Circular 56 of 2018: Medical Scheme benefit options for open schemes approved with effect from 01 January 2019
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1 CIRCULAR Reference: Benefit options status for open schemes 2019 Contact person: Lindiwe Twala Tel: (012) Fax: Date: 21 November 2018 Circular 56 of 2018: Medical Scheme benefit options for open schemes approved with effect from 01 January 2019 The Council for Medical Schemes (CMS) would hereby like to share information on the status of benefit options applicable to open schemes, for the 2019 benefit year. The table below provides details on the approval status for the different scheme benefit options. NAME OF MEDICAL BESTMED MEDICAL PACE4 PACE3 PACE2 PACE1 BEAT4 BEAT3 BEAT3 NETWORK BEAT2 BEAT2 NETWORK Page 1
2 BEAT1 BEAT1 NETWORK PULSE2 PULSE1 BONITAS MEDICAL FUND BONCAP BONCOMPREHENSIVE BONSAVE PRIMARY PRIMARY SELECT STANDARD STANDARD SELECT BONESSENTIAL BONESSENTIAL SELECT BONCLASSIC BONFIT BONCOMPLETE PLUS DISCONTINUED WEF 31/12/2018 STANDARD CAPE MEDICAL PLAN HEALTHPACT PREMIUM HEALTHPACT SILVER HEALTHPACT SELECT COMPCARE WELLNESS MEDICAL DYNAMIX DSP NETWORK PINNACLE DSP NETWORK MUMED DSP NETWORK SYMMETRY DSP NETWORK AXIS DSP NETWORK NETWORX Page 2
3 DSP NETWORK UNISAVE DISCOVERY HEALTH MEDICAL CLASSIC COMPREHENSIVE CLASSIC DELTA COMPREHENSIVE CLASSIC CORE CLASSIC DELTA CORE CLASSIC PRIORITY CLASSIC SAVER CLASSIC DELTA SAVER COASTAL CORE COASTAL SAVER ESSENTIAL COMPREHENSIVE ESSENTIAL DELTA COMPREHENSIVE ESSENTIAL CORE ESSENTIAL DELTA CORE ESSENTIAL PRIORITY ESSENTIAL SAVER ESSENTIAL DELTA SAVER EXECUTIVE KEYCARE CORE KEYCARE PLUS KEYCARE START (was KeyCare Access) CLASSIC COMPREHENSIVE ZERO MSA CLASSIC SMART ESSENTIAL SMART Page 3
4 FEDHEALTH MEDICAL MAXIFED 2 (was Maxima Plus) MAXIFED 1 (was Maxima Executive) MAXIFED 1 Grid (new) FLEXIFED 4 (was Maxima Standard) FLEXIFED 4 Grid (new) FLEXIFED 4 Elect (was Maxima Standard Elect) FLEXIFED 3 (was Maxima Core) FLEXIFED 3 Grid (was Maxima Core Grid) FLEXIFED 3 Elect (new) FLEXIFED 2 (was Maxima Saver) FLEXIFED 2 Grid (was Maxima Saver Grid) FLEXIFED 2 Elect (new) FLEXIFED 1 (was Maxima EntrySaver) FLEXIFED 1 Elect (new) MYFED (was Blue Door Plus) MAXIMA ADVANCED DISCONTINUED Merged in Maxima Standard (FlexiFed 4) WEF Page 4
5 MAXIMA BASIS MAXIMA BASIS GRID ULTIMAX MAXIMA ENTRYZONE DISCONTINUED DISCONTINUED DISCONTINUED DISCONTINUED Merged in Maxima Core (FlexiFed 3) WEF Merged in Maxima Core Grid (FlexiFed 3 Grid) WEF Merged into Maxima Plus (MaxiFed 2) WEF Merged into Maxima EntrySaver (FlexiFed 1) WEF GENESIS MEDICAL HOSMED MEDICAL AID PRIVATE PRIVATE PLUS PRIVATE COMPREHENSIVE PRIVATE CHOICE PLUS ESSENTIAL VALUE VALUE CORE(New) ACCESS KEYHEALTH PLATINUM GOLD SILVER EQUILIBRIUM ESSENCE ORIGIN MAKOTI MEDICAL COMPREHENSIVE PRIMARY MEDIHELP ELITE (was Dimension Elite) Page 5
6 PRIME 1 (was Dimension Prime 1) PRIME 1 NETWORK (was Dimension Prime 1 Network) PRIME 2 (was Dimension Prime 2) PRIME 2 NETWORK (was Dimension Prime 2 Network) PRIME 3 (was Dimension Prime 3) PRIME 3 NETWORK (was Dimension Prime 3 Network) PLUS (was Medihelp Plus) NECESSE UNIFY MEDIMED MEDICAL MEDSHIELD MEDICAL ALPHA MEDISAVE ESSENTIAL MEDISAVE - MAX MEDISAVE - STANDARD MEDIBONUS MEDIPLUS MEDIVALUE MEDICORE PREMIUM PLUS MEDISAVER MEDIPHILA MOMENTUM HEALTH MEDICAL INGWE PRIMARY CARE/STATE Page 6
7 NETWORK PRIMARY CARE/INGWE NETWORK ACTIVE NETWORK/INGWE ANY OPTION CUSTOM STATE/ASSOCIATE D S STATE/ANY S S INCENTIVE STATE/ASSOCIATE D S STATE/ANY S Page 7
8 S EXTENDER STATE/ASSOC S STATE/ANY S S IMPACT (was ACCESS) IMPACT EDO SUMMIT RESOLUTION HEALTH MEDICAL SUPREME MILLENNIUM MILLENNIUM SELECT PROGRESSIVE FLEX PLUS PROGRESSIVE FLEX Proposed amalgamation with Spectramed WEF Page 8
9 SELFMED MEDICAL FOUNDATION SELFMED MEDXXI SELFMED MED ELITE SELFMED 80% SELFMED SELFSURE SELFMED SELFNET SELFMED SELFNET ESSENTIAL SIZWE MEDICAL FUND AFFORDABLE CARE AFFORDABLE CARE VALUE (new) FULL CARE OPTION PRIMARY CARE PRIMARY CARE VALUE (new) CARE CARE VALUE (new) GOMOMO CARE OPTION NOT SPECTRAMED CYAN AZURE AQUA COBALT CAPRI Proposed amalgamation with Resolution WEF SUREMED HEALTH CHALLENGER NAVIGATOR SHUTTLE EXPLORER THEBEMED ENERGY CORE MEDIUM OPEN Page 9
10 UNIVERSAL UNIVERSAL EDO FANTASY TOPMED MEDICAL WEF with effect from TOPMED COMPREHENSIVE TOPMED FAMILY TOPMED EXECUTIVE TOPMED SAVINGS TOPMED ACTIVE SAVER TOPMED ESSENTIAL TOPMED NETWORK TOPMED LIMITED DISCONTINUED WEF 31/12/2018 Page 10
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Join Us At This Year s Premier One-on-One Networking Event SPONSORSHIP OPPORTUNITIES J U N E
P R E S E N T E D B Y : H E D G E C O N N E C T I O N, I N C. Join Us At This Year s Premier One-on-One Networking Event SPONSORSHIP OPPORTUNITIES J U N E 2 2-2 4 2 0 15 From our CEO Lisa Vioni J U N E