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Compare plans

Compare your likely benefit usage and the costs involved. Some plans will require that you use a specific GP and/or hospital network. This is necessary to curb costs, but if you prefer to have freedom of choice and use any provider’s services, you should opt for a non-network option instead. You can compare our options side by side to find out which option will suit you the best.

Remember that the information displayed on this page does not constitute advice. Click here to obtain relevant advice from an accredited adviser.

Prime 1 logo

from R1 488 pm

A hospital plan with additional benefits

(Non-network and network at 22% less)


Prime 1 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 1 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 1 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 1 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 1 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
R1 150 = member per year
R2 300 = family per year
GP and specialist consultations, physiotherapy, acute medicine and self-medication, including visits to emergency units.


Prime 1 Medicine

Medicine

Acute – see consultation benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 1 Radiology & Pathology

Radiology & Pathology

This option is a hospital plan and does not cover these benefits


Prime 1 Dentisrty

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - for member's account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 1 Eye care

Eye care

This option is a hospital plan and does not cover these benefits


Prime 1 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 2 Logo

from R1 974 pm

This option offers cover at private hospitals combined with a 15% savings account and added preventive care and insured benefits.

(Non-network and network at 22% less)


Prime 2 Hopitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 2 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 2 Emergency

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 2 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 2  Insured day-today benefits

Insured day-to-day benefits

Consultations and other day-to-day services are paid from the savings account.


Prime 2 Medicine

Medicine

Acute – savings account

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 2 Radiology & Pathology

Radiology & Pathology

Savings account


Prime 2 Dentistry

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - savings account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 2 Eye care

Eye care

Savings account


Prime 2 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 3 logo

from R2 586 pm

Comprehensive hospital and day-to-day benefits with eye and dental care

(Non-network and network at 20% less)


Prime 3 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 3 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 3 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 3 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 3 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R9 000 per year
Member +1 = R14 300 per year
Member +2 = R16 800 per year
Member +3 = R17 800 per year
GP and specialist consultations, physiotherapy, clinical psychology, supplementary health services, pathology, medical technologist services, standard radiology, acute medicine


Prime 3 Medicine

Medicine

Acute – see consultations benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 3 Radiology & Pathology

Radiology & Pathology

See consultations benefit


Prime 3 Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Prime 3 Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Prime 3 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Elite logo

from R4 698 pm

Comprehensive healthcare benefits with an insured chronic medicine benefit


Elite Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Elite Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Elite Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Elite Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, networks, protocols and pre-authorisation apply)


Elite Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R2 650 per year
Member +1 = R4 500 per year
Member +2 = R5 550 per year
Member +3 = R6 700 per year
GP and specialist consultations, physiotherapy, clinical psychology and supplementary health services.


Elite Medicine

Medicine

Acute
Member = R4 050 per year
Member +1 = R6 850 per year
Member +2 = R8 400 per year
Member +3+ = R9 000per year

Chronic (non-PMB)
Member = R4 300 per year
Member +1 = R6 500 per year
Member +2 = R8 700 per year
Member +3+ = R9 300 per year

PMB chronic - 100% of the Medihelp Reference Price


Elite Radiology & Pathology

Radiology & Pathology

Radiology = R2 650 per family per year
Pathology = R2 650 per family per year


Elite Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Elite Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Elite Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Plus logo

from R8 202 pm

Comprehensive healthcare benefits as well as ample benefits for diverse day-to-day medical services benefit


Plus Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Plus Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Plus Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Plus Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, networks, protocols and pre-authorisation apply)


Plus Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
R3 400 per beneficiary per year, pooled per family
GP and specialist consultations, physiotherapy, clinical psychology and psychiatric nursing and supplementary health services


Plus Medicine

Medicine

Acute
R5 900 per beneficiary per year, pooled per family

Chronic (non-PMB)
R17 200 per beneficiary per year

PMB chronic - 100% of the Medihelp Reference Price


Plus Radiology & Pathology

Radiology & Pathology

100% of the MT
Unlimited


Plus Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Plus Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Plus Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Necesse logo

from R529 pm

An income-based network option for students


Necesse Hospitalisation

Hospitalisation

100% of the Medihelp tariff
123 network hospitals


Necesse Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Necesse Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
Within the borders of the RSA
Subject to pre-authorisation and protocols


