Comprehensive medical aids are costly but can be made more affordable with some simple strategies
You need to protect yourself against high private hospital costs, chronic illnesses, and out-of-hospital treatments.
You can consider joining a private hospital only benefit plan to lower premiums. These plans will enable you to have private hospitalisation and chronic illness and maternity benefits. There is a hospital plan that pays dental treatment as well.
Fedhealth has a hospital plan with the option of a day-to-day savings fund that you only repay once you spend from it.
If you join a comprehensive cover plan that has network providers, you can get excellent benefits at lower premiums.
Some plans have premiums based on your income, so lower income members pay lower premiums. They make healthcare more accessible, although do have certain benefit limitations.
In-hospital private providers are charging fees higher than what most schemes pay and schemes are also increasingly adding procedure co-payments You need to consider joining a Gap/Top-up insurance to meet these added costs.
When it comes to protecting ourselves against high medical costs, private hospital admissions, unexpected out-of-hospital treatments, and chronic illnesses are our primary concerns.
While joining a comprehensive medical aid is a viable option to mitigate these risks, it can be a costly solution for many.
Do this to make your medical aid more affordable without compromising on essential benefits.
3 options to consider when looking for an affordable, low-cost medical aid with good benefits.These are examples of some plans to consider.
There are a wide variety of medical aid plans available, and you need professional advice to investigate those suitable for you.
Protect yourself from soaring medical expenses by bridging the gap between medical scheme rates and the charges imposed by private providers.
1. Join a hospital plan.
A comprehensive private hospital plan forms the foundation of any reliable medical aid, providing financial protection in the face of unexpected medical expenses, such as hospitalization, surgeries, emergencies, and chronic treatments.
By joining a hospital plan, you gain the assurance of accessing unlimited and high-quality private hospital care when needed, ensuring you receive the best possible medical attention without delay.
Unlike traditional medical insurance plans, these medical aid-based hospital plans offer superior benefits and benefits because they encompasses primary care benefits (PMB), which medical aids are obligated to pay for, as well as radiology, scans, prescription drugs, and much more.
2. Join ANY Private Hospital plan.
You may use any private hospital and doctor or medical specialist in South Africa - no networks.Most of these plans will also offer:
- Unlimited hospitalisation at any hospital.
- Guaranteed full cover for listed, in hospital specialists.
- Cover for procedures in a day clinic.
- 2 levels of doctor and specialist claims cover: either twice the scheme rate or the scheme rate of payment which has a lower premium.
- Chronic medication that takes care of certain life-threatening conditions that need ongoing treatment, such as diabetes and heart disease.
- Screening and prevention benefits that cover vital tests to detect early warning signs of serious illness.
- Cover when travelling as well.
- Quality, remote care at your home.
Hospital plans indeed offer a practical and cost-effective option for individuals who are generally healthy and expect to require medical care primarily in emergencies.
With lower monthly premiums compared to comprehensive medical aid plans, hospital plans provide essential benefits for hospitalisation and certain out-of-hospital procedures or treatments that can be safely conducted in doctor's rooms, registered day clinics, or outpatient facilities.
They cover in-hospital dental and oral procedures, ensuring that important treatments are paid when required.
They often have no annual limit on maternity confinement and neonatal intensive care, providing peace of mind to expectant parents.
They offer extensive support for cancer patients, including access to critical diagnostic procedures such as MRI and CT scans, magnetic resonance holangiopancreatography, whole body radioisotope scans, and PET scans. These diagnostic tools are vital for early detection and effective treatment planning.
An all-inclusive private hospital plan from around R 3,000 pm for a single member and R 8,000 pm for a family of four.
Dental benefits are normally NOT part of a hospital medical aid plan, so these plans are unique!
You have freedom of choice when using a hospital or dentist.
Premiums range from R 1,610 pm for a single and R 4,230 pm for a family of four.
Should you feel that joining a plan – where you pay all day-to-day costs – is too much of a risk, there is a hospital plan that offers you the option of an out-of-hospital expenses savings fund.
It is unlike other schemes, because you repay the savings you use, only when you spend them.
Most schemes add a repayment portion of the savings loaned to you, to every premium - whether you spend them or not!
This plan allows you to control your premiums.
You have a safety net of substantial savings, repaying only what you spend so, if you do not spend any of the savings, your premium remains that of a hospital plan!
This plan also pays for several unique benefits that other hospital plans do not:
- Post-hospitalisation treatment for up to 30 days.
- Specialised radiology like MRI/ CT scans whether they are performed in or out-of-hospital.
- Trauma treatment at a casualty ward.
- Cover for female contraception.
- In-hospital dentistry for children under 7
This is the lowest cost hospital plan we sell!
Unlimited (PMB care) in a listed private hospital and unlimited network specialists.
Premiums range from R 1,055 pm!
Are you healthy and feel you have little chance of needing hospitalisation, then this plan may be of interest to you. Accept a R 15,470 excess on planned (NOT emergencies) admission, your premium reduces by 25%!
Premiums range from R 2,505 pm for a single and R 4,901 pm for a family of four.
3. Hospital plans using Listed Hospitals.
If you are prepared to use listed hospitals with that scheme, you can get discounted premiums.In addition, unlimited procedures, treatments conducted at network hospitals are paid for in full, with most of these plans.
