Private healthcare providers can charge up to 500% of medical scheme rates.
Medical aids add procedure co-payments as well.
These are significant costs you must consider.A Gap or Top-Up plan is a separate insurance that covers 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.
Joining a hospital plan with Gap Cover is the most affordable way for families to protect against rising costs in 2026.
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!
No
Medical Aid or have a
Hospital Plan only?
This plan will help you meet the high costs of both normal and specialised dentistry!
Frequently Asked Questions: Why Join a Medical Aid Hospital Plan
1. How do I decide between a hospital and comprehensive medical aid?
Your choice will depend upon your needs and budget. Comprehensive plans offer greater cover because as they include day-to-day benefits. However, they cost more. Your greatest medical financial risk lies with private hospitalisation, so hospital plan is the foundation of your healthcare insurance.
2. What benefits do hospital-only medical aid plans offer?
A hospital plan takes care of your hospital bills from admission to discharge and covers everything from your ward and theatre fees, surgeon, anaesthetist, doctor, specialist, physio, pathology, radiology, emergency treatment and so on. All hospital plans provide cover for the 270 life-threatening conditions and 26 chronic PMB conditions.
3. How do savings funds in comprehensive plans work?
Comprehensive plans have savings funds from which you pay out-of-hospital costs. Some plans give you a portion of a shared pool of funds, while others require you to contribute extra to a savings account as part of your monthly premium. Some plans offer a safety net should you savings be spent.
4. Can I upgrade my plan during the year?
Only one scheme will allow a interim plan upgrade - Fedhealth. If you suffer a major life-changing event, like having a baby or being diagnosed with a serious illness, you can upgrade your plan within 30 days of that diagnosis. You can now join a lower-cost, lower benefit plan, safe in the knowledge that if you need to upgrade – you can.
5. What key considerations are there when choosing a medical aid?
Make sure you get unlimited private hospital cover, cover for doctors' fees at scheme rates or higher and MRI/CT scan benefits. Look at the limits on specific procedures, maternity care, chronic illnesses, and co-payments. Does the plan offer screenings and preventive care. Join a Top up/ Gap Plan to help with in-hospital claim shortfalls and procedure co-payments.
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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 bestmedicalaid.co.za before making any decisions.
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July 24, 2026