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What is Medical Aid in South Africa
and How Does it Work?
2026 Guide to Schemes, Types and Benefits
Medical aid in South Africa is a regulated financial structure designed to protect individuals and families from the rising costs of private healthcare. Whether you are consulting a general practitioner in Johannesburg or undergoing complex surgery in Durban or Cape Town, understanding how private healthcare funding works, ensures you choose and join the right plan for your needs and budget and do not overspend on unnecessary benefits.
- Who: South Africans seeking financial protection against private medical expenses.
- What: A regulated product offering cover for in-hospital treatment, chronic illness, emergencies, and prescribed minimum benefits.
- When/Where: Join anytime, with cover available across all provinces.
- Why: Avoids medical debt, ensures private hospital access, and provides peace of mind.
- How: Compare plans, join a registered scheme, and get expert broker advice at no cost.
Compare medical aid plans and get your free quote today.
You then get help when paying for medical treatments like the hospitalisation, chronic illness and day-to-day treatments.
No one can be refused membership of a medical scheme.
Speak to us, accredited independent broker, to compare choose and join the right plan for your budget.
Do you fear having to use government hospitals?
Do you really feel safe and secure - having to use a state hospital?Do they offer the best care?
Yes, there are fine medical providers in the government healthcare system, but overall the state of care is appalling and it is your health that is at risk!
Public healthcare is more affordable than private, but state hospitals are not always free!
If you are employed and earning more than R70 000 a year, you will have to pay some or all of the costs of your care.
Private healthcare is an alternative, but private healthcare is extremely expensive and unless you have large, easily available money you many not be able to get the best medical treatment you need!
The ONLY way to get ensure that you will get the finest private medical care (immediately in an emergency), is through a medical aid.
Emergency Hospital Admission
Medical emergencies can happen at any time, to anyone and a medical aid guarantees hospital admission without expensive upfront deposits.
There are around 21 medical schemes in South Africa and that you can investigate and consider joining.
However, not all schemes are the same and differ widely in benefits, administration and solvency.
So, it is highly recommended you seek the help of medical aid professionals like ourselves, who can guide you in the right direction when you investigate plans to join, as there is a lot you need to be aware of before you decide on a scheme.
As a healthcare plan member, you do have certain enforceable rights according to the Medical Schemes Act. Please see Council for Medical Schemes
The 5 Main Types of Medical Aid Plans
Choosing the right medical aid option requires balancing your day-to-day healthcare usage against the risk of unexpected, expensive in-hospital procedures.
These plans offer benefits to meet high cost, elective and emergency hospitalisation and essential chronic illness treatment.
They're cheaper than comprehensive plans because they only cover the most important of medical costs - private hospital.
Recommended for those with a strict budget or healthy members who have little need for out-of-hospital benefits.
Benefits include all planned and emergency, in hospital costs from admission to discharge.
That includes ward and theatre fees (which are normally fully paid), anaesthetist and surgeon, pathology, physio and other providers. Hospital plans provide essential in-hospital cover (theatre fees, ward costs, intensive care, and in-hospital specialists) and include PMB benefits.
You self pay for day-to-day costs like GP visits, dentists, and over-the-counter medicine.
These plans suit young, healthy individuals or those seeking affordable hospital only protection.
These plans work with listed doctors and hospitals. You pay a lower premium, but you have to use their network of providers.
Medshield is an example of a scheme that offers these plans.
Momentum is another scheme that offers discounted premiums for using network providers.
There are plans that have premiums based on a level of income.
These are the lowest cost medical scheme plans available.
However, they can be restrictive in the benefits they offer, but do offer life-threatening and life-sustaining benefits for extremely good rates!
These plans are ideal for pensioners, children who become adult dependants on your healthcare plan, students and those who earn low-incomes, but want access to private healthcare.
They are good options if you're on a tight budget but still want access to private healthcare Network plans require the use of specific hospital networks, doctors, and chemists. Monthly premiums are based on a sliding income scale., which the member must prove.
They offer cost-effective cover provided you use the scheme’s nominated network providers.