Premiums range from R 2,192 pm for a single and R 5,244 pm for a family of four.
Hospital plan with discounted premiums depending on where you are prepared to source chronic medication.
Save on your monthly contribution by using a listed providers for your script and medicine.
If you have no chronic conditions, this is an excellent plan to consider!
Premiums range from R 2,353 pm single and R 5,801 pm for family of four.
Hospital plan with a premium based on your income.
An entry-level plan with good benefits for a reasonable cost.
You use listed hospitals and get unlimited cover for admissions and related accounts like specialists, chronic illness benefits, and maternity.
Day surgery network benefits.
Out of hospital specialist cover when referred by listed GP.
Premiums range from R 1,381 pm single and R 3,484 pm for family of four.
4. Join a network provider, comprehensive medical aid
Comprehensive medical plans using a network of listed providers, including hospitals, clinics, and doctors, offer a practical solution for accessing a wide range of healthcare services at discounted rates.By choosing these network-based plans, you can benefit from reduced premiums without compromising the quality of care.
Extensive networks ensure that you have many options when it comes to selecting a healthcare provider. You can discover a suitable healthcare professional near your home or workplace, eliminating the need for long travels or taking time off work for medical consultations and treatments.
They have minimal or no procedure co-payments, unlike traditional medical aid plans where members often have to cover a portion of healthcare costs.
The benefits provided is extensive, from routine check-ups and vaccinations to major surgeries and long-term medical treatments. Some plans even guarantee full payment, offering you added financial security during medical emergencies.
If you are looking for an affordable and convenient way to access healthcare services, network comprehensive medical aid may be the right choice for you.
Listed hospitals and any day-to-day provider
Unlimited hospitalisation, including GP and specialist consultations, blood tests and x-rays, MRI/CT scans, mental health, maturity, physical rehabilitation etc.
Savings for out-of-hospital cover and you have total control over how you spend them.
(You repay only what you you spend, when you spend it - over the next 12-months. A portion is added to your next and subsequent premiums.)
Premiums range from R 2,505 pm single and R 6,302 pm for family of four.
Listed hospitals and network day-to-day providers
Unlimited hospitalisation with a small admission co-payment – except for PMB emergencies.
MTR/CT scans paid.
Unlimited network GP consultations, basic optometry and dental.
Preventative care and Wellness benefits.
Premiums range from R 1,498 pm single and R 5,400 pm for family of four.
5. Join a comprehensive medical aid with premiums based upon your income.
An income-related premium medical aid, has premiums that are based on your income.It is an important option for those who cannot afford traditional medical aid, enabling them to pay less for their medical aid benefits, whilst providing affordable access to healthcare individuals and families.
Schemes offer a choice of plans: those that only cover essential medical expenses, or more comprehensive plans, that include benefits such as dental and optical cover.
It is important to note that premium-based medical aid in South Africa do have some limitations.
For example, they may not cover certain types of treatments or procedures, and members may have to pay out of pocket for certain expenses.
Here a Gap cover plan is an essential insurance for full hospital cover.
Because the cost of benefits is determined by income, those who earn more may be subject to higher premiums, for the same benefits.
Despite these limitations, premium-based medical aid plans are an important option for those who need access to affordable healthcare.
For many South Africans, it is a vital tool for ensuring that they and their families can receive the medical care they need, when they need it.
They offer:
- Unlimited, entry-level hospitalisation.
- Certain specialised procedures/treatment that do not require hospitalisation.
- Unlimited maternity and neonatal.
- Use listed hospitals for a discounted premium.
- 26 Chronic conditions and mostly unlimited day-to-day with listed providers
Premiums range from R 589 pm single and R 2,240 pm for family of four.
Joining a medical aid in South Africa is a challenging task, but by understanding your needs, comparing plans, considering hospital plans, looking for discounts, and considering a family plan, you can discover an affordable medical aid that meets your needs.
Be sure to also check the network of providers for each plan to ensure that the doctors and hospitals you prefer are included.
These are significant costs you must consider.
Gap cover helps bridge the gap between what your medical scheme pays and the actual cost of in-hospital treatment.
GAP or top-up insurance plan. is a separate insurance that will cover most in-hospital claim shortfalls and any co-payments.
It is a vital safety net, ensuring you have enough to cover medical treatments, without having to pay for unexpected costs.
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, and are paid 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!
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Peter Pyburn - Authorised Financial Services Provider has been fully licensed to provide expert financial services since 1991.Based in Sandton, Johannesburg, Gauteng, we specialise in comprehensive financial planning including: Death and Disability Cover, Retirement Planning, Investment Strategies, Medical Aid, Estate Planning
FSP Licence 2995 and Medical Aid Accreditation BR 7428.
Why Choose Peter Pyburn?
Over 30 ears of experience in financial services - Fully Licensed and Accredited for medical aid and other Personalised financial advice.
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Important Disclaimer: This content is for informational purposes only and does not constitute financial or healthcare advice.
Medical aid benefits are subject to change. Please consult the medical aid brochure and speak to me before making any decisions.
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Last verified: September 3, 2025