Topmed other benefits: 2017

Nov 3, 2016

Click here to compare other 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: Other 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. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

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Compcare Pinnacle 2017: Other 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. General Appliances:

R31,500 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit but not payable from above threshold
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Plus A 2017: Other 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. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Fedhealth Maxima EntryZone 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe B 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

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Compcare Pinnacle ED 2017: Other 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. General Appliances:

R31,500 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit but not payable from above threshold
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Plus B 2017: Other Benefits

1. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

View this plan | Sign up for this plan

Sizwe Gomomo A 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Core 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe C 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

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Compcare Dynamix 2017: Other 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. General Appliances:

R15,750 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit but not payable from above threshold
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED A 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Plus C 2017: Other Benefits

1. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

View this plan | Sign up for this plan

Sizwe Gomomo B 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Core Grid 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe D 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Dynamix ED 2017: Other 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. General Appliances:

R15,750 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit but not payable from above threshold
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED B 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Access A 2017: Other 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. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

View this plan | Sign up for this plan

Sizwe Savings Care A 2017: Other 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. General Appliances:

M =R1,240 and M1+ = R2,160

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima EntrySaver 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

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Fedhealth Maxima EntryZone 2017

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe E 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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-

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Momentum Ingwe Network E 2017

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Symmetry 2017: Other 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. General Appliances:

R11,025 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED C 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Access B 2017: Other Benefits

1. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Sizwe Savings Care B 2017: Other Benefits

In brief:

1. General Appliances:

M =R1,240 and M1+ = R2,160

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Saver 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

R250,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe Network A 2017: Other 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. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Symmetry ED 2017: Other 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. General Appliances:

R11,025 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED D 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Access C 2017: Other Benefits

1. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

View this plan | Sign up for this plan

Sizwe Primary Care A 2017: Other Benefits

In brief:

1. General Appliances:

M =R960 and M1+ = R1,550

	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

1.1. Hearing Aids:

R5,500 per family

1.2. Wheelchairs:

R1,790 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Saver Grid 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

R250,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe Network B 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Mumed 2017: Other 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. General Appliances:

R9,975 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED E 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Access D 2017: Other Benefits

1. General Appliances:

R5,200 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

View this plan | Sign up for this plan

Sizwe Primary Care B 2017: Other Benefits

In brief:

1. General Appliances:

M =R960 and M1+ = R1,550

	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

1.1. Hearing Aids:

R5,500 per family

1.2. Wheelchairs:

R1,790 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Basis 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

R250,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe Network C 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Mumed ED 2017: Other 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. General Appliances:

R9,975 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED F 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Core A 2017: Other Benefits

1. General Appliances:

No benefit

	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-

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Discovery KeyCare Access A 2017

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Sizwe Primary Care C 2017: Other Benefits

In brief:

1. General Appliances:

M =R960 and M1+ = R1,550

	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

1.1. Hearing Aids:

R5,500 per family

1.2. Wheelchairs:

R1,790 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Basis Grid 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

R250,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe Network D 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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-

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Momentum Ingwe D 2017

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

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Compcare Unisave 2017: Other 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. General Appliances:

R8,400 per family paid by scheme

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation: from day-to-day benefit
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED G 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Core B 2017: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Sizwe Affordable Care A 2017: Other Benefits

In brief:

1. General Appliances:

M =R1,440 and M1+ = R2,510

	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

1.1. Hearing Aids:

R8,600 per family

1.2. Wheelchairs:

R2,990 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Standard 2017: Other 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. General Appliances:

R10,500 per family, from day-to-day benefit, in and out of hospital
Does not add up to threshold
Foot orthotics: sub-limit of R3,910 per person

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R400,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Medihelp Dimension Prime 1 2017: Other 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. General Appliances:

Medical Appliances, hyperbaric oxygen: No benefit
Stoma products and urine bags: paid by scheme
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R4,080 per family every 3 years

1.2. Wheelchairs:

R4,080 per family every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Unify 2017: Other 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. General Appliances:

Stoma products and urine bags: paid by scheme
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Necesse A 2017: Other 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. General Appliances:

Medical, surgical and orthopaedic appliances: R8,550 per family
CPAP: R8,400 per person every 24 months

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Hosmed Essential A 2017: Other 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. General Appliances:

R2,500 per family, PMBs only

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Genesis Private Choice 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMB only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

No benefit

6. Other:

View this plan

Bonitas Essential 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited (in-hospital) at DSP

