Medical Aid

momentum

Custom

Prices starting from

R1960.00

Per Month (main member)

Benefit Type
Hospital Plan Only

Preferred provider
Network hospitals

Overall annual limit
Unlimited

Co-payment
Yes

Rate
100% Scheme Rate

To-take-home medicines
7 days' supply per event

General practitioners & specialists visits
100% Scheme Rate - Subject to specialist network

Surgical dentistry
Yes - subject to Scheme Benefits

Mental health
Yes

Radiology
100% Scheme Rate

Pathology
100% Scheme Rate

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (subject to pre-auth)
In Hospital :  Yes
Out Hospital ​: Yes

Dialysis
Yes

Oncology (Treatment of cancer)
Yes - R300 000 per beneficiary per year, thereafter a 20% co-payment applies.

Organ transplant
Yes

Internal prosthesis
Yes

External prosthesis / medical and surgical appliances
Yes

Sub-acute facilities
Rehabilitation, hospice, private nursing, wound care and step-down facilities

Yes

MATERNITY BENEFITS CHRONIC BENEFITS TRAVEL BENEFITS

Discovery

Core

Prices starting from

R1923.00

Per Month (main member)

Benefit Type
Hospital Plan Only

Preferred provider
Network hospitals

Overall annual limit
Unlimited

Co-payment
Yes

Rate
100% Scheme Rate

To-take-home medicines
7 days' supply per event

General practitioners & specialists visits
100% Scheme Rate - Subject to specialist network

Surgical dentistry
Yes - subject to Scheme Benefits

Mental health
Yes

Radiology
100% Scheme Rate

Pathology
100% Scheme Rate

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (subject to pre-auth)
In Hospital :  Yes
Out Hospital ​: No

Dialysis
Yes

Oncology (Treatment of cancer)
Yes - R250 000 per beneficiary per year, thereafter, with a 20% - 50% co-payment applies

Organ transplant
Yes

Internal prosthesis
Yes

External prosthesis / medical and surgical appliances
Yes

Sub-acute facilities
Rehabilitation, hospice, private nursing, wound care and step-down facilities

Yes

MATERNITY BENEFITS CHRONIC BENEFITS TRAVEL BENEFITS

Bestmed

Beat1

Prices starting from

R1710.00

Per Month (main member)

Benefit Type
Hospital Plan Only

Preferred provider
Network hospitals

Overall annual limit
Unlimited

Co-payment
Yes

Rate
100% Scheme Rate

To-take-home medicines
7 days' supply

General practitioners & specialists visits
100% Scheme Rate - Subject to specialist network

Surgical dentistry
Yes - subject to Scheme Benefits

Mental health
Yes

Radiology
100% Scheme Rate

Pathology
100% Scheme Rate

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (subject to pre-auth)

In Hospital :  Yes
Out Hospital ​: Yes

Dialysis
Yes

Oncology (Treatment of cancer)
Yes - subject to the PMB level of care at prefered providers.

Organ transplant
Yes

Internal prosthesis
Yes

External prosthesis / medical and surgical appliances
Yes

Sub-acute facilities
Rehabilitation, hospice, private nursing, wound care and step-down facilities

Yes

MATERNITY BENEFITS CHRONIC BENEFITS TRAVEL BENEFITS

fedheaLth

FlexiFED1

Prices starting from

R1583.00

Per Month (main member)

Benefit Type
Hospital Plan Only

Preferred provider
Network hospitals

Overall annual limit
Unlimited

Co-payment
Yes

Rate
100% Scheme Rate

To-take-home medicines
7 days' supply

General practitioners & specialists visits
100% Scheme Rate - Subject to specialist network

Surgical dentistry
Yes - subject to Scheme Benefits

Mental health
Yes

Radiology
100% Scheme Rate

Pathology
100% Scheme Rate

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (subject to pre-auth)

In Hospital :  Yes
Out Hospital ​: Yes

Dialysis
Yes

Oncology (Treatment of cancer)
Yes - subject to the PMB level of care at prefered providers.

