MyHealth 200
About this plan
🥇 Best suited for families needing comprehensive healthcare without a Medical Savings Account.
Principal Member
From
R3,874
per month
Adult Dependant
From
R3,874
per month
Child Dependant
From
R684
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
MyHealth 200
Cape Medical MyHealth 200 Plan 🇿🇦 - Updated (2026)
Overall, the Cape Medical MyHealth 200 Plan is a trustworthy and comprehensive hospital plan that offers 24/7 medical emergency assistance for its Family Members. The Cape Medical MyHealth 200 Plan starts from R3,874 ZAR.| 👤 Main Member Contribution | R3,874 |
| 👥 Adult Dependent Contribution | R3,874 |
| 🍼 Child Dependent Contribution | R684 |
| 🔁 Gap Cover | No, optional extra. |
| 📉 Annual Limit | Unlimited Hospital Cover |
| ➡️ External Prosthesis | Only PMBs are covered |
| ↪️ Oncology Cover | 200% CMP tariff |
| 💶 Prescribed Minimum Benefits | ☑️ Yes |
| 🟦 Medical Savings Account | ❌ No |
| 💙 Maternity Benefits | ☑️ Yes |
Cape Medical MyHealth 200 Plan - 7 Key Point Quick Overview
- ☑️ Cape Medical Plan MyHealth 200 Plan Overview
- ☑️ Cape Medical Plan MyHealth 200 Plan Contributions
- ☑️ MyHealth 200 Plan Benefits and Cover Comprehensive Breakdown
- ☑️ MyHealth 200 Plan Exclusions and Waiting Periods
- ☑️ Cape Medical Plan MyHealth 200 Plan vs. Similar Plans from other Medical Schemes
- ☑️ Our Verdict on The MyHealth 200 Plan
- ☑️ MyHealth 200 Plan Frequently Asked Questions
Cape Medical MyHealth 200 Plan Overview
💙 The Cape Medical MyHealth 200 Plan, previously named HealthPact Premium Plan is one of three, starting from R3,874 and includes a comprehensive hospital plan that covers in-hospital treatments up to 200% of the CMP tariff, covers PMBs, and more. 💙 Gap Cover is not available on the Cape Medical Plan MyHealth 200 Plan. However, Cape Medical Plan offers 24/7 medical emergency assistance. According to the Trust Index, Cape Medical Plan has a trust rating of 3.9.
Cape Medical Plan MyHealth 200 Plan Contributions
| 👤 Main Member | 👥 +1 Adult Dependent | 🍼 +1 Child Dependent |
| R3,874 | R3,874 | R684 |
MyHealth 200 Plan Benefits and Cover Comprehensive Breakdown
MyHealth 200 In-Hospital Benefits
| 🔎 Overall Annual Limit | The unlimited cover is in-hospital for authorized admissions. |
| 🅰️ Hospital Accommodation (Ward Fees, Operating Theatre Costs, Unattached Theatres, Day Hospitals) | Covered up to 100% of the CMP tariff or the agreed tariff. Subject to pre-approval. |
| 🅱️ Emergency Room treatment (Only) | Only PMBs are covered. |
| 📌 Hospitalization for treatment: (Mental Illness, Alcoholism, Drug Addiction) | Only PMBs are covered. Subject to pre-authorization. |
| 📍 Hospitalisation Alternatives (Registered step-down facilities, Hospices, Registered Nurses, Rehabilitation Centres) | Covered up to 100% of the CMP tariff for hospices and registered nurses. Limited to 15 days per beneficiary per year. Subject to pre-approval. |
| ⚠️ Emergency Services | Covered up to 100% of the CMP Tariff unless it is a PMB. Subject to pre-authorization. |
| 🩸 Blood Transfusions | Covered up to 100% of the CMP Tariff unless it is a PMB. Subject to pre-authorization. |
| 🩺 Materials and Devices | Covered up to 100% of the cost to a Single Exit Price, Agreed Tariff, or Pre-Authorised Tariff. Subject to pre-approval. |
| 📈 Medicine | Covered up to 100% of the cost to a Single Exit Price for approved medicines. Subject to pre-authorization. |
| 📉 Supplementary Services (Physiotherapists, Occupational Speech Therapists, Dieticians) | Covered up to 100% of the CMP Tariff. Subject to pre-authorization. |
| 📊 Consultations, Procedures, and Operations by General Practitioners | Covered up to 200% of the CMP Tariff. Subject to pre-authorization. |
| ➡️ Consultations, Procedures, and Operations by Registered Medical Specialists | Covered up to 200% of the CMP Tariff. Subject to pre-authorization & written referral. |
| ↪️ Laparoscopic and Endoscopic Procedures In-Hospital | Covered up to 200% of the CMP Tariff. Subject to pre-authorization & written referral. A Co-payment of R1 500 per scope, per procedure. |
👉🏿 READ more about the 10 Best Hospital Plans in South Africa
MyHealth 200 Out-of-Hospital Benefits
| 👩⚕️ General Practitioner Consultations and Procedures | Limited to 1 GP visit per beneficiary per year. Covered up to 100% of the CMP tariff unless it is a PMB. Pre-authorisation is required. |
