Here are 9 compelling reasons for joining a Medical Aid in South Africa!
Poor public healthcare and the need to go for private care, is the main reason you need reliable and affordable medical aid!Government hospitals are not an option for healthcare treatment.
But, private healthcare is expensive. Receiving care in a private hospital if you’re ill or in an accident can end up costing hundreds of thousands of rand.
To pay for private care, you have no choice but to join a medical aid!
Private hospitals provide higher standards of care and equipment for advanced diagnostic and other technologies.
Nursing and medical professionals are generally better qualified and command higher salaries. This results in high costs for hospitalisation or care for serious injuries, surgery, or chronic illnesses. Costs you must meet for speedy recovery from illness or injury!
It costs over R 8,500 per night for a premature baby's neonatal stay (and some stay for 5 months) - bed only - no consultations, medicine or medical supplies!
The cost of living in South Africa continues to rise, but medical bills are increasing at an even faster rate!
If you do not “insure” your health, you may never be able to pay for the costs of serious hospitalisation or illness.
And that is what a medical scheme will for you!
1. Immediate access to treatment.
Accidents and illnesses are unpredictable and you cannot plan for them.You have to have a way of accessing immediate funds when they strike. You do not know what your health may be like tomorrow!
A medical aid will allow you to immediately afford the best, private treatment you can, without having to experience long, life-threatening delays.
The "golden hour" for life-saving intervention is not a myth!Most private hospitals will not even admit a patient without medical aid.
(Patients without medical aid will be stabilised and treated at a private hospital, until a room can be found in a public hospital. There is also a divert arrangement, where patients are treated in a private facility, if there is no room available at a public facility - HASA report 2010 - presumably only in emergencies.)
You also need to be able to get medication quickly. The sooner a serious ailment is properly treated - the quicker your recovery!
And that medication can be expensive, as generic medicines are not the best when it comes to treating serious concerns.
2. With most plans, you can choose which private providers you want to use.
You can choose a convenient private hospital when you need one.You have no choice with a government or state care and often providers are far from home - an inconvenience for you and your family. You really do not want to be in hospital alone and far from family and friends!
The government ambulance services are slow compared to private services and this can mean the difference between life and death.
In addition, if you need medical help in a remote area, a private service will get you to a hospital way more quickly than the state.
3. Private care
The cost of private hospitalisation can very quickly escalate to several hundred thousand rand. Just using an ambulance can be expensive, as every single swab, suture and disposable item that is used must be paid for.Imagine what 2 weeks in ICU and a month in High Care could cost you!
Unless you are super-rich or have a huge amount of money saved - that you can use on medical costs - you are going to place your recovery and health at risk. Do you really want that?
For a reasonable monthly contribution, you can have immediate access to unlimited hospital benefits!
Medical aid gives you the ability to choose a convenient hospital when you need one - the best of private facilities, the best doctors, nurses, overall medical care and support that money can buy!
4. Chronic care
Chronic conditions such as asthma, cardiac failure, epilepsy, diabetes or rheumatoid arthritis and then the cost of medicines, treatment and related complications can be a crippling, long-term expense.
Medical aids must pay full costs of the diagnosis, treatment and care of certain conditions as well as medicines for chronic illnesses, included in a much longer list of prescribed minimum benefits.
This happens even with a hospital only benefit plan!
5. Dread diseases
The number of dread diseases, like cardiovascular disease, obesity, diabetes, certain cancers and now ... dementia, is increasing at an alarming rate.As a result of today's lifestyles, conditions like type 2 diabetes, hypertension, heart disease and stroke rates are increasingly affecting younger people.
Modern treatment techniques and drugs are so expensive that many without a medical aid, cannot access them. And that has a poor result for recovery. Lying in a hospital ward, trying to recover from a dread disease, is not the time to realise how important the right medical aid really is!
A medical aid will provide you with access to the best treatment, allowing you to recover or control your condition.