Low income earners should be able to access private medical providers, however a standard medical aid plan is way too expensive for their budget.
As a result, medical aids have certain plans with income-related premiums, specifically for these member needs.
In fact, Discovery Health's KeyCare Plan has more members than most total medical aids!
The plans offer hospital, day-to-day and chronic illness cover using a network of providers and include day clinics, maternity, HIV, cancer, diabetes and mental health programmes, preventative and screening and even home-based care benefits.
Momentum Health's Ingwe plan covers the use of any hospital, or a network of hospitals for a further premium discount, or state hospitals with the lowest of all premiums.
These plans offer life-threatening (heart attack, car accident etc.) and life-sustaining (cancer, kidney etc.) benefits for a very affordable premium, which you do need to prove!
Your hospital admissions are paid by the plan, and day-to-day costs are paid from a savings account, really an interest-free loan - paid to you at the beginning of the year. You repay savings through an additional portion added to your premium every month - whether you spend those funds or not.
If you don't use it all, it rolls over to the next year.
Fedhealth medical aid offers innovative and attractive way of using your savings. You can save a great deal of premium with these plans.
Most plans offer a safety net (threshold benefit) should you have spent your savings and still need day-to-day cover.
Once your claims add up to a predetermined amount, they pay further costs that year, subject to some limits.
Genesis medical aid pays essential dental costs, so you don't use your savings on these claims!
These plans are suitable for healthy members who do not need a great deal of day-to-day treatment, but do want the confidence of knowing that if they do, they have protection.
If you have high dental or optometry needs (where sub-limits of a particular medical aid are insufficient) the ability to use more of your savings on certain costs is an ideal benefit.
Advantages: You have the discretion to spend your savings as you want and any unused amount is carried over to your next year.
Disadvantages: You could spend your total savings on one claim and then have nothing for the rest of the year. Or, one family member could spend the entire savings, leaving the rest of the family without cover.
You need self-discipline to effectively manage these plans.
There are also options that use the best of both Traditional and New Generation plans. They have both set benefits and savings all in one plan.
Comprehensive Medical Aid planscover both in and out-of-hospital costs.
They're a bit more expensive, but they offer hospital and day-to-day benefits.
Perfect for people who expect to have a lot of medical expenses or who just want to be fully covered, they typically have no overall limit hospitalisation, excellent set benefit amounts or high savings for day-to-day needs and the highest number of chronic illness medications.
This type of plan covers all your hospitalisation and day-to-day costs in one plan.
You get set amounts of benefits like 10 GP consultations, 2 dentistry visits, one optometry visit and R 5,000 for medicines.
Once you've used up those benefits for the year, you self-pay for further treatments.
Some traditional plans have a daily limit for claims.
Plans can also offer additional benefits like GP or dentistry, so you do not use your limited set benefits for these treatments.
This prevents a situation of having used all the benefits on one condition, with nothing left for other healthcare needs - as can happen with saving plans.
These plans are suitable for members who have a high need of medical services on a monthly basis. GP, medicine, dental etc. visits.
Advantages: If you use one benefit, it does not affect the others. You know exactly what benefits you have at any time.
Disadvantages: Benefits do not roll over to your next year, so if you do not use them, you lose them. That can be seen as a waste of money!
Plans can also offer additional benefits like GP or dentistry, so you do not use your limited set benefits for these treatments.
This prevents a situation of having used all the benefits on one condition, with nothing left for other healthcare needs - as can happen with saving plans.
These plans are suitable for members who have a high need of medical services on a monthly basis. GP, medicine, dental etc. visits.
Advantages: If you use one benefit, it does not affect the others. You know exactly what benefits you have at any time.
Disadvantages: Benefits do not roll over to your next year, so if you do not use them, you lose them. That can be seen as a waste of money!
Student Medical Aid plans.Full time students also have access to medical aid.
Benefits include unlimited hospitalisation at any hospital (including casualty), mostly unlimited basic day-to-day cover with network providers. Dental and optical benefits are included.
This medical aid is recognised by Home Affairs for study visas that International students require.