| 👨⚕️ Registered Medical Specialist Consultations and Procedures | Only PMBs are covered. Subject to pre-approval & written referral. |
| 📌 Laparoscopic and Endoscopic Procedures | Covered up to 200% of the CMP Tariff. Co-payment of R1 500 per scope used, per procedure. Subject to pre-approval & written referral. |
| 📍 Supplementary Services (Physiotherapists, Occupational & Speech Therapists, Dieticians) | Only PMBs are covered. Subject to pre-approval. |
| 🦷 General Dental Practitioner Procedures (In-Hospital Procedures) | Covered up to 100% of the cost and 120% of the CMP tariff. Covers procedures and operations that require hospitalization unless it is a PMB. Subject to Dental Protocols. |
| 😊 Maxillo-Facial Surgeons (In-Hospital Procedures) | Covered up to 120% of the CMP tariff unless it is a PMB. Subject to pre-authorization. |
| 🍼 Maternity Confinement (Birth or Delivery) | Covered up to 200% of the CMP tariff. Only medically necessary caesareans will be covered unless it is a PMB. Subject to pre-approval. |
| 🤰 Antenatal Consultations and Fetal Scans (In and Out-of-Hospital - Provided by a Registered Gynaecologist or Radiologist) | Covered up to 200% of the CMP tariff. Limited to R3 065 per family annually unless there is a PMB. |
| 👶 Paediatrician Consultations | Covered up to 200% of the CMP tariff. Limited to R2 595 per child yearly unless it forms part of a PMB. |
| ❤️ Paediatrician Procedures and Operations | Covered up to 200% of the CMP tariff. Subject to pre-authorization. |
| 📈 Radiologist Procedures (Angiograms, CT scans, Duplex Doppler Scans, International Radiology, MRI scans, Nuclear Medical Investigations) | 100% of the CMP tariff, limited to R16 027 per beneficiary per year, with a co-payment of R1 700 per event (on all procedures) – except for PMBs Pre-approval and written referral is required. |
| 🖤 Black and White X-Rays (in-hospital) | Covered up to 100% of the CMP tariff. Subject to pre-authorization. |
| 🤍 Black and White X-Rays (out-of-hospital) | Only PMBs are covered. |
| ↪️ Mammogram Benefit | 100% of the CMP tariff, with a co-payment of R300, per female beneficiary over the age of 49 years, once every 24 months, limited to R2 064 – except for PMBs. |
| 🦴 Bone Density Benefit | Covered up to 100% of the CMP tariff per beneficiary once every 5 years for beneficiaries 50 years> unless it is a PMB. |
| 🩺 Pathology Services (In and Out-of-Hospital with Pathcare or Lancet Laboratories) | In-and-out pathology is fully covered if you use SANAS-accredited Pathcare or Lancet Laboratories. In-hospital pathology services provided by a provider other than Pathcare or Lancet Laboratories will be covered only during the first 24 hours. Any out-of-hospital pathology must be paid out-of-pocket if you do not use a Preferred Provider. |
| 🦾 Prostheses and Implants (Excludes Hearing Devices & Dental Implants) | Covered up to 100% of the cost if introduced internally as a crucial component in surgery. Subject to CMP prosthetic price list. Limited to R58 743 per beneficiary yearly. Subject to pre-approval. |
| 🦿 External Prostheses and Surgical Appliances (Wheelchairs, Crutches, etc.) | Only PMBs are covered Subject to pre-authorization. |
| ➡️ Chronic Renal Dialysis | Covered at 100% of the CMP if: PMB level of care criteria is met. Treatment is offered by a Preferred Provider. Subject to pre-approval. |
| 💖 Organ Transplants | Covered at 100% of the CMP if: PMB level of care criteria is met. Treatment is offered by a Preferred Provider. Subject to pre-approval. |
| 🟩 Oncology | Covered at 100% of the CMP according to SA Oncology Consortium Primary Level of Care treatment guidelines if: Formularies and Treatment Protocols of CMP and SA Oncology Consortium tier guidelines are applied according to an agreed treatment plan. Subject to pre-approval. |
| 🟦 Oncology Treatment (Anti-emetics, Vitamins, Cosmetic and Prosthetic Appliances) | Only PMBs are covered. |
| 🟪 Chronic Medication | Covered up to 100% of the cost to a maximum of a Single Exit Price and the Preferred Provider dispensing fee. Subject to the chronic program protocols and authorisation. |
| 🟥 Acute Medication | Only PMBs are covered. |
| 🟧 Take-home Medication after discharge | Only PMBs are covered. |
