Most affordable medical aid schemes and hospital plans in South-Africa for 2017

The medical aid industry saw a massive shake-up in April as National Treasury introduced new regulations which will see a limit on the amount of gap cover and hospital cash-back policies you can claim, as well as the discontinuation of all primary healthcare policies.

This is was done in an effort to differentiate between “medical scheme products” and “health insurance”, both of which are regulated by separate Acts causing confusion in the medical arena.

The new regulations will now outlaw all primary healthcare policies from 1 April. According to legislation these are not seen as full medical schemes, instead providing limited medical service benefits, such as GP visits, basic dentistry and optometry, and some acute and chronic medication.

The new laws also stipulate that hospital cash-back plans are limited to paying their clients a maximum of R3,000 per day, or a total lump sum of R20,000 per year. Currently there are no limits in place for these payments.

The regulations, which were demarcated in terms of the Long-term and Short-Term Insurance Acts, came into effect as of 1 April 2017 for new policies and retrospectively from January 2018 for existing policies.

Affordable options

South Africans looking to avoid free public healthcare and turn to private health are most accustomed to medical aids to see them through. But even at their cheapest, medical aids can cost over R1,000 a month – which is something the vast majority of South Africans can ill afford.

Cheaper alternatives exist in the form of health insurance products, which often cater to a more specific type of cover (hospital, or day-to-day cover for example) at a reduced price.

Beyond the big medical aid brands, such as Discovery, or Bonitas, smaller insurers play in this field. These include companies like Affinity Health and Essential Med, who offer more affordable packages, catered to individual profiles.

Cover from smaller brokers can vary from R330 per month for a single member (covering day-to-day) to over R800 for more comprehensive cover.

Venturing past these amounts, consumers tend to enter medical aid territory. Below, are the cheapest offerings from range of major medical aid brands in South Africa.

Prices were correct at time of writing. This is not an exhaustive list of all the products on the market but should work as a comparative tool.

For a full breakdown of medical aid schemes by each provider, and each category, as well as a detailed comparison of the services you are offered, check out the listings at Medicalaidcomparisons.co.za.

Hospital Plan

A Hospital Plan will cover all the services provided in a hospital including the anesthetist and surgeon. You would have to be admitted to a hospital, out patients and trauma units are generally not considered a hospital event if you are not admitted.

Plan Monthly contribution for principle member

Discovery Health Essential Smart Plan R1 100
Momentum Custom Option R1 266
Discovery Health Essential Delta Core R1 317
FedHealth Entryzone R1 329
Bonitas Bonessential R1 473
Discovery Health Coastal Core R1 496
Discovery Health Classic Smart Plan R1 535
Resolution Health Hospital Plan R1 565
Medihelp Dimension Prime R1 608
Discovery Health Essential Core R1 648
Momentum Custom Option R1 742
Fedhealth Maxima Core R1 907
Discovery Health Classic Core R1 918

Hospital plans with savings

Hospital plans with savings provide cover for services rendered in hospitals (both hospital and specialists incl.) and further provide a member with a limited savings account (normally available upfront) for day-to-day expenses (eg. GP, medicines, dentist,etc.). Once the savings account is exhausted, the member needs to pay for their day-to-day expenses from his/her pocket

Plan Monthly contribution for principle member

Medihelp Unify R1 994
Discovery Health Coastal Saver R2 007
Discovery Health Essential Saver R2 047
Discovery Health Classic Delta Saver R2 058
Bonitas Bonsave R2 135
Medihelp Dimension Prime 2 R2 136
Medshield Medisaver R2 571
Discovery Health Classic Saver R2 577
Fedhealth Maxima Standard R3 032
Momentum Extender Option R3 732
Resolution Health Millennium R4 199
Momentum Extender Option (2) R4 671

Comprehensive plans

Comprehensive Medical Aid plans have unlimited hospital cover and comprehensive day-to-day benefits. In new generation plans, initial claims will be funded from a medical savings account. Thereafter when all accumulated day-to-day claims reach a specified threshold, another risk benefit kicks in and continues to pay claims until the end of the year.

Plan Monthly contribution for principle member

Genesis Private Comprehensive R2 200
Discovery Health Classic Priority R2 968
Fedhealth Maxima Standard R3 032
Resolution Health Millenium R3 359
Discovery Health Classic Delta R4 059
Comprehensive
Discovery Health Classic Comprehensive R4 506
Resolution Health Supreme R4 565


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