Medihelp Medical Scheme

Medihelp medical scheme is one of the biggest medical aid schemes in South Africa. This medical aid scheme provides medical cover for more than 220 000 members and beneficiaries. They have been in the medical industry for more than 100 years and know the ins and outs of the industry very well.

Medihelp have a solvency percentage of 32.75% and an AA rated claims payout rating with the average time a claims payout take is 5.4 days. This results in fast and easy claims payout with enough money to pay your claims.

The age profile of the average member is 36.9 years, meaning the risk amount they have to spend on much less than other schemes, leaving more funds to create better benefits.

The scheme is self administered meaning they have to spend less money on administration that leaves more money to pay your claims. They have regional offices in Cape Town, Port Elizabeth, Durban and Bloemfontein.

MedihelpMedihelp sponsors the kyknet show ‘n Lewe met / living with where medical conditions are discussed and focussed on in great detail. They also sponsor the Tekkie Challenge and the Dolphin Coast Ultra Challenge.

Why Medihelp may be the scheme for you?

• You only pay for the first 2 children.
• Excluding the network plan you have a free choice of doctors, specialists and hospitals.
• All of the plans have unlimited annual limits that includes procedures in day clinics, sub-acute clinics, hospices and private nursing.
• Preventive care benefits like health checks, immunizations, vaccinations and certain tests. A maternity program that includes; 12 consultations and 2 2D scans.

The 7 medical aid options available at Medihelp medical scheme;

1.    Necesse: the network option. This product is available for the lower income groups and the premiums are salary banded. The plan includes both day to day and hospital cover.
2.    Dimension Prime 1: The Medihelp hospital plan.
3.    Dimension Prime 2:  A comprehensive medical aid plan with a medical savings account to cover day to day medical costs.
4.    Dimension Prime 3: This is a comprehensive plan with ample day to day cover.
5.    Dimension Elite: This is a comprehensive option that includes unlimited GP visits and ample additional day to day benefits.

With the Dimension 1, 2 and 3 options you are allowed to choose a network option. The choice of the network option will allow you more affordable medical aid as the rates and tariffs are pre-determined with the service providers.

All of the plans pay claims at 100% of the Medihelp scheme rates and include the screening and prevention, maternity and immunization benefits.

All of the plans from Medihelp medical aid only cover the 26 chronic conditions listed on the prescribed minimum benefits list. Any other chronic condition is medicated out of the member’s pocket.

Medihelp medical scheme is a scheme well worth considering as they offer you great plans with additional benefits like; prevention, screening and maternity benefits. Their high solvency ratio and claims pay out status makes them able to pay out claims in a fast and easy manner.