- Foundation Medical Aid Plan

- Foundation

Foundation is an elementary primary healthcare plan for basic day-to-day cover and in-hospital benefits designed for low to medium income earners.

In Hospital Benefits

Overall Annual Limit

Unlimited subject to sub-limits
100% (Resolution Rate)


Network hospitals, R4 110 co-payment for use of non-network hospital

GP's & Specialists

Professional fees paid at 100% scheme tariff covered at DSP
GPs and Specialists: Unlimited
Radiology and Pathology: Unlimited
Oncology: R80 904 per family per annum at ICON Network.
Organ transplants: Limited to PMBs at State hospitals
Dialysis: PMBs and subject to Network
Internal prostheses: R37 685 Procedure based. Sub-limits apply / PMB cover.
Mental health: PMBs at designated providers.


25 PMBs + HIV, BPH & HRT

Out of Hospital Benefits

Saving / Day to Day / OHEB

Unlimited network GP visits, subject to authorisation after 4th visit
Specialists limits: Subject to PMBs and referral by GP
2 non-network GP visits per year

Pooled Day to Day Benefit

No benefit / not applicable

Threshhold / Safety Net

Not applicable

Self-Payment Gap Before Threshold

Not applicable

Above Threshold Limits

Not applicable

Maternity Care

Subject to scheme protocols and PMBs. 2x2D scans, 9 visits to a GP or midwife



Income Based: R0 - R4 840
Member: R961
Adult: R961
Child: R289


Income Based: R4 841 - R7 470
Member: R1 151
Adult: R1 151
Child: R397


Income Based: R7 471 - R10 210
Member: R1 492
Adult: R1 492
Child: R476


Income Based: R10 211+
Member: R2 255
Adult: R2 255
Child: R774






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Finding it difficult to make sense of all this? Not to worry, you can:

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