Organ transplant
Yes

Internal prosthesis
Yes

External prosthesis / medical and surgical appliances
Yes

Sub-acute facilities
Rehabilitation, hospice, private nursing, wound care and step-down facilities

Yes

MATERNITY BENEFITS CHRONIC BENEFITS TRAVEL BENEFITS

profmed

ProSelect Savvy

Prices starting from

R2055.00

Per Month (main member)

Benefit Type
Hospital Plan Only

Preferred provider
Network hospitals

Overall annual limit
Unlimited

Co-payment
Yes

Rate
100% Scheme Rate

To-take-home medicines
7 days' supply

General practitioners & specialists visits
100% Scheme Rate - Subject to specialist network

Surgical dentistry
Yes - subject to Scheme Benefits

Mental health
Yes

Radiology
100% Scheme Rate

Pathology
100% Scheme Rate

MRI and CT scans, magnetic resonance cholangiopancreatography (MRCP), whole body radioisotope and PET scans (subject to pre-auth)

In Hospital :  Yes
Out Hospital ​: Yes

Dialysis
Yes

Oncology (Treatment of cancer)
Yes - R233 078 per beneficiary per year, thereafter, subject to the PMB level of care at prefered providers.

Organ transplant
Yes

Internal prosthesis
Yes

External prosthesis / medical and surgical appliances
Yes

Sub-acute facilities
Rehabilitation, hospice, private nursing, wound care and step-down facilities

Yes

MATERNITY BENEFITS CHRONIC BENEFITS TRAVEL BENEFITS

Travel Benefits

Ambulance services
Yes - Netcare 911

International
Yes - up to R7.66 million emergency cover per 90 day journey.

Chronic Benefits

Designated service provider (DSP)
Any/Network

Conditions covered
CDL in PMB

Formulary
Yes

27 Chronic Conditions
Yes

Maternity Benefits

In hospital:
Yes

Out of hospital:
(Subject to registration on maternity programme) 
12 Antenatal visits
2 Paediatric visit in baby’s first year
List of blood test
Doula benefit : 2 visits per pregnancy
1 Nurse home visit day after discharge from hospital, and 2 weeks after initial visit
2 pregnancy scans. 3D/4D scans are covered at 2D scan price

Traveling Benefits

Ambulance services
Yes - Netcare 911

International
Yes - up to R5 million emergency cover per 90 day journey.

Chronic Benefits

Designated service provider (DSP)
Any/Network

Conditions covered
CDL in PMB

Formulary
Yes

27 Chronic Conditions
Yes

Maternity Benefits

In hospital:
Yes

Out-of-hospital:

8 Antenatal visits (GP/Gynae/Midwife)
2 x 2D scans incl. 1 nuchal translucency test 3D and 4D scans are covered at 2D scans rate
Selected blood tests
1 Flu vaccination during pregnancy
5 Pre- or postnatal visits
Cover for first 2 years after birth:
2 GP, paediatric or ENT visits for baby
1 post-birth consult with Midwife, GP or Gynae
1 Dietitian nutritional assessment
2 Mental health consultations
1 Lactation consultations

Travel Benefits

Ambulance services
Yes - ER24

International
Yes - up to R5 million emergency cover per 45 day journey.

Chronic Benefits

Designated service provider (DSP)
Any/Network

Conditions covered
CDL in PMB

Formulary
Yes

27 Chronic Conditions
Yes

Maternity Benefits

In-hospital:
Yes

Out-of-hospital:
6 consults at GP/gynae/midwife
1x lactation consultation at registered
nurse or lactation specialist
2 x 2D scans per pregnancy
3 baby growth and development assessments per year for children
0-2 years

Chronic Benefits

Designated service provider (DSP)
Any/Network

Conditions covered
CDL in PMB

Formulary
Yes

27 Chronic Conditions
Yes

Travel Benefits

Ambulance services
Yes - Europ Assistance

International
Yes - up to R5 million emergency cover per 90 days journey

Maternity Benefits

In-hospital:
Yes

Out-of-hospital:
Paid Savings or self funded
Antenatal classes: R1 120 with a midwife
4 Postnatal midwife consultations
1 amniocentesis test
Infant hearing screening benefit up to the age of 8 weeks
2 x 2D scans per pregnancy
Paed-IQ telephonic advice line
myFed Baby Programme

Chronic Benefits

Designated service provider (DSP)
Any/Network

Conditions covered
CDL in PMB

Formulary
Yes

27 Chronic Conditions
Yes

Maternity Benefits

In-hospital:
Yes

Out-of-hospital:
None

Travel Benefits

Yes - up to R2.5 million emergency cover per 90 days journey