| 🟨 Spectacles and Contact Lenses | Only PMBs are covered. |
| 📌 Supplementary Services | Only PMBs are covered. |
| ☑️ Mammograms for female beneficiaries | Limited to one every 24 months per female beneficiary over the age of 49 |
| ✅ Bone Mineral Density Tests | Limited to one per beneficiary every 5 years over age of 50. |
| 🅰️ Pap Smears for female beneficiaries | Subject to pathology benefit. See page 4 of the MyHealth 200 brochure. |
| 🅱️ Prostate Test (PSA level) for male beneficiaries | Subject to pathology benefit. See page 4 of the MyHealth 200 brochure. |
| ✴️ Antenatal Visits for pregnant beneficiaries | 200% of the CMP tariff, limited to R3 065 per family per year – except PMBs. |
| ✳️ Voluntary HIV testing and counseling | Subject to pathology benefit. See page 4 of the MyHealth 200 brochure. |
| 💉 Flu Vaccines | No benefits |
MyHealth 200 Plan Chronic Conditions and Medication
💙 Access to the chronic medicine benefit is contingent upon CMP’s formularies and protocols. Individuals diagnosed with a chronic condition will likely be required by their physician to adhere to a regimen of regular medication. 💙 While all CMP members are provided coverage for chronic conditions, this coverage is not automatic. Rather, individuals must obtain pre-authorization by enrolling in our Chronic Disease Management program.
Upon registration, re-registration will only be necessary if medication changes occur or administrative purposes necessitate it. The Chronic Disease List (CDL) includes the following covered conditions.
- ✅ Addison’s Disease
- ✅ Anti-coagulating therapy
- ✅ Asthma
- ✅ Bipolar Mood Disorder
- ✅ Bronchiectasis
- ✅ Cardiac failure
- ✅ Cardiomyopathy
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MyHealth 200 Plan Exclusions and Waiting Periods
MyHealth 200 Exclusions
Similar to other medical schemes, there are certain procedures, products, and services that CMP will not cover.
As per PMB rules, these exclusions are listed across all products and cannot be paid for from insured benefits. The following exclusions are applicable:
- ✅ Procedures to correct eye refraction errors, including blepharoplasties and excimer laser/Lasik
- ✅ Treatment for sexual dysfunction in males and females
- ✅ Infertility treatment, except if authorized within PMB level of care criteria
- ✅ Breast reductions, including scar revision, Botox, breast augmentation, and gynecomastia
- ✅ MammaPrint genetic testing and any other type of genetic testing
- ✅ Non-diseased breast reconstruction, nipple reconstruction, and symmetry, unless authorized within PMB level of care criteria
- ✅ Cosmetic surgery
- ✅ Long-term nursing care, such as frail care nursing
- ✅ Non-PMB treatment for alcohol or substance abuse, willful self-injury, or attempted suicide
- ✅ Non-PMB psychological and psychiatric treatment, including sleep studies
MyHealth 200 Waiting Periods
New members can be subjected to two types of waiting periods: a general three-month waiting period for all new members and a condition-specific waiting period of up to 12 months.Cape Medical Plan MyHealth 200 Plan vs. Similar Plans from other Medical Schemes
| 🔎 Medical Aid Plan | 🥇 Cape Medical MyHealth 200 Plan | 🥈 Sizwe Hosmed Gold Ascend (2026) | 🥉 KeyHealth Equilibrium |
| 👤 Main Member Contribution | R3,874 | R3,726 | R3,296 |
| 👥 Adult Dependent Contribution | R3,874 | R3,578 | R2,035 |
| 🍼 Child Dependent Contribution | R684 | R1,029 | R1,014 |
| 💙 Hospital Cover | Unlimited | Unlimited for PMBs | Unlimited |
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Our Verdict on The MyHealth 200 Plan
💙 The MyHealth 200 plan is a comprehensive medical aid plan offered by Comprehensive Medical Plan (CMP) in South Africa. The plan is designed to provide a range of benefits to its members, including cover for in-hospital treatments, day-to-day medical expenses, and chronic medication. 💙 One of the key features of the MyHealth 200 plan is the unlimited coverage for hospitalization, which provides members with peace of mind knowing that they will not face any financial burden when receiving medical treatment in a hospital.
You might also consider the following options Cape Medical has to offer:
- ☑️ Cape Medical Plan Medical Aid
- ☑️ Cape Medical MyHealth 100 Saver Plan
- ☑️ Cape Medical Plan Late Joiner Fee
