2026 Rules Active
2026 Validated
Three-Child Cap Hospital Safety Net
Actuarial Objective
Catastrophic hospital cover for large families with 4+ children, exploiting flat-rate pricing and child capping
Running Actuarial Simulation...
More Plan Options
Save R-994 pm
Bestmed
Beat 1 Network
Strategy: Network Hospital-Only Young Starter
Upgrade for +R455 pm
Bonitas
BonCap
Strategy: BonCap Income Band 1 Single Starter
Key Terms for this Strategy
- Network Restriction
- You must use hospitals and doctors listed in the scheme's specific network. Voluntary use of non-network providers will result in a heavy co-payment.
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
- PMB (Prescribed Minimum Benefits)
- By law, this plan must cover the costs of 27 specific chronic conditions and emergency treatments, even though it is a basic Hospital Plan.
People Also Ask
Can I choose to have a Caesarean section?
No, C-sections are only covered for approved PMB emergencies. Elective C-sections are not covered.
Do I have savings for day-to-day doctors?
No, there is no medical savings account. You only have a 'Benefit Booster' of up to R1,000 per family if you complete a wellness screening.
Is my hip replacement covered?
No, joint replacement surgery and internal prostheses are excluded unless it is a Prescribed Minimum Benefit (PMB) case.
What happens if I use a hospital not on the list?
You will be liable for a co-payment of R14,680 unless it is a medical emergency.
Are MRI and CT scans covered?
MRI and CT scans are covered for PMB conditions only. There is no benefit for non-PMB scans.
Do I have to pay a co-payment for admission?
Yes, there is a R5,500 co-payment per admission, except for motor vehicle accidents, maternity confinements, and PMB emergencies.
Is depression medication covered?
Yes, depression is covered as an additional chronic condition, with medication cover up to R165 per beneficiary per month.
Do I get any cover for emergency room visits?
Yes, you are covered for 2 emergency consultations per family at a casualty ward, strictly for emergencies only.