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

No benefit

6. Other:

View this plan

Bonitas BonFit 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited (in-hospital) at DSP

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

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Momentum Custom (Any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive (Any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at any chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender (Any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at any chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Access 2017: Other 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. General Appliances:

In-hospital: R5,630 per family

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,600 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R3.38 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Keyhealth Essence 2017: Other 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. General Appliances:

R6,200 per family, in and out of hospital

	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-

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Keyhealth Equilibrium 2017

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMB only

3. HIV:

Unlimited
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Discovery Executive 2017: Other 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. General Appliances:

External appliances limited to R58,800 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R22,900 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R10 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Comprehensive 2017: Other 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. General Appliances:

External appliances limited to R58,800 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R22,900 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Priority 2017: Other 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. General Appliances:

External appliances limited to R39,400 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R18,300 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Saver 2017: Other 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. General Appliances:

Cochlear implants: R207,000
Otherwise, from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Smart 2017: Other 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. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Core 2017: Other Benefits

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

1. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Topmed Essential 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Topmed Network A 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medimed Alpha 2017: Other 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. General Appliances:

R4,000 per family
Nebulisers and glucometers: R500
60% scheme rate, member pays balance

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R100,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Medimed Essential A 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R50,000 per family, shared with organ transplant and oncology benefits

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Medimed Standard A 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R100,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R4,000 per family, paid at 80% scheme rate

View this plan

Medimed Max A 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R200,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R6,000 per family, paid at 80% scheme rate

View this plan

Bestmed Beat 1 2017: Other 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. General Appliances:

No benefit out of hospital

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Bestmed Pace 1 2017: Other 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. General Appliances:

R9,000 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,850 per family, from day-to-day benefit
Rehab after trauma: vested savings

View this plan

Bestmed Pulse 1 A 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

No benefit

View this plan

Spectramed Aqua 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Fedhealth Blue Door A: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

6. Other:

View this plan

Resolution Hospital 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R750,000 per person per emergency incident

6. Other:

Cochlear implants: no benefit

View this plan

Resolution Fundation A 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

Cochlear implants: no benefit

View this plan

Cape Medical Premium 2017: Other Benefits

In brief:

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMB level of care criteria

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Suremed Shuttle 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

No benefit

6. Other:

View this plan

Suremed Explorer A 2017: Other 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. General Appliances:

R3,700 per family, at preferred provider in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Medshield MediPhila 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Commed Roots A 2017: Other 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. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Shina A 2017: Other 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. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Standard A 2017: Other 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. General Appliances:

R10,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Deluxe 2017: Other 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. General Appliances:

R15,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Makoti Primary A 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Comprehensive A 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

R2,400 per person every 4 years

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Selfmed Selfnet Essential 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

2. Dialysis:

Unlimited

3. HIV:

Covered if part of Disease management Programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Momentum Ingwe Network E 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Axis 2017: Other Benefits

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

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED H 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Discovery KeyCare Core C 2017: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

No benefit

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Sizwe Affordable Care B 2017: Other Benefits

In brief:

1. General Appliances:

M =R1,440 and M1+ = R2,510

	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

1.1. Hearing Aids:

R8,600 per family

1.2. Wheelchairs:

R2,990 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Standard Elect 2017: Other 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. General Appliances:

R10,500 per family, from day-to-day benefit, in and out of hospital
Does not add up to threshold
Foot orthotics: sub-limit of R3,910 per person

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R400,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe State A 2017: Other 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. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Axis ED 2017: Other Benefits

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

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED Plus A 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Sizwe Affordable Care C 2017: Other Benefits

In brief:

1. General Appliances:

M =R1,440 and M1+ = R2,510

	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

1.1. Hearing Aids:

R8,600 per family

1.2. Wheelchairs:

R2,990 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Advanced 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

R400,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe State B 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

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Compcare Networx ED Plus B 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Sizwe Full Benefit A 2017: Other Benefits

In brief:

1. General Appliances:

M =R2,510 and M1+ = R4,180

	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

1.1. Hearing Aids:

R12,700 per family

1.2. Wheelchairs:

R4,170 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Exec 2017: Other 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. General Appliances:

R14,000 per family, from day-to-day benefit, in and out of hospital
Does not add up to threshold
Foot orthotics: sub-limit of R3,910 per person

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R500,000

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe State C 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Sizwe Full Benefit B 2017: Other Benefits