And we can get you your certificate in a very short time!
Join an in-hospital only plan and invest the savings premium portion of a comprehensive medical aid in your own day-to-day savings fund.
Open a bank savings account, or better, use your home access bond by paying extra into it and using that for high day-to-day expenses.It is extremely likely that you will pay your bond off early, saving thousands in interest!
All in-hospital costs and chronic care care is covered (depending upon the plan you choose).
These are your highest-risk medical expenses taken care of.
An example of a scheme with hospital and defined day-to-day benefits.
Example of an excellent hospital and saving fund plan that you can fully control.
Compare these South African Medical aid schemes ...
- GENESIS - the Best, affordable medical aid that pays dental costs as well! Why pay more?
- FEDHEALTH - The Best In-Hospital benefits!
- MOMENTUM STUDENT - The Best, Affordable, Low Premium Medical Cover for Students.
- COMPCARE STUDENT - affordable student rates!
- DISCOVERY HEALTH - Market-Leader with the excellent Vitality gym subsidy!
- MOMENTUM HEALTH - Your health is Your Wealth!
- MEDSHIELD - mostly traditional plans with defined benefits!
- COMPCARE MEDICAL AID - One of the healthiest open medical scheme in South Africa.
- OXYGEN
- BONITAS
- GEMS
- LIBERTY
- MEDIHELP
- PROSANO
- SELFMED
- SPECTRAMED
- top-up PLAN - Buy a cheaper medical plan and Boost your Benefits!
What are waiting periods?
A medical scheme may impose waiting periods after underwriting your application.You need to accept them before a plan will begin.
A 3-Month Waiting Period - depending upon when you were last a medical aid member.
A 12-month Waiting Period - will be imposed if you join with a preexisting medical condition.
After that period, you should have full cover.
Waiting periods are allowed in order to protect the scheme where, new members submit claims when they join, then leave the scheme and return to an old plan - where they may have used up their benefits, but do prefer that old scheme!
Waiting periods do not apply to:
- Prescribed minimum benefits (PMBs) other than those specified.
- A child dependant born during the period of membership.
- A member moving between benefit options, unless there is a remaining period of previously imposed waiting periods still to complete.
- An involuntarily transfer to another scheme, due to a change of employment.
- Where an employer changes the medical scheme with effect from the beginning of the financial year.
You must pay contributions during a waiting period.
What are late joiner penalties?
New applicants older than 35 need to prove they have had past membership or a monthly Late Joiner Penalty is imposed. The penalty is added to your monthly contribution indefinitely and is determined by this table:| No. of Years Applicant Was Not a Member of Medical Aid Since Age 35 | Penalty Percentage |
|---|---|
| 1 – 4 years | 5% |
| 5 – 14 years | 25% |
| 15 – 24 years | 50% |
| 25+ years | 75% |
As you can see, it is important you make the effort to identify (and prove) all your past healthcare membership.
You do this by providing current membership certificates or an affidavit attesting to your membership.
How does a medical aid pay claims?
The monthly premium you pay, is pooled and it is from this collective fund that claims for medical expenses are paid. A medical aid plan pays claims either:- from the scheme itself, the risk cover (insurance portion) usually for major events and hospitalisation or,
- a member's day-to-day savings, for doctor’s visits, blood tests and medication.
When these funds are spent, you need to pay for costs except on higher plans which may offer a safety net when savings are used.
What are 100% or 200% of medical aid rates?
At the beginning of the year, medical schemes meet with providers to determine a basic rate for services.However private providers can charge any fee (often up to 500% of scheme rates).
A list of recommended tariffs (Reference Price List or RPL) for specific in hospital treatments and procedures exists and medical aids generally pay at these published tariffs.
These are the Medical Scheme Rates.
To try help members who may face claim shortfalls, medical aids offer plans that pay at 200% and even 300% of these rates andf these plans are more expensive.
Plans with linked (network) providers can pay cost in full, irrespective of these scheme rates.
In an attempt to control the ever-increasing cost of medical aid, many schemes are also have co-payments for certain services, hospitalisation, MRI and CT scans, specialised dentistry etc.
