2026 Rules Active
2026 Validated
Network Hospital Safety Net with Emergency Room Benefit
Actuarial Objective
Hospital-only cover for individuals who self-fund day-to-day and need catastrophic protection with 2 ER visits
Running Actuarial Simulation...
More Plan Options
Save R814 pm
Bestmed
Rhythm2
Strategy: Rhythm2 High Income Optimizer
Upgrade for +R27 pm
Bonitas
Primary
Strategy: Primary Family Day-to-Day Moderate Coverage
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
Does Hospital Standard cover hip and knee replacements?
No. The plan explicitly excludes cover for joint replacements and back/neck surgery, unless it qualifies as a Prescribed Minimum Benefit (PMB).
Is there a co-payment for a gastroscopy?
Yes, a R2,020 co-payment applies to gastroscopies and colonoscopies performed in hospital. You also face a R6,500 penalty if you don't use a day hospital.
Can I go to any hospital?
No. You must use a hospital on the Hospital Standard Network. If you use a non-network hospital for a planned procedure, you will pay a 30% co-payment.
What is the limit for cancer treatment?
Non-PMB cancer treatment is limited to R168,100 per family. Once depleted, you have 80% cover at a DSP and no cover at a non-DSP.
Are MRI scans covered?
Yes, but they are limited to R32,040 per family and require a R2,800 co-payment per scan (unless it is a PMB).
Does this plan cover depression medication?
Yes, it covers depression medication up to R165 per beneficiary per month, in addition to the standard 27 chronic conditions.
Do I get free casualty visits?
Yes, you are covered for 2 emergency consultations per family at a casualty ward, but this benefit is strictly limited to emergencies only.
Is pregnancy covered?
Yes, you get 6 antenatal consultations, 2 ultrasound scans, and post-birth paediatric visits, funded from the risk benefit.