In brief:

1. General Appliances:

M =R2,510 and M1+ = R4,180

	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

1.1. Hearing Aids:

R12,700 per family

1.2. Wheelchairs:

R4,170 per family

2. Dialysis:

PMBs only

3. HIV:

Subject to treatment protocols

4. Emergency Transport:

Europ Assist

5. International Coverage:

6. Other:

View this plan

Fedhealth Maxima Plus 2017: Other 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. General Appliances:

Out-of-hospital:

R14,000 per family, from day-to-day benefit
Foot orthotics: sub-limit of R3,910 per person

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

100% scheme tariff

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe State D 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Networx ED Plus D 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Fedhealth Ultimax 2017: Other 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. General Appliances:

Out-of-hospital:

R14,000 per family, from day-to-day benefit
Foot orthotics: sub-limit of R3,910 per person

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

100% scheme tariff

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

R5 million, for under 70yrs

6. Other:

View this plan

Momentum Ingwe State E 2017: Other Benefits

1. General Appliances:

In-hospital: R4,650 per family
Out-of-hospital: no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Anti-retroviral treatment: R30,200 per family
HIV related admissions: R32,200 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

View this plan | Sign up for this plan

Compcare Networx ED Plus F 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED Plus G 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Compcare Networx ED Plus H 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

International benefit: subject to benefits per individual benefit category. Paid at South African rates

6. Other:

Oxygen home ventilation:
PMBs only
Wound care in lieu of hospitalisation: subject to protocols
Trauma: unlimited phone consults with psychologists/social workers and 3 face-to-face sessions per person per year

View this plan

Medihelp Dimension Prime 1 Network 2017: Other Benefits

1. General Appliances:

Medical Appliances, hyperbaric oxygen: No benefit
Stoma products and urine bags: paid by scheme
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R4,080 per family every 3 years

1.2. Wheelchairs:

R4,080 per family every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Plus 2017: Other 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. General Appliances:

Insulin pumps, glucometers, medical appliances and hyperbaric oxygen: R1,650 per person
Stoma products and urine bags: paid by scheme
Wigs: R1,650 every three years
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R13,560 per person every 3 years

1.2. Wheelchairs:

R7,440 per person every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Necesse B 2017: Other 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. General Appliances:

Medical, surgical and orthopaedic appliances: R8,550 per family
CPAP: R8,400 per person every 24 months

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Hosmed Essential B 2017: Other Benefits

1. General Appliances:

R2,500 per family, PMBs only

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Genesis Private 2017: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

No benefit

6. Other:

View this plan

Bonitas Primary 2017: Other 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. General Appliances:

General Appliances: R6,200 per family. paid by scheme.
Stoma products: Additional R5,900
Foot orthotics: No benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan | Sign up for this plan

Bonitas BonSave 2017: Other 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. General Appliances:

General Appliances: R6,200 per family. paid by scheme.
Stoma products: Additional R5,900
Foot orthotics: day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited (in-hospital) at DSP

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan | Sign up for this plan

Momentum Custom Associate (and any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive Network hospital (and any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at any chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender Network hospital (and any provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at any chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Summit 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, limited to R25,900 per family

	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

1.1. Hearing Aids:

R15,100, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R9.01 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Keyhealth Equilibrium 2017: Other 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. General Appliances:

R6,200 per family, in and out of hospital

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMB only

3. HIV:

Unlimited
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Discovery Classic Delta Comprehensive 2017: Other 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. General Appliances:

External appliances limited to R58,800 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R22,900 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Priority 2017: Other 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. General Appliances:

External appliances limited to R26,450 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R13,000 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Delta Saver 2017: Other 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. General Appliances:

Cochlear implants: R207,000
Otherwise, from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Smart 2017: Other 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. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Classic Delta Core 2017: Other Benefits

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

1. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Topmed Active Saver 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Topmed Network B 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medimed Essential B 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R50,000 per family, shared with organ transplant and oncology benefits

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Medimed Standard B 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R100,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R4,000 per family, paid at 80% scheme rate

View this plan

Medimed Max B 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R200,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R6,000 per family, paid at 80% scheme rate

View this plan

Bestmed Beat 1 Network 2017: Other 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. General Appliances:

No benefit out of hospital

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Bestmed Pace 2 2017: Other 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. General Appliances:

R8,150 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R22,450 per family, every 2 years