A co-payment is an amount you pay when having one of these treatments or procedures.
A Gap/Top Up plan is vital to help you meet these threats.
What are Prescribed Minimum Benefits (PMB's)?
Medical Aids must ensure that you have access to certain minimum health services, irrespective of the type of plan you join.
These are known as the Prescribed Minimum Benefits (PMB).
They must pay for the diagnosis, treatment and care of:
- any emergency medical condition;
- a limited set of 270 medical conditions (defined in the Diagnosis Treatment Pairs)
- and 25 chronic conditions (defined in the Chronic Disease List).
A scheme can require you to use only listed medicines and certain Service Providers or networks when covering PMB conditions.
(Please note that Prescribed Minimum Benefits may be refused during the waiting period, if you have never belonged to a scheme or did not belong to a scheme for at least 90 days before you applied for new membership).
What chronic medicines must a medical aid pay?
In terms of the PMB guidelines, schemes have to pay for 25 PMB chronic conditions. It includes the costs for the diagnosis, treatment and care of these listed conditions, no matter what medical aid plan you are on.If you have a chronic need, outside of these PMB conditions, you may need to look at a plan with higher chronic benefits to get cover.
Every plan has a list of medicines - called a formulary - which they provide. Certain schemes also allow for medicines not on that list, but you will get a co-payment if you use them.
The scheme may also require you to use a designated provider.
You must make sure you register for chronic benefits or the scheme will use your savings to pay for chronic medicines!
Schemes offer specific care programmes to help members live with certain chronic illnesses like HIV, Oncology, Diabetes, Cardio and Mental Health. You register for a programme and then have access to additional, relevant benefits that may be offered.
We can help you if you have any concerns.
How does a medical aid pay for cancer benefits?
Most schemes offer a separate benefit for oncology.Some plans only pay for PMB-related cancer treatments and others have a limited amount for non-PMB care. Other plans may offer unlimited benefits, but have a co-payment after as specified limit is used. Lastly, there are plans that have unlimited oncology, but only from network providers.
Most schemes apply Independent Clinical Oncology Network protocols. ICON is a organisation of oncology specialists and offers management and treatment for oncology patients.
A few plans offer benefits for specialised oncology medicines, but those plans are very expensive.
What is preventative care?
Schemes offer a range of preventative care benefits in order for you detect (and then treat) medical conditions early. By doing this you will get the best care as soon as possible.Benefits such as ‘flu injections, blood glucose and pressure tests, mammograms, Pap smears and prostate screenings, all paid for by the scheme and not from your savings!
Some even offer child growth assessments and milestone tracking!
You may have to use network providers but, can get a range of benefits such as GP, dental and screening benefits paid.
You should investigate the value of these benefits, as they will aid in preventing more serious (and costly) conditions developing in years to come!
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.
Protect yourself by joining Zest's GAP/Top-up insurance plan.
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!
What Medical Aid Terms mean?
Your very first step is to understand what the various medical aid terms mean.This is critical to your understanding of what you are buying.
Because there are so many, here is a separate page listing several of them.
What are the risk and savings of a medical aid?
There are 2 main area of funding in a medical aid.1. Risk pool - Part of your contribution goes into this funding pool.
It is designed to pay claims for all members of that plan and allows for cross-subsidisaton, where members at higher risk of having to claim, are subsidised by those with lower claims risks.
The size of the fund gives an idea of future of claims, allowing the scheme to spread the risk they face, hopefully allowing for lower premiums and making that plan more affordable.
2. Savings pool - A plan with savings fund has up to 25% of the premium paid into this fund, designed to help you pay day-to-day healthcare costs.
These funds are yours to help pay for medical costs.
The scheme will advance you (interest-free) up to a year's worth of these savings at the beginning of each calendar year. You can only use these funds to pay medical costs (not co-payments) and you cannot "top-up" a fund when savings are used up. You can roll over any balance at year-end.
Because it is your money, there is no cross-subsidisation allowed and once your savings are used, you either pay further costs yourself (the self-payment gap), have access to additional benefits or use a threshold benefit, which the more expensive plans have.