6. Screening and Preventative Health benefits
A healthy lifestyle is an attainable goal for most people. And joining a medical aid is the first step on that path, because it helps pay for essential check-ups and routine visits to doctors.It offers cover for tests that are vital for early detection of illness and disease and in getting treatment as soon as possible! If you identify concerns early, the prognosis of a full recovery is multiplied many times over!
Most medical aids offer test for blood glucose, blood pressure, cholesterol, body mass index and HIV screening. Cover is also offered for mammograms, Pap smears, prostate screening and more.
7. Access to extended lifestyle benefits such as gym membership discounts.
Most schemes offer some sort of wellness and rewards programme.This is done to incentivise members to get and stay healthy. It also helps reduces claims on the scheme.
If you understand how best to use these incentives and use these programmes, you can gain significant rewards.
8. Peace of mind
Knowing that you and your family can afford to get the best private care, the minute you need it, gives huge peace of mind.South Africa is sadly a violent country and events like a car accidents, crime or sport-related incidents can happen to anyone at any age.
9. Young and older members
A medical scheme relies on cross subsidisation to be affordable. The younger, more healthy members, help pay the greater costs of the older member - and remember that one day you too will be older and have more need for medical aid benefits!Medical cover is the most important safety net you can buy for yourself and your family.
Consider your health as an investment, for without it you will not be able to earn a living!
You should, at least, have a Private Hospital and Essential Dental benefit plan
Is Fedhealth the Best Medical Aid?
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!
All these points are equally true for a small business owner because, along with hard work, comes the risk to your health, causing stress-induced illnesses such as ulcers and migraines.
If you are forced to take sick leave (and that could be for some time) how will your business survive? Who will look after it the way you do?
Joining a healthcare plan is one of the most important investments you will ever make as a small business owner, because it will allow you to access the best care.... fast. And that can substantially speed up your recovery, so your business will not suffer and affect other people as well. By keeping yourself healthy, you will eliminate business problems too!
The importance of belonging to a medical aid cannot be underestimated!
The Need to Join a medical plan must be your priority!
You insure your car, house and other personal things - Don't ignore your health costs!
They can be way more expensive than a damaged vehicle!
There are a wide variety of plans to choose from and you can be assured, that together, we will discover one that suits your needs and budget!
Frequently Asked Questions: Why You need Medical Aid
1. Why do I need medical aid?
Poor public healthcare and high costs of private care in South Africa means you must look at joining a medical aid. If you are not a member, getting immediate and quality treatment will be very difficult, risking your health and finances.
How does medical aid provide you with immediate access to treatment?
As a member of a medical aid you are assured of immediate funds to pay for private treatment, so important in case of accidents or serious illnesses. Private hospitals give priority to patients with medical aid, resulting in faster access to care and medication and a much improved recovery.
Why do you need to use private providers with medical aid?
As a medical aid member, you can use private hospitals and other healthcare providers. That compared to government services, gives you quicker ambulance response and access to healthcare providers who are close to your home and family. If you need medical help in a remote area, a private service will get you to a hospital way more quickly than the state.
How does medical aid assist with chronic conditions?
Chronic illness means high, long-term costs. Medical aids pay for the diagnosis, treatment, and medication of these conditions, so you do not suffer financially. You are ensured of getting comprehensive care for conditions like asthma or diabetes.
What about dread diseases and preventative care?
The number of dread diseases, like cardiovascular disease, obesity, diabetes, certain cancers and now ... dementia, is increasing at an alarming rate
A medical aid will provide you with access to the best treatment, allowing you to recover or control your condition. A healthy lifestyle is a goal for most people. And joining a medical aid is the first step on that path, because it helps pay for essential check-ups and routine visits to doctors. It offers cover for tests that are vital for early detection of illness and disease and in getting treatment as soon as possible!
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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.
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Over 30 ears of experience in financial services - Fully Licensed and Accredited for medical aid and other Personalised financial advice.
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Last verified: December 14, 2025