Overall, the Cape Medical MyHealth 200 Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and a comprehensive hospital plan for its Family Members. The Cape Medical MyHealth 200 Plan starts from R3,577 ZAR.
| 👤 Main Member Contribution | R3,577 |
| 👥 Adult Dependent Contribution | R3,577 |
| 🍼 Child Dependent Contribution | R631 |
| 🔁 Gap Cover | None |
| 📉 Annual Limit | Unlimited Hospital Cover |
| ➡️ External Prosthesis | Only PMBs are covered |
| ↪️ Oncology Cover | 100% CMP tariff |
| 💶 Prescribed Minimum Benefits | ☑️ Yes |
| 🟦 Medical Savings Account | ☑️ Yes |
| 💙 Maternity Benefits | ☑️ Yes |
💙 The Cape Medical MyHealth 200 Plan, previously named HealthPact Premium Plan is one of three, starting from R3,577, and includes a comprehensive hospital plan that covers in-hospital treatments up to 100% 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.
| 👤 Main Member | 👥 +1 Adult Dependent | 🍼 +1 Child Dependent |
| R3,577 | R3,577 | R631 |
| 🔎 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. 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. |
| ↪️ Laparoscopic and Endoscopic Procedures In-Hospital | Covered up to 200% of the CMP Tariff. Subject to pre-authorization. A Co payment of R1500 per scope. |
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| 👩⚕️ 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-authorization is required. |
| 👨⚕️ Registered Medical Specialist Consultations and Procedures | Only PMBs are covered. Subject to pre-approval. A written referral is required. |
| 📌 Laparoscopic and Endoscopic Procedures | Covered up to 200% of the CMP Tariff. Subject to pre-authorization. Endoscopic surgeon-guided laparoscopic procedures with a co-payment per scope, per procedure. A written referral is required. |
| 📍 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 R2,950 per family annually unless there is a PMB. |
| 👶 Paediatrician Consultations | Covered up to 200% of the CMP tariff. Limited to R2,498 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 R15 425 per beneficiary per year, with a co-payment of R1 700 per event (on all procedures) – except for PMBs Pre-approval is required. Written referral 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 R1 987 – 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, excluding: 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 R56,538 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. |
| 🟥 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 per female beneficiary every 2 years. |
| ✅ Bone Mineral Density Tests | Limited to one per beneficiary every 5 years. |
| 🅰️ Pap Smears for female beneficiaries | Female beneficiaries 21 to 65 years, once every 3 years. |
| 🅱️ Prostate Test (PSA level) for male beneficiaries | Once yearly for males between 40 and 75 years. |
| ✴️ Antenatal Visits for pregnant beneficiaries | According to CMP guidelines. |
| ✳️ Voluntary HIV testing and counseling | Once yearly per beneficiary. |
| 💉 Flu Vaccines | Once yearly per beneficiary. |
💙 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.
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💙 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:
💙 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.
| 🔎 Medical Aid Plan | 🥇 Cape Medical MyHealth 200 Plan | 🥈 Sizwe Hosmed Gold Ascend | 🥉 KeyHealth Equilibrium |
| 👤 Main Member Contribution | R3,577 | R3,726 | R3,054 |
| 👥 Adult Dependent Contribution | R3,577 | R3,578 | R1,886 |
| 🍼 Child Dependent Contribution | R631 | R1,029 | R939 |
| 💙 Hospital Cover | Unlimited | Unlimited for PMBs | Unlimited |
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💙 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.
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The MyHealth 200 plan is a comprehensive medical aid plan offered by Comprehensive Medical Plan (CMP) in South Africa. It covers in-hospital treatments, day-to-day medical expenses, and chronic medication.
The cost of the MyHealth 200 plan varies depending on the individual or family’s healthcare needs, as well as their age and other factors. However, MyHealth 200 costs R3,577 for the main member, R3,577 per adult, and R631 per child dependent.
A medical aid plan is a type of health insurance covering medical expenses, such as hospitalization, consultations with healthcare professionals, and prescribed medication.
Hospitalization cover is a medical aid benefit covering the cost of medical treatment received in a hospital.
Day-to-day medical expenses are medical expenses that are incurred outside of a hospital setting, such as consultations with healthcare professionals, laboratory tests, and prescribed medication.
Chronic medication is prescribed to manage a chronic condition, such as diabetes or hypertension.
Unlimited coverage is a type of medical aid benefit that covers medical expenses without a limit on the amount that can be claimed.
Value-added services are additional benefits provided to members of a medical aid plan, such as emergency medical assistance, trauma counseling, and wellness benefits.
Emergency medical assistance is a service that provides immediate medical support in the case of a medical emergency, such as an accident or sudden illness.
Trauma counseling is a service that provides emotional and psychological support to individuals who have experienced a traumatic event.
Wellness benefits, such as gym memberships or nutritionist access, are provided to encourage and support healthy living.
Healthcare benefits cover medical expenses, such as hospitalization and prescribed medication.
Out-of-pocket expenses are not covered by a medical aid plan and are therefore paid for by the individual.
A high out-of-pocket threshold is a type of medical aid plan where members must pay a significant amount before their medical expenses are fully covered.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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