This savings can be seen as as "compulsory loan," funded by way of added amounts to the premium!
Should you not need to spend the funds, you have no choice but to pay towards the savings. That is unfair!
There is an innovative scheme that "parks" the savings account until you spend from it.
Only then do you re-pay what you spend - over the next 12-months (interest-free).
Your next and subsequent premiums increase slightly until the loan is paid.This is the only scheme that allows you to control your medical aid premium!
More expensive plans offer a safety net (threshold benefit) which pays further claims, once your savings are used and your claims have added up to a predefined amount.
Plans can pay certain day-to-day costs from the risk portion of a medical aid, thus extending the buying-power of your savings and here is one that pays dental costs from Risk!
Medical Aid vs Health Insurance: The Key Differences
Many consumers confuse medical schemes with health insurance or hospital cash-back plans.While both provide financial support, their regulatory standards and protections are fundamentally different.
| Medical Aid Scheme | Health / Hospital Insurance | |
|---|---|---|
| Governing by | Medical Schemes Act (Regulated by CMS) | Insurance Act (Financial Sector Conduct Authority) |
| Prescribed Minimum Benefits (PMBs) | Mandatory 100% cover for 271 conditions and 25 chronic diseases | Not required to cover PMBs in full |
| Claim Payouts | Settles actual medical and hospital invoices directly | Pays a fixed daily or event-based cash sum regardless of invoice total |
| Underwriting & Refusal | Open schemes cannot refuse cover; subject to standard waiting periods | Can decline cover based on medical history and risk profiling |
Schemes must hold 25% of every member's annual contribution in in a reserve fund.
This creates confidence in a scheme, ensuring that there are always funds for claims.
Common Queries About Medical Aid in South Africa
What does medical aid pay for?Hospitalisation, doctor visits, prescribed medications, dental and optical treatments, preventative disease screenings, chronic illness management and much more.
Is medical aid essential for me?
In South African having, at least, an in-hospital benefit plan is necessary. With such high healthcare costs, a medical aid provides you with important financial protection, especially for older individuals and those with ongoing health concerns.
Can the unemployed secure medical aid?
Yes, provided the premium can be paid. Some schemes offer income-related plans for individuals with lower or no income, offering valuable benefits at an affordable price. Your premium can be paid by another party.
Can I join 2 medical aids at the same time?
No, you can only be a member of 1 medical aid at a time. Medical insurance plans are available for additional benefits, focusing on specific treatments like hospitalisation and dentistry.
Adding loved ones to your medical aid
You can add a partner to your medical aid if you are living together - as if married. This may give you a lower premium than 2 single members. You can add close family members, including stepchildren or adopted children.
Can I get pregnancy benefit if I am pregnant when joining?
No, most medical aids do not offer pregnancy benefits for a new member who is already pregnant. Pregnancy is often considered a preexisting condition and may be excluded from benefits.
Can my ex-spouse stay on my medical aid?
If a court awards medical benefits to your ex-spouse as part of a divorce settlement, you can keep them on your medical scheme. Additionally, if you get married again, your new spouse can also join your medical scheme. Any children, including stepchildren or adopted children who are your dependants, can also be included in your medical aid.
Can I put my mother, father, grandparents, or siblings on my medical aid?
Most medical aid schemes allow you to add close family members to your plan. However, you may need to prove that they are financially dependent on you for their livelihood or provide a court order as guardian.
Eligibility criteria can vary between different schemes.
Can someone use my medical aid?
No that is fraud.
Unlimited Benefits
This means there are no predefined limits on the amount medical aid will pay for specific treatments or services. This allows for unlimited claims (within the rules, limits and benefits), ensuring comprehensive benefits in various medical scenarios.
Co-payments
Even with unlimited benefits, certain costs may remain your responsibility, particularly with expensive procedures. You need to be aware of them. Top-up/Gap plans are highly recommended to help meet these added costs.
Evaluating Risk Factors
Medical aids assess personal and family health history when underwriting applications. While adverse factors don't affect premiums, they may result in waiting periods, so you must be honest with disclosing any health factors you may have.
