Do I Need a Hospital Plan in South Africa?
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The ONLY way to ensure you get the finest hospitalisation care when you need it, is by joining a hospital plan.
In South Africa, you unfortunately cannot rely on the government for medical care. You have to use private healthcare. These costs are huge and only through a medical aid hospital plan will you be able to afford them.
There is an urgent need for you to - at least - join an affordable hospital plan.
The Corona virus was not the only reason you have to join a medical aid.
Medical inflation is way higher than normal inflation. The cost of healthcare is unaffordable for most people and they land up in state facilities with longer waiting times and limited resources.
Not desirable at all.
The need for private hospital care is unpredictable and can quickly escalate.
A week in high care can cost upwards of R86,500, while maternity care can exceed R60,000.
Major procedures, such as a heart bypass or hip replacement, can range from R150,000 to R350,000.
These costs highlight the critical need for a hospital plan to protect against unforeseen and expensive medical emergencies.
Now you can see why a hospital plan is vital for you and your family.
Comprehensive Benefits for Common Medical ProceduresHospital plans cover a wide range of medical procedures that are expensive. Procedures like:
- Treatment of a Gunshot Wound: R25,000
- Hip Replacement: R150,000
- Renal Dialysis: R200,000
- CT Scan: R10,000
- Heart Bypass: R350,000
- Tonsillectomy: R8,000
- Grommets: R6,500
- Hernia Repair: R25,000
Choosing the Right Hospital Plan
If you are already a medical aid member and are concerned about rising premiums, there are ways for you to keep your medical aid while managing costs.You can join an in-hospital only benefit plan and self-fund day-to-day costs.
You then have benefits for large, unforeseen in hospital medical expenses and control over your lower, daily healthcare costs.
Naturally the premiums are a lot less that comprehensive benefit plans.
Most medical aid schemes offer hospital only plans.
Here are 3 schemes to consider
- All plans offer unlimited in-hospital cover at any hospital you choose.
- They pay in-hospital ward, theatre, specialists, physio, medicines, MRI and CT scans and more.
- Emergency treatment and transport.
- Certain chronic medicines.
- They do have "added benefits" to differentiate themselves.
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 about Fedhealth Medical Aid benefits
Just look at their hospital benefits:
- No overall annual limit private hospital cover, for emergencies and planned procedures.
- Unlimited network GP and Specialist covered at cost in-hospital.
- Treatment for selected procedures in a day ward, day clinic or doctors’ rooms.
- Unlimited Specialised radiology.
- Unlimited accident and emergency treatment.
- 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.
- Costs paid for treatment at a clinic or hospital with a life- threatening condition where you are admitted immediately for further treatment.
- 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.
- Unlimited maternity covered at cost with network GPs and specialists.
- Specialised radiology, like MRI/ CT scans done in or out-of-hospital, is paid by the scheme and not you!
- Chronic illness.
Premiums range 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.
The Genesis Hospital plan is rated as one of the best hospital plans in South Africa by the GTC Medical Aid Survey: Benefit and cost comparisons.
Genesis offer you:
- the lowest annual contribution increase of all South African medical aids over the last 10 years. Only 4,9% this year!
- one of the lowest child contribution rates!
- the use of any doctor or specialist you choose as there are no compulsory networks!
- psychiatric treatment, so vital during this pandemic.
- out-of-hospital MRI and CT scans as well!
- diagnostic endoscopes
- pain relief for conservative back and/or neck (spinal/vertebral) conditions.
- surgical procedures done in doctors’ rooms
- cancer, stroke, motor-neuron disease, organ transplant and Hospice.
- Chronic illness.
- screening tests.
AND
- Basic dentistry - yes cover for day-to-day and in-hospital dentistry!
Premiums range from as little as R 1,610 pm for a single member!
Genesis does not “authorise” treatment for any admission to hospital. Instead, you are issued with a hospital admission reference number because, nor do they it interfere with any clinical decisions or protocols made by or recommended by your doctor(s).
This medical aid is really a hidden gem!
They are the smart choice when it comes to affordable, hospital only cover!
Save up to R1 000 on per month when you choose to use an Associated provider.
Momentum Health offers you:
- a discount on your contribution if you elect to use a specific, listed private hospital!
- cover for certain specialised procedures/treatments, when clinically appropriate, in and out-of-hospital.
- Netcare 911.
- chronic benefits, at a discount premium depending on your choice of associated doctors or suppliers!
- no annual limit on maternity confinement and neonatal intensive care.
- maternity programme with 12 antenatal visits, including a urine test, 2 pregnancy scans and 2 visits to the paediatrician during the baby's first year, plus a home visit from a nurse!
- no annual limit for MRI and CT scans, magnetic resonance cholangiopancreatography, whole body radioisotope and PET scans.
- preventative screening tests, certain check-ups and more.
- free talk to a doctor, anytime, anywhere!
Momentum offer you great cash-back rewards and partner discounts with Multiply.
Make healthier lifestyle choices, so you can reap the benefits like, rewards for being active - up to R3 000 per family per month to help pay for day-to-day healthcare expenses - free yearly health assessment at a Dis-Chem, Clicks or Pick n Pay Pharmacy or Multiply-affiliated pharmacies!
Premiums range from as little as R 2,353 pm for a single member.
Momentum Health ranks among the top 3 open medical schemes and are administered by one of the biggest and most credible healthcare solutions companies in South Africa.
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.
Protect yourself 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 enough to cover medical treatments, without having to pay for 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, 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!
Do this today:
1. If you do not have a hospital plan ... join today!You are taking a high risk without cover. You know that!
Get a quote or contact me if you have questions by using the form below...
2. If you are a medical aid member and want to reduce your premium, investigate whether your scheme will allow you to downgrade to a hospital only plan.
All medical schemes allow a change of plan during a window period at year-end and some will allow a change during the year, with sufficient motivation for such a move.
If you are unable to change plans, look to an alternative scheme?
Just be aware you could get waiting periods when joining a new scheme, but that may be acceptable when considering no medical aid at all!
Many members of comprehensive medical aid plans, who change to in-hospital benefit only plans, have great enough premium saving, to join a top-up plan as well!
That means they then have a healthcare plan that pays hospital costs in full - no shortfalls and no procedure co-payments!
Better hospital benefits than with their old, comprehensive plan and at a lower combined premium!
Talk to us if you have concerns.
We deal with a number of medical schemes.
Appoint us to your medical aid at no added cost, because you pay the same premium whether you use a broker or not.
We will investigate your plan and give you some ideas of your options.
Terms and conditions do apply.
If a hospital only benefit plan interests you, please contact us.
We can help you at no charge.
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!
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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: May 30, 2025