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The Best Medical Aid in South Africa

What You can do about the 2025 Premium Increases.

The 2025 premium increases have been announced, and they are around 10% higher than the 2024 rates!

• Discovery Health: 9.3%
• Bonitas: 10.2%
• Momentum: 9.4%
• Medihelp: 10.8%
• Bestmed:2.7%

This is frightening, especially when CPI is around 6%!
It has now become vital that you look to ways of securing the finest hospital care at the best price you can.

Your Needs:

Private hospitalisation can have unforeseen, huge expenses.
Costs can be so high that you cannot afford private care and may have to resort to state hospitals for treatment, which is not a desirable situation.

A medical aid with unlimited hospital benefits must be the foundation of your plan.

Costs like GP visits, dentist appointments, and chemist bills form out-of-hospital costs.
We have never had a client who has become bankrupt because of high out-of-hospital costs.

Although many members self-pay these costs, you may want some security so you can afford to pay for these treatments.

A medical aid offers two ways to pay for out-of-hospital costs:

• A savings account from which you pay expenses.
• Set benefits and limits that pay these costs.

Either way, having these out-of-hospital benefits increases your overall premium.

What to Do:

Living in a country with an ineffective national health service, you need to be able to afford the finest private hospital care.

Here are three ideas to consider:

1. Join a Medical Aid Plan with Unlimited Private Hospital Benefits

All medical aids offer these plans however, Fedhealth offers an excellent plan that deserves your attention!

Fedhealth Medical Aid is truly an exceptional medical aid because they really do offer the best, affordable, unique, value-added benefits of any scheme in South Africa.

All plans have excellent in-hospital benefits and the offer of day-to-day savings which are re-paid only when you spend them!

If you choose NOT to use the savings, you have a hospital plan!

Read more here...

Just look at their hospital benefits:

1. No overall annual limit private hospital cover, for emergencies and planned procedures.
2. Unlimited network GP and Specialist covered at cost in-hospital.
3. Treatment for selected procedures in a day ward, day clinic or doctors’ rooms.
4. Unlimited Specialised radiology.
5. Unlimited accident and emergency treatment.
6. Emergency treatment at a trauma unit of a clinic or hospital, like stitches and broken bones – whether you’re admitted to the hospital or not.
7. Costs paid for treatment at a clinic or hospital with a life- threatening condition where you are admitted immediately for further treatment.
8. If medicines are not readily available Fedhealth will arrange for medicine or blood products to be delivered to the facility where you are being treated.
9. Unlimited maternity covered at cost with network GPs and specialists.
10. Specialised radiology, like MRI/ CT scans done in or out of hospital, is paid by the scheme and not you!
11. Chronic illness.

Premiums from as little as R 1,055 pm for a single member.

From generous maternity and childhood benefits for young families, to extensive chronic benefits for older members, or treatment in a casualty ward after falling off a mountain bike for sporty members… they have you covered.

2. Consider Combining a Medical Aid Hospital Plan with Day-to-Day Medical Insurance

Some brokers advocate joining a medical aid hospital plan and combining it with a day-to-day medical insurance for out of hospital benefits.

However, this idea has several concerns:

• Your combined premium is more than that of a low-cost medical aid.
• The two products can be difficult to understand when it comes to benefits, exclusions, co-payments, and waiting periods or restrictions.
  Each plan has its own rules.

• Medical aids must pay for certain treatments known as Prescribed Minimum Benefits.
  This makes them way more secure than a medical insurance which can totally exclude certain pre-existing conditions and elective procedures.
• A medical aid guarantees acceptance regardless of pre-existing conditions.
  They cannot exclude these conditions, and only impose a maximum waiting period of one year.
• Medical schemes typically pay providers directly, reducing the members' administrative burden and eliminating up-front payments.
  Medical insurance generally requires members to pay costs upfront and then submit claims for reimbursement.
  This can be problematic.
• Medical insurance benefits are generally kept at predetermined amounts, which may not cover the full cost of the treatment.
• Unlike medical aids with an in-hospital shortfall, a gap cover plan will not pay medical insurance shortfalls.
  You are responsible for paying any shortfall.
• Medical insurance does not cover chronic illness as comprehensively as a medical aid.
  Medical aids must provide full benefits for 27 chronic illnesses.
• Medical aids offer additional benefits like preventative services, routine check-ups, and wellness benefits that medical insurance does not.
  These are vital in reducing the severity and cost of possible future illnesses.

These concerns aside, you can join a Day-to-Day insurance plan along with your Medical Aid to increase your out-of-hospital benefits.

Combining a day-to-day insurance plan with your medical aid can increase your out-of-hospital benefits, providing you with more comprehensive cover.
And it works with any medical aid.

3. Join a medical aid hospital-only plan and self-pay your day-to-day costs or create your own savings fund to do this.

This approach allows you to create your own savings fund for medical expenses and although it takes time to grow, it is your money, and you can spend it as you wish.

The fund can double as your emergency fund, unlike savings held within a medical aid, which can only be spent on medical expenses.

You can use an access-type home bond as your savings fund.
In this way, when you do not need to spend from the bond, you pay your loan capital far more quickly and can save huge interest over the term.

Facing these huge medical aid increases going into 2025, many members may have no choice but to downgrade their plans

If this is something you are concerned about, we urge you to contact us for support and guidance on any decision you may make.

But never be without private hospital cover!

Private healthcare providers can charge up to 500% of medical scheme rates.
Medical aids add procedure co-payments as well.
These are significant concerns for medical aid members.

Protect yourself against these potential threats, by joining Zest's GAP or top-up insurance plan.

This separate insurance will cover most in-hospital claim shortfalls and any co-payments. It is a vital safety net, ensuring you have adequate benefits for medical treatments without bearing the full burden of unexpected costs.

Protect yourself from soaring medical expenses by bridging the gap between medical scheme rates and the charges imposed by private providers.

Specialised Dental treatments can be extremely expensive!
The costs of braces, root canal, implants and so on, can run into thousands of rand. Most treatments are done out of hospital, so are funded from your savings.

That can result in less money available for other medical needs and family limits being used on one member only!

Dental treatment is something we all need and it is vital you consider the Best Dental Insurance Plan OR Most Affordable Dental Plan in South Africa.

No Medical Aid or have a Hospital Plan only?
This plan will help you meet the high costs of both normal and specialised dentistry!

What is the cost.

Talk to me .... I am here to help you - at no charge!
Send me your questions and concerns. I'll answer them for you.

083 655 2164

You must consult the schemes/company product brochures and rules for comprehensive benefit descriptions.

We will offer you the best help at no cost!

How to Choose a Medical Aid

Medical aid pays healthcare costs.
What if a disability stops your income?

YOUR TRUSTED, QUALIFIED ADVISOR:
Peter Pyburn - Authorsed Financial Services Provider, fully licensed to render financial services since 1991. Death and Disability Planning; Retirement Planning; Investment Planning; Healthcare and Estate Planning.
FSP Licence 2995 and Medical Aid Accreditation BR 7428
Based in Sandton.

Council of Medical Schemes
Disclaimer, Medical Disclosure

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Last update: March 24, 2025