistry (in-hospital): R1,600
Impacted wisdom teeth: R1,060
Tonsils, adenoids, grommets: R1,000

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: R131,676 per person

View this plan

Medimed Essential E 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,990	R1,990	R440
Children:	Pay for all children
Income limit:	R17,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, GPs, specialists, medication, dentistry, optometry, radiology and pathology. Limits apply. All else paid from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,388	R2,388	R528

Compare with these plans:

Medimed Standard D 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or a 20% co-payment applies

3. Specialised Radiology:

3 scans per family, up to R10,000 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

R2,000 per person

5. Transplants:

R50,000 per family
Benefit is shared with Dialysis and Oncology Benefit

6. Co-payments:

7. Alternatives to hospitals:

R6,000 per person

View this plan

Bestmed Beat 3 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: preventative dentistry, optometry, maternity, wound care, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R2,359	R1,676	R911
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, wound care, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,812	R3,420	R1,860

Compare with these plans:

Bestmed Beat 3 Network 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Bestmed Pace 4 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,096	R6,096	R1,428
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Optometry, maternity, specialised radiology, trauma rehab, medication, contraceptives and preventative benefits. Limits apply. All else paid from extended fund, from savings or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R996	R996	R516

Compare with these plans:

Bestmed Beat 3 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

100% scheme rate

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Azure A 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: mental health, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,371	R1,875	R1,016
Children:	Pay for max 3 children, with 2nd child=R616 and 3rd child=R415pm
Income limit:	R0-R8,000 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: mental health, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,488	R4,164	R2,256

Compare with these plans:

Spectramed Cobalt 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-paymentand limited to R14,600 per family

4. Supplementary Services: (Physio, etc)

Physio: R5,550 per family

5. Transplants:

R500,000 per family

6. Co-payments:

Dental in-hospital: R2,000 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy: R1,500 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,000 co-payment
Arthroscopy: R1,000 co-payment
Reflux surgery: R2,000 co-payment
Joint replacement and spinal surgery: R4,500 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

Nursing and hospice: R8,200 per family

View this plan

Fedhealth Blue Door E: In-hospital Benefits

1. Payout Rate:

Covered in full for specialists and GPs in Fedhealth network
Otherwise, 100% scheme rate, limited to R2,000 per person

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,378	R2,061	R895
Children:	Pay for all children
Income limit:	R12,001+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: prescribed medication, GP consults, dentistry, optometry. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Fedhealth Maxima EntryZone 2017

View this plan in full
.
.

2. Hospital Choice:

Network, or R10,000 co-payment

3. Specialised Radiology:

R12,100 per person and R24,400 per family

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only, in state facilities

6. Co-payments:

7. Alternatives to hospitals:

PMBs only, excludes hospice

View this plan

Resolution Millennium Select 2017: In-hospital Benefits

In brief:

1. Payout Rate:

150% scheme rate for contracted providers, otherwise 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,819	R3,271	R890
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R9,180	R7,848	R2,124
(SP) Self Payment:	R4,391	R3,409	R849
Threshold (S+SP):	R13.571	R11,257	R2,973
Above Threshold:	5,544	4,728	774

Compare with these plans:

Resolution Millennium 2017

View this plan in full
.
.

2. Hospital Choice:

Network or R3,896 co-payment

3. Specialised Radiology:

R15,003 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

Unlimited

6. Co-payments:

Excision nail bed, skin lesions:R1,881 co-payment
Dental admissions, circumcision, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, gastroscopy: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment, hernia repair, hysterectomy: R3,751 co-payment
Nasal surgery: R5,632 co-payment
Joint replacements, rotator cuff surgery: R7,157 co-payment
Spinal surgery: R7,824 co-payment
Reflux surgery: R10,752 co-payment

7. Alternatives to hospitals:

Home nursing: 10 days per family
Hospice, rehab and step down facility: 18 days per family

View this plan

Medshield MediSaver 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), alternatives to hospitalisation, some non-surgical procedures including scopes, maternity, preventative benefits, dentistry. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,571	R2,151	R615
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), alternatives to hospitalisation, some non-surgical procedures including scopes, maternity, preventative benefits, dentistry. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,192	R5,184	R1,476

Compare with these plans:

Medshield MediPlus 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R15,880 per family, with 10% co-payment in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

R250,000 per family

6. Co-payments:

non-PMBs internal prostheses and devices: 25% co-payment
non-PMBs PET and PET-CT scan: 10% co-payment
Nissen Fundoplication: R5,000 co-payment
Hernia repair: R3,000 co-payment
Diagnostic laparoscopy: R3,000 co-payment
Hysterectomy: R5,000 co-payment
Functional nasal surgery: R5,000 co-payment
Back surgery: R5,000 co-payment
Scopes: R1,500 co-payment, in hospital

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R50,000 per family

View this plan

Makoti Primary E 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R611	R490	R223
Children:	Pay for all children
Income limit:	R12,001-R16,000 (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive D 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Medihelp Dimension Prime 3 Network 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Network hospitals. Some co-payments. Scheme pays out-of-hospital claims for: radiology (co-payment), pathology, GPs, specialists, supplementary services, medicine, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R2,184	R1,848	R636
Children:	Pay for maximum 2 children under 18yrs.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, GPs, specialists, supplementary health and medication, dentistry, optometry, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Dimension Prime 3 2017

View this plan in full
.
.