1.2. Wheelchairs:

R11,050 per family every 4 years

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R5,400 per family, from day-to-day benefit
Rehab after trauma: 100% scheme rate

View this plan

Bestmed Pulse 1 B 2017: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

No benefit

View this plan

Spectramed Cyan A 2017: Other 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. General Appliances:

Subject to authorisation

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Fedhealth Blue Door B: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

6. Other:

View this plan

Resolution Progressive Flex 2017: Other Benefits

In brief:

1. General Appliances:

R3,896 per family, subject to sub limits and PMBs

	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

1.1. Hearing Aids:

See above

1.2. Wheelchairs:

See above

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R750,000 per person per emergency incident

6. Other:

Cochlear implants: no benefit

View this plan

Resolution Fundation B 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

Cochlear implants: no benefit

View this plan

Cape Medical Silver 2017: Other Benefits

In brief:

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMB level of care criteria

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Suremed Navigator 2017: Other 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. General Appliances:

From savings first. Thereafter, limited to R2,330 per family, from overallday-to-day benefit

CPAP machine: R5,000 every 3 years
Nebulisers/Humidifiers: R500
Glucometers: R500 every 3 years
Back support: R2,500
Orthotics: R1,000

	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

1.1. Hearing Aids:

Limited to R5,000 every 3 years, subject to appliance limit

1.2. Wheelchairs:

2. Dialysis:

R132,000 per family

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Suremed Explorer B 2017: Other Benefits

1. General Appliances:

R3,700 per family, at preferred provider in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Medshield MediValue 2017: Other 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. General Appliances:

Overall limit: R2,140 per family, in and out of hospital
Peak flow meters, nebulizers, glucometers and blood pressure monitors: R750 per person, subject to above limit
Stoma products: Unlimited
Oxygen therapy equipment: unlimited, PMBs only
Ventilators: unlimited, PMBs only

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Commed Roots B 2017: Other Benefits

1. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Shina B 2017: Other Benefits

1. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Standard B 2017: Other Benefits

1. General Appliances:

R10,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Makoti Primary B 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Comprehensive B 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

R2,400 per person every 4 years

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Selfmed Selfnet 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

2. Dialysis:

Unlimited

3. HIV:

Covered if part of Disease management Programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Medihelp Dimension Prime 2 2017: Other 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. General Appliances:

Medical Appliances and CPAP apparatus: paid from day-to-day savings
Hyperbaric oxygen: R550 per family
Stoma products and urine bags: paid by scheme

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited
Paid by scheme

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

View this plan | Sign up for this plan

Medihelp Necesse C 2017: Other Benefits

1. General Appliances:

Medical, surgical and orthopaedic appliances: R8,550 per family
CPAP: R8,400 per person every 24 months

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

View this plan | Sign up for this plan

Hosmed Essential C 2017: Other Benefits

1. General Appliances:

R2,500 per family, PMBs only

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Genesis Private Plus 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

No benefit

6. Other:

View this plan

Bonitas BonComplete 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited (in-hospital) at DSP

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan | Sign up for this plan

Bonitas Standard 2017: Other 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. General Appliances:

General Appliances: R6,900 per family. paid by scheme.
Stoma products: Additional R5,900
Foot orthotics: No benefit

	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

1.1. Hearing Aids:

R14,400 per family every two years, with a 20% co-payment

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan | Sign up for this plan

Momentum Custom (Network for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive (Network provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender (Network provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Keyhealth Silver 2017: Other 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. General Appliances:

R6,300 per family, in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMB only

3. HIV:

Unlimited
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Discovery Classic Comprehensive Zero MSA 2017: Other 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. General Appliances:

External appliances limited to R58,800 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R22,900 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Saver 2017: Other 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. General Appliances:

Cochlear implants: R207,000
Otherwise, from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Core 2017: Other Benefits

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

1. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Topmed Limited 2017: Other 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. General Appliances:

R5,076 per person
20% 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

1.1. Hearing Aids:

R12,132 per person every 2 years
Paid from Overall Annual Limit (OAL)
20% co-payment

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Subject to Overall Annual Limit and 20% co-payment

3. HIV:

Subject to Overall Annual Limit and 20% co-payment

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

View this plan

Topmed Network C 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medimed Essential C 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R50,000 per family, shared with organ transplant and oncology benefits

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Medimed Standard C 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R100,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R4,000 per family, paid at 80% scheme rate

View this plan

Medimed Max C 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R200,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R6,000 per family, paid at 80% scheme rate