Choosing the Right Network Plan
Some plans offer guaranteed full in-hospital payment, however they do require you use a network of hospitals and healthcare providers. Use providers outside of the network, you may be liable for extra charges.
Bridging Gaps with Top-Up Plans
Schemes normally pay claims at 100% of medical aid rates, however private providers can charge up to 500% of medical aid rates. A top-up/Gap plan will pay any of these shortfalls for you.
Chronic Illness
A comprehensive plan with good chronic medicines benefits is essential for those with a history of hereditary chronic diseases.
If you have existing or are expecting future health issues that are NOT PMB conditions - a comprehensive plan may be best for you.
bestmedicalaid.co.za can help you identify and join one of the top medical aids in South Africa!
Frequently Asked Questions: What is Medical Aid in South Africa?
What is Medical Aid?
Medical aid in South Africa is a type of insurance plan where you pay a monthly premium and get help with various healthcare benefits. These benefits cover hospitalisation, day-to-day treatments, chronic illness, healthcare and wellness programmes. A medical aid will provide you with the immediate funds to pay for private medical treatment. You are guaranteed admission to private hospitals. No one can be denied membership. There are around 21 medical schemes available and it can be a challenging exercise when investigating plans. It is highly recommended you use a professional medical aid broker to assist you. We will do help you at no additional charge.
How does a medical aid work?
Medical aids are regulated by the Medical Schemes Act and overseen by the Council for Medical Schemes. They are non-profit organizations who pool members' contributions to cover their healthcare expenses. The same premium applies to all members, regardless of age or health. Young and healthy members cross-subsidise the elderly and infirm. Schemes are managed by a board of trustees, elected by members. Understanding how your medical aid plan works will allow you to get the most from your benefits and receive the best care you need when you need it.
What are waiting periods and late joiner penalties?
Waiting periods may apply when joining a medical scheme, as they protect the scheme from adverse selection where someone joins a plan, has expensive treatment and then immediately resigns, leaving the other members having to pay those costs. You may get a 3-month general or 12-month specific conditions waiting period - or both depending upon your health status and prior medical aid membership. It is important to fully understand waiting periods and late joiner penalties and what is required to try reduce or waive them. We will help you with these concerns.
How does a medical scheme pay claims and what are medical aid rates?
Medical schemes pay claims from pooled funds, either covering risk (hospital) or day-to-day expenses. Hospital costs are paid by the scheme, however you may have certain procedure co payments. Out of hospital costs are paid by the plan or from a savings fund or a combination of both. More expensive plans also offer a safety net benefit, should you use your day-to-day funds. Medical aid rates, are negotiated amounts paid to healthcare providers. Private providers charge more than these rates, so it is important you know the extent of your claims payments. Most medical aid plans pay at 100% of the rate, and there are more expensive plans that offer up to 300% of that medical aid rate. A top up plan is recommended to prevent in-hospital claim shortfalls and help with procedure co payments. Understanding these rates and how claims are processed helps you anticipate how future claims will be paid enabling you choose the right plan for your needs.
What are prescribed minimum benefits (PMBs) and preventative care?
All medical aids have to cover certain conditions, treatments and medicines. These are known as Prescribed Minimum Benefits and ensure you have access to essential healthcare services, regardless of your plan. They are complicated to understand and you definitely need the help of a medical aid broker should these become a concern. Preventative care benefits pay for tests, screenings and vaccinations that are done to detect and prevent illnesses.
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You must consult the schemes/company product brochures and rules for comprehensive benefit descriptions.
You must consult the schemes/company product brochures and rules for comprehensive benefit descriptions.
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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?
- ✔ FSCA Registered Financial Services Provider
- ✔ Over a decade of hands-on experience
- ✔ Independent advice across multiple schemes like Discovery, Momentum, Bonitas, Fedhealth, Genesis, CompCare and Medshield.
- ✔ Focused on your long-term outcomes
- ✔ No Broker fee as the medical aid pay us.
Council of Medical Schemes
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