2. Hospital Choice:

Network (106 facilities)

3. Specialised Radiology:

Co-payment of R1,500, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R7,850 co-payment
In-hospital dentistry for children younger than 5yrs: R780 co-payment
Gastroscopy and Colonoscopy in doctor's rooms: no co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R2,800 co-payment
Specialised radiology: R1,500 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Hosmed Plus 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,184	R3,115	R700
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Hosmed Value 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Unlimited

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

paid by scheme

6. Co-payments:

n/a

7. Alternatives to hospitals:

No benefit

View this plan

Momentum Custom Associate (and State provider for chronic) 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

100% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,266	R957	R448
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: maternity, preventative benefits. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Momentum Custom (State for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Gastroscopies, nail surgery, cystoscopies, colonoscopies, sigmoidoscopies, removing of extensive skin lesions: R500 co-payment if done in day-clinic
Otherwise, R1,200 co-payment for most admissions other than for maternity, motor accident and emergency treatment
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Incentive Network hospital (and State provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. Chronic benefits at State facilities. Scheme pays out-of-hospital claims for: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R1,700	R1,333	R883
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (co-payment), maternity, preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R2,040	R2,040	R1,600

Compare with these plans:

Momentum Incentive (State provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R44,400 per family. paid by scheme.

View this plan | Sign up for this plan

Momentum Extender Network hospital (and State provider for chronic) 2017: In-hospital Benefits

In brief: 200% scheme rate for specialists. Network hospitals. 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.

1. Payout Rate:

200% scheme rate
Network specialists covered in full

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,732	R2,805	R1,149
Children:	Pay for maximum 3 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R11,196	R8,415	R3,447
(SP) Self Payment:	R5,904	R6,385	R1,653
Threshold (S+SP):	R17,100	R14,800	R5,100
Above Threshold:	No limit	No limit	No limit

Compare with these plans:

Momentum Extender (State provider for chronic) 2017

View this plan in full
.
.

2. Hospital Choice:

Network hospitals

3. Specialised Radiology:

Unlimited with a R2,030 co-payment

4. Supplementary Services: (Physio, etc)

5. Transplants:

Recipient: Unlimited
Donor R17,600 cadaver costs and R35,700 for live donor costs. Only covered if recipient is a member of the scheme

6. Co-payments:

Some in-hospital procedures: R1,200 co-payment applies
Specialised radiology: R2,030 co-payment

7. Alternatives to hospitals:

Medical rehabilitation, private nursing, hospice and step-down facilities: R45,400 per family. paid by scheme.

View this plan | Sign up for this plan

Topmed Executive 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,453	R3,554	R1,355
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. Limits apply. 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.
	Main:	Adult:	Child:
(S) Savings:	R12,356	R10,656	R4,044

Compare with these plans:

Topmed Family 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate
Stomatherapy: R18,900 per family

5. Transplants:

Covered

6. Co-payments:

Hysterectomy: R2,500
Hernia Repair: R5,000
Laparoscopic surgery: R2,000
Scopes: R2,500
Specialised radiology: R2,500 per scan

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: R131,676 per person

View this plan

Bestmed Beat 3 Network 2017: In-hospital Benefits

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

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, but sub-limits can apply
Contributions:
Total Cost:	R2,123	R1,509	R820
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, wound care, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R4,332	R3,084	R1,668

Compare with these plans:

Bestmed Beat 3 2017

View this plan in full
.
.