View this plan

Bestmed Beat 2 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Bestmed Pace 3 A 2017: Other 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. General Appliances:

R8,150 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R25,300 per family, every 2 years

1.2. Wheelchairs:

R11,050 per family every 4 years

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R8,350 per family, from day-to-day benefit
Rehab after trauma: 100% scheme rate

View this plan

Bestmed Pulse 1 C 2017: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

No benefit

View this plan

Spectramed Cyan B 2017: Other 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. General Appliances:

Subject to authorisation

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Fedhealth Blue Door C: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

6. Other:

View this plan

Resolution Progressive Flex Plus 2017: Other Benefits

In brief:

1. General Appliances:

R3,896 per family, subject to sub limits and PMBs

	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

1.1. Hearing Aids:

See above

1.2. Wheelchairs:

See above

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R750,000 per person per emergency incident

6. Other:

Cochlear implants: no benefit

View this plan

Resolution Fundation C 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

Cochlear implants: no benefit

View this plan

Cape Medical Select 2017: Other Benefits

In brief:

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMB level of care criteria

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Suremed Challanger 2017: Other 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. General Appliances:

R8,700 per family, in and out of hospital, with sub limits as below

CPAP machine: R5,000 every 3 years
Nebulisers/Humidifiers: R500
Glucometers: R500 every 3 years
Back support: R2,500
Orthotics: R1,000

	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

1.1. Hearing Aids:

Limited to R5,000 every 3 years, subject to appliance limit

1.2. Wheelchairs:

2. Dialysis:

R165,000 per family

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Suremed Explorer C 2017: Other Benefits

1. General Appliances:

R3,700 per family, at preferred provider in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Medshield MediCore 2017: Other 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. General Appliances:

Stoma products: Unlimited
CPAP apparatus: PMBs only
Oxygen therapy equipment:

PMBs

Ventilators: PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Commed Roots C 2017: Other Benefits

1. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Shina C 2017: Other Benefits

1. General Appliances:

R8,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Commed Standard C 2017: Other Benefits

1. General Appliances:

R10,000 per family
Stoma care: from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit every 2 years

1.2. Wheelchairs:

Every 3 years, subject to above limit

2. Dialysis:

3. HIV:

4. Emergency Transport:

ER24

5. International Coverage:

Emergency cover in SADC countries

6. Other:

View this plan

Makoti Primary C 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Comprehensive C 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

R2,400 per person every 4 years

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Selfmed MexXXI 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited

3. HIV:

Covered if part of Disease management Programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Cochlear implant: R30,200 per implant

View this plan

Medihelp Dimension Prime 2 Network 2017: Other 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. General Appliances:

Medical Appliances and CPAP apparatus: paid from day-to-day savings
Hyperbaric oxygen: R550 per family
Stoma products and urine bags: paid by scheme

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited
Paid by scheme

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Necesse D 2017: Other Benefits

1. General Appliances:

Medical, surgical and orthopaedic appliances: R8,550 per family
CPAP: R8,400 per person every 24 months

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Hosmed Access 2017: Other 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. General Appliances:

R5,600 per family, PMBs only

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Genesis Private Comprehensive 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

No benefit

6. Other:

View this plan

Bonitas Standard Select 2017: Other 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. General Appliances:

General Appliances: R6,900 per family. paid by scheme.
Stoma products: Additional R5,900
Foot orthotics: No benefit

	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

1.1. Hearing Aids:

R14,400 per family every two years, with a 20% co-payment

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

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Bonitas BonClassic 2017: Other 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. General Appliances:

General Appliances: R7,000 per family. paid by scheme.
Foot orthotics: paid from day-to-day benefit

	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

1.1. Hearing Aids:

R15,200 per family every three years, with a 10% co-payment

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

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Momentum Custom Associate (and Network provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive Network hospital (and Network provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender Network hospital (and Network provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at Network chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Keyhealth Gold 2017: Other 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. General Appliances:

R7,600 per family, in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

R13,500 per family, every 4 years/li>
R840 for maintenance

2. Dialysis:

PMB only

3. HIV:

Unlimited
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Discovery Essential Comprehensive 2017: Other 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. General Appliances:

External appliances limited to R39,400 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R18,300 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Delta Saver 2017: Other 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. General Appliances:

Cochlear implants: R207,000
Otherwise, from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Essential Delta Core 2017: Other Benefits

