Medical Insurance for South Africans

Health and medical insurance cover is of the utmost importance. That’s no matter whether you require cover for chronic conditions or cover in case of emergencies and illnesses requiring hospitalisation.

Life insurance and medical insurance ensure that you and your family have cover when needed. Life insurance actually pays out a lump sum in the event of your death, making sure that your loved ones are provided for.

Medical insurance

So what is medical insurance? Medical schemes pay out medical expenses according to the National Health Recommended Price List. That is a national price list for all in and out-of-hospital medical services.

Medical Insurance in South AfricaOnly a few schemes allow for pay outs based on the South African Medical Association – according to which most healthcare professionals charge.

Significantly, health medical insurance policies pay out a set rate for every day a person spends in hospital. The member can use the money for medical treatment or any day-to-day expenses. A health insurance policy does not offer the same type of cover as medical aid does.

Suiting peoples needs and finances

Medical aid schemes offer a variety of plans to suite people’s need and pockets. One of the most common and straightforward plans is a hospital plan. These are for young, healthy individuals who do not require day-to-day or chronic medical care but who want insurance for hospitalisation and medical emergencies.

Hospital plans are usually the most affordable type of plan offered by schemes.

Many schemes offer the flexibility of medical savings accounts to their members. This means that members have cover for in-hospitalization but can manage their out-of-hospital expenses such as doctor’s visits, eye care and dental care.

Should the funds in savings account deplete before the end of the year, members will be responsible for additional medical expenses. Should there be remaining funds, those will be carried over to the next year.

Ideal for elderly people

Comprehensive medical scheme cover is ideal for elderly people and those who require chronic medical treatment and medication. Comprehensive types of plans will cover in-hospitalization expenses, as well as day-to-day expenses, chronic disease medication, Prescribed Minimum Benefits and various types of specialized treatment such as oncology and gynecology.

Preventative treatments will also be covered such as MRI scans, flu vaccinations, cholesterol tests and sometimes back treatment programs. Many plans will also cover maternity benefits.

Additional benefits

Numerous medical aid schemes will offer additional benefits for members such as points accumulation or premium discounts when joining a gym and attending regularly; quitting smoking; having regular preventative tests such as cholesterol tests and having regular health examinations.

Medical insurance in South Africa has become somewhat of a necessity for quality healthcare services and high-tech treatments.

Be sure to take your lifestyle, age and medical needs into consideration when choosing the right plan for your needs.


All info was correct at time of publishing