2. Hospital Choice:

Netcare Hospitals, or up to R10,000 co-payment if you voluntarily choose another hospital

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

Scopes: R3,000 co-payment if in private hospital

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Azure B 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,501	R2,206	R1,137
Children:	Pay for max 3 children, with 2nd child=R865 and 3rd child=R604pm
Income limit:	R8,001- R11,500 (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: mental health, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R7,776	R4,896	R2,520

Compare with these plans:

Spectramed Cobalt 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-payment and limited to R14,600 per family

4. Supplementary Services: (Physio, etc)

Physio: R5,550 per family

5. Transplants:

R500,000 per family

6. Co-payments:

Dental in-hospital: R2,000 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy: R1,500 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,000 co-payment
Arthroscopy: R1,000 co-payment
Reflux surgery: R2,000 co-payment
Joint replacement and spinal surgery: R4,500 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

Nursing and hospice: R8,200 per family

View this plan

Resolution Supreme 2017: In-hospital Benefits

In brief:

1. Payout Rate:

220% scheme rate for contracted providers, otherwise 100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,565	R4,345	R1,130
Children:	Pay for all children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R18,755 per family with R1,892 co-payment. In and out of hospital

4. Supplementary Services: (Physio, etc)

5. Transplants:

Unlimited

6. Co-payments:

Dental admissions: R2,504 co-payment
Hysteroscopy: R2,816 co-payment
Arthroscopy, endometrial ablation, laparoscopic procedures, urinary incontinence repair, varicose veins, conservative back, spinal treatment: R3,751 co-payment
Joint replacements: R7,157 co-payment
Spinal surgery: R7,824 co-payment

7. Alternatives to hospitals:

Home nursing: 12 days per family
Hospice, rehab and step down facility: 21 days per family

View this plan

Medshield MediBonus 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,119	R2,829	R819
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology, maternity, alternative to hospitalisation, optometry, preventative benefits. Limits apply. All else paid from extended fund or out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-
Extended Fund:	RM =R9,300 M1 = R13,040 M2 =R14,460 M3 = R15,930 M4 = R17,240	R	R

Compare with these plans:

Medshield Premium Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R18,030 per family, with 10% co-payment in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

Unlimited

6. Co-payments:

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R70,000 per family

View this plan

Makoti Primary F 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
PMBs only, in state hospitals
Contributions:
Total Cost:	R656	R510	R235
Children:	Pay for all children
Income limit:	R16,001+ (other limits)
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Makoti Comprehensive D 2017

View this plan in full
.
.

2. Hospital Choice:

State hospitals

3. Specialised Radiology:

PMBs only, in state hospitals

4. Supplementary Services: (Physio, etc)

PMBs only, in state hospitals

5. Transplants:

PMBs only, in state hospitals

6. Co-payments:

None

7. Alternatives to hospitals:

View this plan

Selfmed 80% 2017: In-hospital Benefits

In brief:

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,335	R5,485	R1,100
Children:	Pay for maximum 3 children
Day-to-Day Benefit:

	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

No items found

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R1,100 co-payment

4. Supplementary Services: (Physio, etc)

Unlimited

5. Transplants:

Donor costs covered up to limits only if recipient is part of the scheme

6. Co-payments:

20% co-payment for consults and clinical procedures

7. Alternatives to hospitals:

View this plan

Medihelp Dimension Elite 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: radiology (co-payment), pathology, GPs, specialists, supplementary services, psychologists, medicine, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,972	R3,714	R1,080
Children:	Pay for all children.
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: radiology (co-payment), pathology, GPs, specialists, supplementary services, psychologists, medicine, optometry, dentistry, maternity, infant paediatrics, medical appliances. Limits apply. All else paid from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Medihelp Plus 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

Co-payment of R1,000, in or out of hospital

4. Supplementary Services: (Physio, etc)

100% scheme rate
In addition, scheme covers professional services for up to 30 days after discharge following hospital admission, including speech therapy, occupational therapy and physiotherapy. M =R1,650 and M+ =R2,200

5. Transplants:

Cornea implants: R24,750 per implant
Otherwise, unlimited

6. Co-payments:

Back and neck fusion: R6,700 co-payment
In-hospital dentistry for children younger than 5yrs: R750 co-payment
Gastroscopy and Colonoscopy in doctor's rooms: no co-payment
Gastroscopy, Colonoscopy, Arthroscopy, Sigmoidoscopy in-hospital: R2,800 co-payment
Specialised radiology: R1,000 co-payment

7. Alternatives to hospitals:

Hospice and sub-acute facilities: paid by scheme, subject to authorisation
Private nursing: paid by scheme, subject to authorisation

View this plan | Sign up for this plan

Topmed Comprehensive 2017: In-hospital Benefits

In brief: 300% scheme rate. 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 (paid at 80% scheme rate) or out-of-pocket, unless PMB. Sub-limits apply.