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

1. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Topmed Savings 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Topmed Network D 2017: Other Benefits

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medimed Essential D 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R50,000 per family, shared with organ transplant and oncology benefits

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Medimed Standard D 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

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Medimed Essential D 2017

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R100,000 per family
Benefit is shared with Organ Transplant Benefit

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

Oxygen: R4,000 per family, paid at 80% scheme rate

View this plan

Bestmed Beat 2 Network 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Bestmed Pace 3 B 2017: Other 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. General Appliances:

R8,150 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R25,300 per family, every 2 years

1.2. Wheelchairs:

R11,050 per family every 4 years

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R8,350 per family, from day-to-day benefit
Rehab after trauma: 100% scheme rate

View this plan

Bestmed Pulse 2 2017: Other 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. General Appliances:

R8,100 per family

	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

1.1. Hearing Aids:

R22,450 per family, every 2 years

1.2. Wheelchairs:

R10,400 per family, every 4 years

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

R7,750 per family

View this plan

Spectramed Capri 2017: Other 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. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Fedhealth Blue Door D: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

6. Other:

View this plan

Resolution Millennium 2017: Other Benefits

In brief:

1. General Appliances:

R11,252, with sub limits

	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

1.1. Hearing Aids:

See above

1.2. Wheelchairs:

See above

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R2 million per person per emergency incident

6. Other:

Cochlear implants: R75,016 per family

View this plan

Resolution Fundation D 2017: Other Benefits

In brief:

1. General Appliances:

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

No benefit

6. Other:

Cochlear implants: no benefit

View this plan

Suremed Explorer D 2017: Other Benefits

1. General Appliances:

R3,700 per family, at preferred provider in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

PMBs only

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

View this plan

Medshield MediPlus 2017: Other Benefits

1. General Appliances:

Overall limit: R7,490 per family
Peak flow meters, nebulizers, glucometers and blood pressure monitors: R750 per person, subject to above limit
Stoma products: Unlimited
Oxygen therapy equipment: Unlimited
Ventilators: Unlimited

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R175,000 per family

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Primary D 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Comprehensive D 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

R2,400 per person every 4 years

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Selfmed Selfsure 2017: Other Benefits

In brief:

1. General Appliances:

R4,300 per family
This may be increased to R12,900 with respect to certain appliances, under case management

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

See above

2. Dialysis:

Unlimited

3. HIV:

Covered if part of Disease management Programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Cochlear implant: R30,200 per implant

View this plan

Medihelp Dimension Prime 3 2017: Other 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. General Appliances:

Medical Appliances, hyperbaric oxygen: No benefit
Stoma products and urine bags: paid by scheme
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R4,080 per family every 3 years

1.2. Wheelchairs:

R4,080 per family every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Medihelp Necesse E 2017: Other Benefits

1. General Appliances:

Medical, surgical and orthopaedic appliances: R8,550 per family
CPAP: R8,400 per person every 24 months

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Hosmed Value 2017: Other 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. General Appliances:

R12,020 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Bonitas BonComprehensive 2017: Other 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. General Appliances:

General Appliances: R7,550 per family. paid by scheme.
Stoma products: Additional R5,550
Foot orthotics: paid from savings

	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

1.1. Hearing Aids:

R23,200 per family every 2 years, with a 10% co-payment

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

In-hospital: Unlimited if you register on the HIV/AIDS programme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

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Momentum Custom (State for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive (State provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender (State provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Keyhealth Platinum 2017: Other 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. General Appliances:

R9,700 per family, in and out of hospital

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

R29,300 per family, every 4 years/li>
R1,115 for maintenance

2. Dialysis:

Unlimited

3. HIV:

Unlimited
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Discovery Essential Delta Comprehensive 2017: Other 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. General Appliances:

External appliances limited to R39,400 per family from day-to-day benefit
Cochlear implants: R207,000

	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

1.1. Hearing Aids:

R18,300 per family paid from day-to-day benefit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Coastal Saver 2017: Other Benefits

1. General Appliances:

Cochlear implants: R207,000
Otherwise, from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Trauma recovery: out-of-hospital claims related to certain traumatic events paid until the end of the year following the event
DNA Analysis: paid in full from day-to-day benefit or 50% from above threshold
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Discovery Coastal Core 2017: Other Benefits

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

1. General Appliances:

Cochlear implants: R207,000
Otherwise, no benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Covered in full if you use network provider

