Types of Medical Cover
Here is an overview of the three types of medical cover available to South Africans. Health and medical insurance are not medical aid and cannot replace medical aid benefits. South Africans can opt to have more than one type of cover.
Medical Aid
From R 1 200 p/m
-
Hospital Plan or Comprehensive Cover
- Maternity benefits & chronic cover
- Pre-existing conditions covered*
- No age limit for adults
- *Waiting periods apply
Health Insurance
From R 250 p/m
-
Pays for each day in hospital
- Payout up to R 3 000 per day
- Maternity benefits included
- Cash payout to member
- *Terms & conditions apply
Medical Insurance
From R 299 p/m
-
Doctor, Medication & Hospital Cover
- Limited GP visits (network only)
- Acute medication benefit
- Private hospital admission
- *Terms & conditions apply
How much does medical aid cost?
The monthly cost of medical aid varies depending on the medical scheme, the selected plan and the number of dependants (adult and child) on the same medical aid plan.
Are there low cost medical aid plans?
Apart from the cheapest plan available from every medical scheme, some schemes have options for low income individuals. The reduced rates depend on proof of income and may have limited benefits.
Which is the best medical aid?
Although various surveys and reviews name the best medical aid of each year, this is highly subject. There is no single medical scheme can claim to be the best. All schemes offer similar plans with similar benefits around the same price range.
Can a South African join any medical aid?
No. Some medical schemes are restricted. This means only people who work in a certain industry or for a specific employer can be a medical aid member. However, there are numerous open medical aid schemes which any South African can join.
Does my employer have to pay for medical aid?
No. Medical aid is not a mandatory benefit of employment. However, many employers choose to pay for medical aid cover at least to some degree as an incentive to employees. It is important to note that changes in tax laws may affect the subsidy that an employer can offer.
Does medical aid cover pensioners?
Yes. Medical schemes do cover pensioners. There is no age limit to be a member of a medical scheme in South Africa. Some medical aids for pensioners are low cost options based on income levels.
Is there a penalty for being older?
Any person over 35 years of who is not currently on medical aid cover will be held liable for a late joiner penalty. This penalty fee is applied to the monthly medical aid contribution.