Necesse Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Necesse Insured day-to-day benefits

Insured day-to-day benefits

Consultations
Necesse network GP consultations - 9 consultations per beneficiary per year
Specialist care
(Subject to referral by a Necesse network GP, clinical protocols and pre-authorisation, which includes one follow-up consultation.)
R3 050 = per member per year
R4 300 = per family per year


Necesse Medicine

Medicine

Acute - formulary applies
PMB Chronic - 100% of the Medihelp Reference Price (formulary and network applies)


Necesse Radiology & Pathology

Radiology & Pathology
100% of the Medihelp tarrif
Medihelp codes and pathology designated service provider applies (Lancet/PathCare)


Necesse Dentisrty

Dentistry

Conservative dentistry at network dentist (DRC)


Necesse Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Necesse Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 1 logo

from R1 488 pm

A hospital plan with additional benefits

(Non-network and network at 22% less)


Prime 1 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 1 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 1 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 1 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 1 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
R1 150 = member per year
R2 300 = family per year
GP and specialist consultations, physiotherapy, acute medicine and self-medication, including visits to emergency units.


Prime 1 Medicine

Medicine

Acute – see consultation benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 1 Radiology & Pathology

Radiology & Pathology

This option is a hospital plan and does not cover these benefits


Prime 1 Dentisrty

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - for member's account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 1 Eye care

Eye care

This option is a hospital plan and does not cover these benefits


Prime 1 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 2 Logo

from R1 974 pm

This option offers cover at private hospitals combined with a 15% savings account and added preventive care and insured benefits.

(Non-network and network at 22% less)


Prime 2 Hopitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 2 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 2 Emergency

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 2 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 2  Insured day-today benefits

Insured day-to-day benefits

Consultations and other day-to-day services are paid from the savings account.


Prime 2 Medicine

Medicine

Acute – savings account

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 2 Radiology & Pathology

Radiology & Pathology

Savings account


Prime 2 Dentistry

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - savings account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 2 Eye care

Eye care

Savings account


Prime 2 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 3 logo

from R2 586 pm

Comprehensive hospital and day-to-day benefits with eye and dental care

(Non-network and network at 20% less)


Prime 3 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 113 network hospitals


Prime 3 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 3 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 3 Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Prime 3 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R9 000 per year
Member +1 = R14 300 per year
Member +2 = R16 800 per year
Member +3 = R17 800 per year
GP and specialist consultations, physiotherapy, clinical psychology, supplementary health services, pathology, medical technologist services, standard radiology, acute medicine


Prime 3 Medicine

Medicine

Acute – see consultations benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - 100% of the Medihelp Reference Price, designated service provider and formulary apply


Prime 3 Radiology & Pathology

Radiology & Pathology

See consultations benefit


Prime 3 Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Prime 3 Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Prime 3 Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Elite logo

from R4 698 pm

Comprehensive healthcare benefits with an insured chronic medicine benefit


Elite Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Elite Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Elite Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Elite Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, networks, protocols and pre-authorisation apply)


Elite Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R2 650 per year
Member +1 = R4 500 per year
Member +2 = R5 550 per year
Member +3 = R6 700 per year
GP and specialist consultations, physiotherapy, clinical psychology and supplementary health services.


Elite Medicine

Medicine

Acute
Member = R4 050 per year
Member +1 = R6 850 per year
Member +2 = R8 400 per year
Member +3+ = R9 000per year

Chronic (non-PMB)
Member = R4 300 per year
Member +1 = R6 500 per year
Member +2 = R8 700 per year
Member +3+ = R9 300 per year

PMB chronic - 100% of the Medihelp Reference Price


Elite Radiology & Pathology

Radiology & Pathology

Radiology = R2 650 per family per year
Pathology = R2 650 per family per year


Elite Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Elite Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Elite Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Plus logo

from R8 202 pm

Comprehensive healthcare benefits as well as ample benefits for diverse day-to-day medical services benefit