3. HIV:

Covered if on the HIV Care program

4. Emergency Transport:

Discovery 911

5. International Coverage:

Up to R5 million per person on each journey for emergency medical costs while outside South Africa
Up to R500,000 for treatment overseas that is not available in South Africa, with a 20% co-payment
Emergency medical evacuations from certain sub-Saharan African countries back to South Africa

6. Other:

Internal nerve stimulators: R142,200
Second opinion from Cleveland Clinic for life-threatening and life-changing conditions. 50% co-payment

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Topmed Family 2017: Other 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. General Appliances:

R4,332 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R11,568 per family
Shared with wheelchair, hearing aid and external prostheses benefit
Paid from day-to-day benefit

1.2. Wheelchairs:

R11,568 per family
Shared with wheelchair, hearing aid and external prostheses benefit
Paid from day-to-day benefit

2. Dialysis:

R230,400

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Medimed Essential E 2017: Other Benefits

1. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R50,000 per family, shared with organ transplant and oncology benefits

3. HIV:

Unlimited, subject to protocols

4. Emergency Transport:

ER 24

5. International Coverage:

6. Other:

View this plan

Bestmed Beat 3 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Bestmed Pace 4 2017: Other 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. General Appliances:

R8,150 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R28,150 per family, every 2 years

1.2. Wheelchairs:

R11,050 per family every 4 years

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R10,800 per family, from day-to-day benefit
Rehab after trauma: 100% scheme rate

View this plan

Spectramed Azure A 2017: Other 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. General Appliances:

Subject to authorisation

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Fedhealth Blue Door E: Other Benefits

1. General Appliances:

No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

PMBs only, at state facilities

3. HIV:

Covered if on the management program

4. Emergency Transport:

Europ Assistance

5. International Coverage:

6. Other:

View this plan

Resolution Millennium Select 2017: Other Benefits

In brief:

1. General Appliances:

R11,252, with sub limits

	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

1.1. Hearing Aids:

See above

1.2. Wheelchairs:

See above

2. Dialysis:

PMBs only, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R2 million per person per emergency incident

6. Other:

Cochlear implants: R75,016 per family

View this plan

Medshield MediSaver 2017: Other 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. General Appliances:

Overall limit: R8,025 per family
Peak flow meters, nebulizers, glucometers and blood pressure monitors: R750 per person, subject to above limit
Stoma products: Unlimited
Oxygen therapy equipment: Unlimited
Ventilators: Unlimited

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

R250,000 per family

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Makoti Primary E 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medihelp Dimension Prime 3 Network 2017: Other 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. General Appliances:

Medical Appliances, hyperbaric oxygen: No benefit
Stoma products and urine bags: paid by scheme
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R4,080 per family every 3 years

1.2. Wheelchairs:

R4,080 per family every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Hosmed Plus 2017: Other 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. General Appliances:

R13,344 per family

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

3. HIV:

100% scheme rate
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare911

5. International Coverage:

6. Other:

View this plan

Momentum Custom Associate (and State provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

No benefit

1.2. Wheelchairs:

No benefit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R7.66 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

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Momentum Incentive Network hospital (and State provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,630 per family
Out-of-hospital: No benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R144,500 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Momentum Extender Network hospital (and State provider for chronic) 2017: Other 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. General Appliances:

In-hospital: R5,950 per family
Out-of-hospital: paid from day-to-day benefit, R21,000 per family

	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

1.1. Hearing Aids:

R6,380, subject to "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited, at State chronic provider

3. HIV:

HIV related admissions: R62,500 per family
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

R8.22 million international emergency cover
R1,470 co-payment applies for each outpatient claim

6. Other:

Cochlear implants: R157,000 per person
Trauma: Scheme covers some day-to-day benefits following certain traumatic events

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Topmed Executive 2017: Other 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. General Appliances:

Appliances: R2,700 per family
Oxygen, in and out of hospital: R22,740 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

R14,208 per family every 3 years
Paid from day-to-day benefit

1.2. Wheelchairs:

R14,208 per family every 5 years
Paid from day-to-day benefit

2. Dialysis:

Covered

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Bestmed Beat 3 Network 2017: Other 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. General Appliances:

Paid from day-to-day benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit

1.2. Wheelchairs:

Paid from day-to-day benefit

2. Dialysis:

PMBs only

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R2,750 per family, paid by scheme

