Compare medical aid plans

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Plus Plan
Comprehensive cover for hospitalisation and most in-hospital services via an unrestricted network of hospitals

100% of cost at contracted rate, unlimited for Bankmed Network Specialists (DSPs)
300% of Scheme Rate for non-DSPs

Certain categories subject to Rand limits in-hospital GP/specialist procedures covered at 300% of Scheme Rate

Chronic medication limit:

Limited to R22 900 pbpa (Insured Benefit) and paid as follows:

  • 100% of the Scheme’s Maximum Medical Aid Prices (MMAP) for Bankmed Network GPs (DSPs) or Bankmed Pharmacy Network (DSP)
  • 80% of Scheme’s Maximum Medical Aid Prices (MMAP) for non-DSPs
  • Continued benefits for PMBs after depletion of annual limit, subject to PMB regulations

This Plan has a Medical Savings Account (MSA) and an Above Threshold Benefit (ATB). Claims paid from the MSA accumulate towards the Annual Threshold (AT) at 100% of the Scheme Rate

This Plan has access to all Netcare, National Hospital Network (NHN), Life Healthcare, Mediclinic and Clinix hospitals, any other independent private hospitals contracted to the Scheme
Deductibles: Member to pay hospital or day clinic on admission (HR)

For certain procedures performed in-hospital and at a day clinic a deductible will apply, except for emergencies, readmissions within six weeks of discharge, confinements and PMB-related conditions

  • Day clinics: R215 per admission
  • Private hospitals: R540 per admission
  • Dental admissions to private hospitals: R1 600 per admission.

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Comprehensive Plan
Comprehensive cover for hospitalisation and most in-hospital services via an unrestricted network of hospitals. Certain categories subject to Rand limits

100% of cost at contracted rate, unlimited for Bankmed Network Specialists (DSPs)
125% of Scheme Rate for non-DSPs

Chronic medication limit:

Limited to R19 200 pbpa (Insured Benefit) and paid as follows:

  • 100% of the Scheme’s Maximum Medical Aid Prices (MMAP) for Bankmed Network GPs (DSPs) or Bankmed Pharmacy Network (DSP)
  • 80% of Scheme’s Maximum Medical Aid Prices (MMAP) for non-DSPs
  • Continued benefits for PMBs after depletion of annual limit, subject to PMB regulations

This Plan has a Medical Savings Account (MSA) only

This Plan has access to all Netcare, National Hospital Network (NHN), Life Healthcare, Mediclinic and Clinix hospitals, any other independent private hospitals contracted to the Scheme

Deductibles: Member to pay hospital or day clinic on admission (HR)

For certain procedures performed in-hospital and at a day clinic a deductible will apply, except for emergencies, readmissions within six weeks of discharge, confinements and PMB-related conditions

  • Day clinics: R215 per admission
  • Private hospitals: R540 per admission
  • Dental admissions to private hospitals: R1 600 per admission.

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Core Saver Plan
Comprehensive cover for hospitalisation and most in-hospital services via an unrestricted network of hospitals
Certain categories subject to Rand limits
Organ transplants and oncology limited to PMBs

100% of cost at contracted rate, unlimited for Bankmed Network Specialists (DSPs)
100% of Scheme Rate for non-DSPs

Chronic medication limit:

Limited to Core Saver formulary for PMB conditions and paid as follows:

  • 100% of the Scheme’s Maximum Medical Aid Prices (MMAP) for Bankmed Network GPs (DSPs) or Bankmed Pharmacy Network (DSP)
  • 80% of Scheme’s Maximum Medical Aid Prices (MMAP) for non-DSPs

This Plan has a Medical Savings Account (MSA) only

This Plan has access to all Netcare, National Hospital Network (NHN), Life Healthcare, Mediclinic and Clinix hospitals, any other independent private hospitals contracted to the Scheme
Deductibles: Member to pay hospital or day clinic on admission (HR)

For certain procedures performed in-hospital and at a day clinic a deductible will apply, except for emergencies, readmissions within six weeks of discharge, confinements and PMB-related conditions

  • Day clinics: R215 per admission
  • Private hospitals: R540 per admission.