Plus Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Plus Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Plus Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Plus Essential cover

Chronic illness/PMB

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, networks, protocols and pre-authorisation apply)


Plus Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
R3 400 per beneficiary per year, pooled per family
GP and specialist consultations, physiotherapy, clinical psychology and psychiatric nursing and supplementary health services


Plus Medicine

Medicine

Acute
R5 900 per beneficiary per year, pooled per family

Chronic (non-PMB)
R17 200 per beneficiary per year

PMB chronic - 100% of the Medihelp Reference Price


Plus Radiology & Pathology

Radiology & Pathology

100% of the MT
Unlimited


Plus Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Plus Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Plus Additional insured benefits

Added insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Necesse logo

from R529 pm

An income-based network option for students


Necesse Hospitalisation

Hospitalisation

100% of the Medihelp tariff
123 network hospitals


Necesse Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Necesse Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
Within the borders of the RSA
Subject to pre-authorisation and protocols


Necesse Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). (DSPs, formularies, networks, protocols and pre-authorisation apply)


Necesse Insured day-to-day benefits

Insured day-to-day benefits

Consultations
Necesse network GP consultations - 9 consultations per beneficiary per year
Specialist care
(Subject to referral by a Necesse network GP, clinical protocols and pre-authorisation, which includes one follow-up consultation.)
R3 050 = per member per year
R4 300 = per family per year


Necesse Medicine

Medicine

Acute - formulary applies
PMB Chronic - 100% of the Medihelp Reference Price (formulary and network applies)


Necesse Radiology & Pathology

Radiology & Pathology
100% of the Medihelp tarrif
Medihelp codes and pathology designated service provider applies (Lancet/PathCare)


Necesse Dentisrty

Dentistry

Conservative dentistry at network dentist (DRC)


Necesse Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Necesse Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 1 logo

from R1 356 pm

A hospital plan with additional benefits

(Non-network and network at 22% less)


Prime 1 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 1 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 1 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 1 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 1 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
R1 100 = member per year
R2 200 = family per year
GP and specialist visits, physiotherapy, contraceptives, acute and self-medication


Prime 1 Medicine

Medicine

Acute – see consultations

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 1 Radiology & Pathology

Radiology & Pathology

This option is a hospital plan and does not cover these benefits


Prime 1 Dentisrty

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - for member's account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 1 Eye care

Eye care

This option is a hospital plan and does not cover these benefits


Prime 1 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 2 Logo

from R1 800 pm

This option offers cover at private hospitals combined with a 15% savings account and added preventive care and insured benefits.

(Non-network and network at 22% less)


Prime 2 Hopitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 2 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 2 Emergency

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 2 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 2  Insured day-today benefits

Insured day-to-day benefits

Consultations
Consultations and other day-to-day services are paid from savings account.


Prime 2 Medicine

Medicine

Acute – savings account

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 2 Radiology & Pathology

Radiology & Pathology

Savings account


Prime 2 Dentistry

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - savings account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 2 Eye care

Eye care

Savings account


Prime 2 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 3 logo

from R2 352 pm

Comprehensive hospital and day-to-day benefits with eye and dental care

(Non-network and network at 20% less)


Prime 3 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 3 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 3 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 3 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 3 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R8 600 per year
Member +1 = R13 700 per year
Member +2 = R16 000 per year
Member +3 = R17 000 per year
GPs & specialists
Clinical psychology & physiotherapy
Acute medicine & self-medication
Radiology & pathology


Prime 3 Medicine

Medicine

Acute – see consultations benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 3 Radiology & Pathology

Radiology & Pathology

See consultations benefit


Prime 3 Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Prime 3 Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Prime 3 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Elite logo

from R4 272 pm

Comprehensive healthcare benefits with an insured chronic medicine benefit


Elite Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Elite Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Elite Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Elite Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Elite Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R2 550 per year
Member +1 = R4 300 per year
Member +2 = R5 300 per year
Member +3 = R6 400 per year
GPs & specialists
Clinical psychology & physiotherapy
Supplementary health services