View this plan

Spectramed Azure B 2017: Other Benefits

1. General Appliances:

Subject to authorisation

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Resolution Supreme 2017: Other Benefits

In brief:

1. General Appliances:

R14,981, with sub limits

	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-

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No items found

1.1. Hearing Aids:

See above

1.2. Wheelchairs:

See above

2. Dialysis:

Unlimited, at network providers

3. HIV:

Covered at network hospitals if on HIV Management Programme

4. Emergency Transport:

Netcare 911

5. International Coverage:

R2 million per person per emergency incident

6. Other:

Cochlear implants: R125,057 per family
Trauma counselling: 3 psychologist visits per person

View this plan

Medshield MediBonus 2017: Other 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. General Appliances:

R11,500 per family
Peak flow meters, nebulizers, glucometers and blood pressure monitors: R750 per person, subject to above limit
Stoma products: Unlimited
Oxygen therapy equipment and home ventilators: Unlimited

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

Up to R500,000 per person per journey, with R350,000 limit on pre-existing conditions

6. Other:

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Makoti Primary F 2017: Other Benefits

In brief:

1. General Appliances:

PMBs only

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

PMBs only

3. HIV:

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Selfmed 80% 2017: Other Benefits

In brief:

1. General Appliances:

20% co-payment and limited to R5,300 per family
This may be increased to R15,900 with respect to certain appliances, under case management

	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

1.1. Hearing Aids:

20% co-payment and limited to R16,200 per family

1.2. Wheelchairs:

2. Dialysis:

Unlimited

3. HIV:

Covered if part of Disease management Programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Cochlear implant: R74,500 per implant

View this plan

Medihelp Dimension Elite 2017: Other 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. General Appliances:

Medical Appliances and hyperbaric oxygen: R1,350 per person
Stoma products and urine bags: paid by scheme
CPAP apparatus: R8,400 per person every two years

	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

1.1. Hearing Aids:

R6,800 per person every 3 years

1.2. Wheelchairs:

R5,440 per person every 3 years

2. Dialysis:

Unlimited

3. HIV:

Post exposure prophylaxis in the event of sexual assault or accidental exposure to HIV
Paid by scheme
Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

Netcare 911

5. International Coverage:

6. Other:

Oxygen out-of-hospital: Unlimited, at 100% scheme rate

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Topmed Comprehensive 2017: Other 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. General Appliances:

Paid from day-to-day benefit, with 80% scheme rate when from above threshold benefit

	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

1.1. Hearing Aids:

Paid from day-to-day benefit, with 80% scheme rate when from above threshold benefit

1.2. Wheelchairs:

Paid from day-to-day benefit, with 80% scheme rate when from above threshold benefit

2. Dialysis:

Covered

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

ER24

5. International Coverage:

R10 million per family per year, maximum of 90 days

6. Other:

Post-operative benefits hip and knee replacement (trauma only), heart attack, post crime trauma, stroke

View this plan

Bestmed Beat 4 2017: Other 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. General Appliances:

R9,000 per family
Paid from day-to-day benefit

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

100% scheme rate

3. HIV:

Managed care programme

4. Emergency Transport:

ER24

5. International Coverage:

6. Other:

Wound care: R3,900 per family, from day-to-day benefit

View this plan

Spectramed Azure C 2017: Other Benefits

1. General Appliances:

Subject to authorisation

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Medshield Premium Plus 2017: Other 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. General Appliances:

R5,350 per family
Peak flow meters, nebulizers, glucometers and blood pressure monitors: R750 per person, subject to above limit
Stoma products: Unlimited
Oxygen therapy equipment: Unlimited
Ventilators: Unlimited

	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

1.1. Hearing Aids:

See "General Appliances" limit

1.2. Wheelchairs:

See "General Appliances" limit

2. Dialysis:

Unlimited

3. HIV:

Since HIV is a PMB certain out-of-hospital benefits are automatically covered by all schemes according to protocols

4. Emergency Transport:

5. International Coverage:

Up to R1 million per person per journey, with R350,000 limit on pre-existing conditions

6. Other:

View this plan

Spectramed Cobalt 2017: Other 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. General Appliances:

Subject to authorisation and Benefit Booster limit

	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

1.1. Hearing Aids:

1.2. Wheelchairs:

2. Dialysis:

DSP only

3. HIV:

Includes post exposure prophylaxis and mother-to-child transmission

4. Emergency Transport:

5. International Coverage:

6. Other:

View this plan

Income limited plans

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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.
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