1. Payout Rate:

300% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R6,070	R5,010	R1,425
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: specialised radiology (with co-payment), maternity, scopes, alternatives to hospitalisation, extended rehab benefits, preventative benefits. Limits apply. 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.
	Main:	Adult:	Child:
(S) Savings:	R0-	R0-	R0-

Compare with these plans:

Topmed Executive 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

R2,500 co-payment per scan

4. Supplementary Services: (Physio, etc)

100% scheme rate
Stomatherapy: R18,900 per family

5. Transplants:

Covered

6. Co-payments:

Gastroscopies and colonoscopies: R2,500
Specialised radiology: R2,500 per scan
Dentistry (in-hospital): R1,600
Impacted wisdom teeth: R1,060

7. Alternatives to hospitals:

Private nursing and step down facilities and hospice: R131,676 per person

View this plan

Bestmed Beat 4 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Some co-payments. Scheme pays out-of-hospital claims for: preventative dentistry, optometry, maternity, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,618	R2,988	R895
Children:	Pay for maximum 4 children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: Preventative dentistry, optometry, maternity, specialised radiology, contraceptives, some medicine and preventative benefits. Limits apply. All else paid from savings, from extended fund or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R6,516	R5,376	R1,608
Extended Fund:	R10,000 (main)	R20,000 (family)	R

Compare with these plans:

Bestmed Beat 3 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited

3. Specialised Radiology:

100% scheme rate

4. Supplementary Services: (Physio, etc)

100% scheme rate

5. Transplants:

PMBs only

6. Co-payments:

n/a

7. Alternatives to hospitals:

100% scheme rate

View this plan

Spectramed Azure C 2017: In-hospital Benefits

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R3,651	R2,582	R1,282
Children:	Pay for max 3 children, with 2nd and 3rd child=R1,175pm
Income limit:	R11,500+ (other limits)
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: mental health, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R8,100	R5,736	R2,844

Compare with these plans:

Spectramed Cobalt 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-paymentand limited to R14,600 per family

4. Supplementary Services: (Physio, etc)

Physio: R5,550 per family

5. Transplants:

R500,000 per family

6. Co-payments:

Dental in-hospital: R2,000 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Hysterectomy: R1,500 co-payment
Laparoscopy, hysteroscopy, endometrial ablation: R2,000 co-payment
Arthroscopy: R1,000 co-payment
Reflux surgery: R2,000 co-payment
Joint replacement and spinal surgery: R4,500 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

Nursing and hospice: R8,200 per family

View this plan

Medshield Premium Plus 2017: In-hospital Benefits

In brief: 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.

1. Payout Rate:

200% scheme rate or agreed cost

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R4,284	R3,909	R792
Children:	Pay for three children only
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: 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.
	Main:	Adult:	Child:
(S) Savings:	R12,852	R11,736	R2,376
Threshold (S+SP):	R12,730	R11,770	R2,350
Above Threshold:	4,280	3,210	2,140

Compare with these plans:

Medshield MediBonus 2017

View this plan in full
.
.

2. Hospital Choice:

Network

3. Specialised Radiology:

R21,550 per family, in and out of hospital

4. Supplementary Services: (Physio, etc)

Physiotherapy: Unlimited

5. Transplants:

Unlimited

6. Co-payments:

7. Alternatives to hospitals:

Physical rehabilitation, sub-acute facilities, nursing services, hospice: R100,000 per family

View this plan

Spectramed Cobalt 2017: In-hospital Benefits

In brief: 100% scheme rate for specialists. Scheme pays out-of-hospital claims for: mental health, appliances, optometry, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.

1. Payout Rate:

100% scheme rate

	Main:	Adult:	Child:
Overall Annual Limit (OAL):
Unlimited overall, with sub-limits
Contributions:
Total Cost:	R5,321	R4,831	R1,865
Children:	Pay for all children
Day-to-Day Benefit:
Out-of-hospital, scheme pays for some: mental health, appliances, optometry, specialised dentistry and preventative benefits. Limits apply. All else paid from savings or from out of pocket, unless PMB.
	Main:	Adult:	Child:
(S) Savings:	R14,688	R13,332	R5,148

Compare with these plans:

Spectramed Azure C 2017

View this plan in full
.
.

2. Hospital Choice:

Unlimited, but a Designated Service Provider must be used for many benefits

3. Specialised Radiology:

R1,500 co-payment from second scan and limited to R20,700 per family

4. Supplementary Services: (Physio, etc)

Physio: R11,100 per family

5. Transplants:

Covered

6. Co-payments:

Dental in-hospital: R1,500 co-payment
Gastroscopy, Colonoscopy: R1,500 co-payment if in hospital
Sigmoidoscopy: R1,500 co-payment
Arthroscopy: R1,500 co-payment
Reflux surgery, Joint replacement and spinal surgery: R1,000 co-payment
Non-surgical admissions: R1,000 co-payment

7. Alternatives to hospitals:

Nursing and hospice: R13,600 per family

View this plan

Income limited plans

“]”]

“]

Medical Aid Bible helps South Africans choose the best medical aid plan for their needs. Quickly view the benefits on any open plan, and compare any two plans with a simple click.
.