Elite Medicine

Medicine

Acute
Member = R3 900 per year
Member +1 = R6 550 per year
Member +2 = R8 000 per year
Member +3+ = R8 600 per year

Chronic (non-PMB)
Member = R4 100 per year
Member +1 = R6 200 per year
Member +2 = R8 300 per year
Member +3+ = R8 900 per year

PMB chronic - 100% of the Medihelp Reference Price


Elite Radiology & Pathology

Radiology & Pathology

Radiology = R2 550 per family per year
Pathology = R2 550 per family per year


Elite Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Elite Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Elite Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Plus logo

from R7 464pm

Comprehensive healthcare benefits as well as ample benefits for diverse day-to-day medical services benefit


Plus Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Plus Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Plus Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Plus Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Plus Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
R3 250 per beneficiary per year, pooled per family
GPs & specialists
Clinical psychology & physiotherapy
Supplementary health services


Plus Medicine

Medicine

Acute
R5 650 per beneficiary per year, pooled per family

Chronic (non-PMB)
R16 400 per beneficiary per year

PMB chronic - 100% of the Medihelp Reference Price


Plus Radiology & Pathology

Radiology & Pathology

100% of the MT
Unlimited


Plus Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Plus Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Plus Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Necesse logo

from R474 pm

An income-based network option for students


Necesse Hospitalisation

Hospitalisation

100% of the Medihelp tariff
124 network hospitals


Necesse Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Necesse Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
Within the borders of the RSA
Subject to pre-authorisation and protocols


Necesse Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Necesse Insured day-to-day benefits

Insured day-to-day benefits

Consultations
Network GPs - 9 consultations per beneficiary per year
Specialist
R2 950 = per member per year
R4 100 = per family per year


Necesse Medicine

Medicine

Acute - formulary applies
PMB Chronic - 100% of the Medihelp Reference Price (formulary and network applies)


Necesse Radiology & Pathology

Radiology & Pathology
100% of the Medihelp tarrif
Medihelp codes and pathology designated service provider applies (Lancet/PathCare)


Necesse Dentisrty

Dentistry

Conservative dentistry at network dentist (DRC)


Necesse Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Necesse Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 1 logo

from R1 356 pm

A hospital plan with additional benefits

(Non-network and network at 22% less)


Prime 1 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 1 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 1 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 1 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 1 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
R1 100 = member per year
R2 200 = family per year
GP and specialist visits, physiotherapy, contraceptives, acute and self-medication


Prime 1 Medicine

Medicine

Acute – see consultations

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 1 Radiology & Pathology

Radiology & Pathology

This option is a hospital plan and does not cover these benefits


Prime 1 Dentisrty

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - for member's account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 1 Eye care

Eye care

This option is a hospital plan and does not cover these benefits


Prime 1 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 2 Logo

from R1 800 pm

This option offers cover at private hospitals combined with a 15% savings account and added preventive care and insured benefits.

(Non-network and network at 22% less)


Prime 2 Hopitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 2 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 2 Emergency

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 2 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 2  Insured day-today benefits

Insured day-to-day benefits

Consultations
Consultations and other day-to-day services are paid from savings account.


Prime 2 Medicine

Medicine

Acute – savings account

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 2 Radiology & Pathology

Radiology & Pathology

Savings account


Prime 2 Dentistry

Dentistry

Subject to DSP’s managed care protocols and pre-authorisation

  • Conservative and specialised dental services - savings account
  • Dental procedures under conscious sedation in the dentist’s chair (sedation cost) for the removal of impacted teeth only (dentist’s account - item codes apply
  • 100% of the MT


Prime 2 Eye care

Eye care

Savings account


Prime 2 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Prime 3 logo

from R2 352 pm

Comprehensive hospital and day-to-day benefits with eye and dental care

(Non-network and network at 20% less)


Prime 3 Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Non-network – any private hospital
Network – 108 network hospitals


Prime 3 Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Prime 3 Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Prime 3 Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Prime 3 Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R8 600 per year
Member +1 = R13 700 per year
Member +2 = R16 000 per year
Member +3 = R17 000 per year
GPs & specialists
Clinical psychology & physiotherapy
Acute medicine & self-medication
Radiology & pathology


