2018 is upon us and getting expensive. A Hospital Plan overview spells it out.

The 2018 Hospital Plan overview helps you to understand a complex maze of medical jargon.

A Hospital Plan gives you full access to in-hospital services such as anaesthesia and surgery.

Medical services outside the hospital are not included as the patient is not considered admitted.

The anaesthetist and the surgeon normally charge Private Rates, known as the National Reference Price List. Private rates are on average three times higher.

If the hospital you are in has a set tariff with your medical aid, which is usually the case, then hospital bills are paid in full.

2018 Hospital Plan overview Puts you In the Picture

Discovery Essential Smart Plan –

• • In Hospital Benefit – 100% Scheme Rate
  • No Overall Annual Limit
  • Network Hospitals only

Annual Sub-limits per person –

• Psychiatric Treatment  –  21 days
• Hospice Care  – R 57,000
• Oncology R200 000 thereafter – 20%
• co-payment
• Internal Prostheses:   See detailed benefit schedule

Chronic medication Benefit –

• 100% Scheme Rate
• 27 PMB Chronic Disease Conditions
• Subject to scheme rules
• Only from MedXpress,Clicks or Dischem

 

Annual day To day Benefit –

• Unlimited GP Benefit
• R100 co-payment for face-to-face
• Consultations
• Video call consultations paid in full
• 1 Dental check up with a R150
• Co-payment
• 1 eye test with R100.
• Annual threshold benefit does not apply

Monthly rates –

• Main Member  -R 1,180
• Partner/Adult dependant  –  R 1,180
• Per Child (Max 3)  -R 1,180

 

2018 Hospital Plan overview continued

Momentum custom Option 1 –

In hospital benefit –

• 100% Scheme Rate
• No Overall Annual Limit
• *7 days Take Home Medicine
• *R1,300 co-payment except for emergencies, MVA’s and maternity
• Network Hospitals to be used

Annual Sub-limits –

• Psychiatric Treatment – R33,900
• Hospice Care – R46,400  (including rehab & step-down facilities)
• Oncology R300,000 – thereafter 20% co-pay
• Internal Prostheses

 

Chronic medication benefit –

• 100% Scheme Rate
• 27 Chronic Disease Conditions
• Subject to scheme rules
• Only from state hospitals

 

Annual day to day benefit –

• Does not apply

 

Annual threshold benefit –

• Does not apply

 

Monthly rates –

• Principal Member – R 1,366
• Partner/Adult dependant – R 1,033
• Per Child (Max 3) – R 484

 

2018 Hospital Plan overview continued

Discovery Essential Delta Core –

In hospital benefit –

•  100% Scheme rate
• No overall annual limit
• Use of Network Hospitals
• Annual Sub-limits per person:
• Psychiatric Treatment – 21 days
• Hospice Care – R 57,000
• Oncology R200 000 thereafter 20%
• Co-payment
• Internal Prostheses

Chronic medication –

• 100% Scheme Rate
• 27 PMB Chronic Disease Conditions
• Subject to scheme rules
• Only from MedXpress

 

Annual day to day benefit –

• No Benefit

 

Annual threshold benefit –

• Does not apply

 

Monthly rates –

• Principal Member – R 1,417
• Partner/Adult dependant – R 1,065
• Per Child (Max 3) – R 569

 

We strive to cater to the needs of our clients in the best way possible. This means you are able to make informed decisions when looking for a health care plan.

If you want more details on a Plan – just click on it. If you have found the perfect match, download and fill out the form. Fax it back to us on 0866200320.

The Quote Request is also there for you to confirm price details. You can contact us on +27 21 712-8866 to ask for more details on the plans listed.