Prime 3 Medicine

Medicine

Acute – see consultations benefit

PMB chronic
Non-network – 100% of the Medihelp Reference Price any provider
Network - Designated service provider and formulary apply


Prime 3 Radiology & Pathology

Radiology & Pathology

See consultations benefit


Prime 3 Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Prime 3 Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Prime 3 Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Elite logo

from R4 272 pm

Comprehensive healthcare benefits with an insured chronic medicine benefit


Elite Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Elite Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Elite Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Elite Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Elite Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
Member = R2 550 per year
Member +1 = R4 300 per year
Member +2 = R5 300 per year
Member +3 = R6 400 per year
GPs & specialists
Clinical psychology & physiotherapy
Supplementary health services


Elite Medicine

Medicine

Acute
Member = R3 900 per year
Member +1 = R6 550 per year
Member +2 = R8 000 per year
Member +3+ = R8 600 per year

Chronic (non-PMB)
Member = R4 100 per year
Member +1 = R6 200 per year
Member +2 = R8 300 per year
Member +3+ = R8 900 per year

PMB chronic - 100% of the Medihelp Reference Price


Elite Radiology & Pathology

Radiology & Pathology

Radiology = R2 550 per family per year
Pathology = R2 550 per family per year


Elite Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Elite Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Elite Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Plus logo

from R7 464pm

Comprehensive healthcare benefits as well as ample benefits for diverse day-to-day medical services benefit


Plus Hospitalisation

Hospitalisation

100% of the Medihelp tariff
Cover at any private hospitals


Plus Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Plus Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
In beneficiary’s country of residence (RSA, Lesotho, Swaziland, Mozambique, Namibia and Botswana)
Subject to pre-authorisation and protocols


Plus Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Plus Insured day-to-day benefits

Insured day-to-day benefits

Consultations
100% of the Medihelp Tariff
R3 250 per beneficiary per year, pooled per family
GPs & specialists
Clinical psychology & physiotherapy
Supplementary health services


Plus Medicine

Medicine

Acute
R5 650 per beneficiary per year, pooled per family

Chronic (non-PMB)
R16 400 per beneficiary per year

PMB chronic - 100% of the Medihelp Reference Price


Plus Radiology & Pathology

Radiology & Pathology

100% of the MT
Unlimited


Plus Dentisrty

Dentistry

Subject to DSP's managed care protocols and pre-authorisation
Conservative (including routine check-ups, fillings, X-rays and oral hygiene) and specialised dentistry (including crowns, bridges and orthodontic treatments)


Plus Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Plus Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

Necesse logo

from R474 pm

An income-based network option for students


Necesse Hospitalisation

Hospitalisation

100% of the Medihelp tariff
124 network hospitals


Necesse Trauma

Trauma

Unlimited cover for trauma that necessitates hospitalisation


Necesse Emergency cover

Emergency cover

(Netcare 911)
Unlimited - road & air transport
Within the borders of the RSA
Subject to pre-authorisation and protocols


Necesse Essential cover

Essential cover

100% cover for 270 PMB conditions and 26 chronic conditions (CDL). DSPs & specialist network apply


Necesse Insured day-to-day benefits

Insured day-to-day benefits

Consultations
Network GPs - 9 consultations per beneficiary per year
Specialist
R2 950 = per member per year
R4 100 = per family per year


Necesse Medicine

Medicine

Acute - formulary applies
PMB Chronic - 100% of the Medihelp Reference Price (formulary and network applies)


Necesse Radiology & Pathology

Radiology & Pathology
100% of the Medihelp tarrif
Medihelp codes and pathology designated service provider applies (Lancet/PathCare)


Necesse Dentisrty

Dentistry

Conservative dentistry at network dentist (DRC)


Necesse Eye care

Eye care

Per beneficiary in a 24-month cycle and PPN network applies
1 examination
Spectacles or contact lenses


Necesse Additional insured benefits

Additional insured benefits

Protocols, item codes and DSPs apply

  • Pregnancy & baby benefits
  • Health tests
  • Immunisation
  • Back treatment programme

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