10 Best Hospital Plans in South Africa

The 10 Best Hospital Plans in South Africa revealed.

We tested them side by side and verified their hospital plans.

This is a complete guide to the best hospital plans in South Africa.

In this in-depth guide you’ll learn:

• 👉🏾 What is a hospital plan?
• 👉🏾 What is the difference between a hospital plan and a medical aid?
• 👉🏾 Do you need gap cover if you are on a hospital plan?
• 👉🏾 How much is affordable for a hospital plan?
• 👉🏾 Why do you need a hospital plan in South Africa?

So if you’re ready to go “all in” with the best hospital plans in South Africa, this guide is for you.

Let’s dive right in…

Best Hospital Plans in South Africa (2024)

10 Best Hospital Plans in South Africa Summary

1. Discovery Health – Overall, Best Hospital Plan in South Africa
2. BestMed – One of the Most Popular Independent Medical Schemes
3. Bonitas – South Africa’s Largest Health Insurer
4. Medihelp – Offers Self-Administered Medical Aid Care
5. Momentum Health – Top Third Largest Open Schemes
6. KeyHealth – 24/7 Medical Emergency Assistance
7. Fedhealth – Best Low-Cost Medical Treatment Provider
8. Medshield – Obtained a AA Global Credit Rating
9. Genesis Medical Aid  Scheme – Any South African Citizen Can Join This Medical Aid
10. CompCare – One of South Africa’s Oldest Medical Aid Scheme’s

📌 You might consider Dischem Health Insurance from R206 per month

Overview

📣 A hospital plan helps you pay for medical bills that may arise if you are admitted to the hospital. Your insurance will pay a certain amount towards your admission, stay, doctors’ fees, and other charges.

📣 Some hospital plans provide more benefits and require fewer co-payments, whilst others impose stricter limitations, exclusions, and limits.

📣 It is critical to understand that hospital insurance only covers expenses incurred while in the hospital. Out-of-hospital expenses such as GP visits and acute medications will be your responsibility.

📣 Even if you are not hospitalised, all medical aid plans, including hospital plans, are required under the Medical Schemes Act to offer prescription coverage for a set list of 27 chronic diseases known as Prescribed Minimum Benefits (PMBs).

📣 Except in an emergency, when the hospital will coordinate admittance with your provider, you must obtain pre-authorization from your provider before being admitted to the hospital.

📣 All medical aids can impose a three-month general waiting period during which no claims will be paid, as well as a 12-month exclusion for any pre-existing medical conditions.

📣 There are no waiting periods for accident-related hospitalisation. However, if the start date of the hospitalisation falls within the waiting period and the hospitalisation lasts longer than the waiting period, benefits will not be provided.

Hospital Plan vs Medical Aids

👉🏾 Medical aid cover is significantly more comprehensive than hospital programmes. A hospital plan covers treatment and medical expenses spent while the insured is hospitalised, but a comprehensive medical aid plan covers hospital charges as well as other private medical needs such as specialist consultations, GP visits, and further tests or procedures.

👉🏾 Because a hospital plan is less expensive than full medical aid, it may be a viable option for people with lower incomes or in better health who want access to private healthcare.

👉🏾 Because medical aid hospital plans cover the 27 required minimum benefit chronic diseases, your decision should be influenced by your willingness to self-fund other general out-of-hospital expenses rather than paying the higher monthly premium for comprehensive medical aid.

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Who should consider getting a hospital plan?

✅ If you have no health issues, rarely need to see a doctor, and don’t use chronic medication, you might want to consider a hospital plan.

✅ Another factor that may make a hospital plan the best option is your budget. It doesn’t matter if you have the best medical aid plan if you keep skipping payments because you can’t afford it.

✅ If you do not spend a significant amount of your monthly salary on medical expenses, you may benefit from a less expensive choice. You’ll know you’re protected in an emergency and can still see a doctor if you get sick.

✅ For the reasons outlined above, hospital plans are popular among younger people.

✅ As a senior, you must have some type of medical coverage because the demand for medical treatment increases with age and your ability to earn an income decreases.

✅ Even though a hospital plan would require the retiree to fund a percentage of their annual medical bills, the plan would be available to cover the most expensive medical expenses associated with an in-hospital stay.

✅ You must pay for any out-of-hospital expenditures as a pregnant woman on a hospital plan. However, the hospital visit for labour and any associated fees will be covered. A maternity hospital plan is a low-cost option that covers the majority of the costs associated with childbirth.

✅ If your hospital plan does not cover all of your costs, you may want to look into gap insurance, which pays the difference between medical aid rates and the higher hospital fee. So, gap insurance is something you purchase in addition to your current medical aid or hospital coverage.

⚠️ READ ALSO: Hospital Plans versus Medical Aid Plans

1. Discovery Health

Overview

✅ The core purpose of Discovery Health is to assist its members, and this reality influences every choice. Discovery employs shared values to find a balance between the needs of individual members and the overall needs of the Scheme.

✅ In South Africa, medical costs for Discovery Health Medical Scheme (DHMS or the Scheme) participants are covered by a pooled fund managed with a focus on social solidarity rather than financial gain.

Discovery Health Classic Smart Plan

✅ The Discovery Health Classic Smart Medical Aid Plan is a dependable and comprehensive medical aid plan that provides up to three family members with 24/7 medical emergency assistance and unlimited hospital coverage. The Discovery Health Classic Smart Medical Aid Plan costs R2,627 ZAR per month.

✅ The Discovery Classic Smart plan includes a variety of benefits, like as unlimited hospital coverage, chronic medication coverage, and day-to-day benefits like GP visits and specialist consultations. The Discovery Health Classic Smart includes Gap Coverage as well as 24-hour medical emergency support. Discovery Health has a trust rating of 4.8 on the Trust Index.

Discovery Health Flexicare Healthcare solution (Medical Insurance Product)

• ✅ Discovery Flexicare only covers essential day-to-day medical expenses or the cost of specific medical procedures.

• ✅ Discovery Flexicare gives affordable medical insurance to more South Africans who are looking for cheaper options under R500. The Flexicare starts at R350 per month for a main Member and R469 for Flexicare Plus.

• ✅ Access to emergency medical services through Netcare 911 ambulance services.

• ✅ Transportation to an appropriate state hospital.

2. BestMed

Overview

☑️ With over a million members, BestMed is one of South Africa’s most popular independent medical aid schemes.

☑️ BestMed is committed to remaining a large enough organisation to make a difference in the lives of those they serve, but small enough to know each individual receiving their assistance by name and responsive enough to respond to feedback in order to fine-tune their approach to better serve you now and in the future.

☑️ BestMed is founded on the notion that people’s healthcare needs vary according to demographic criteria such as age, marital status, family size, health status, preferences, and financial means.

BestMed Beat 1

☑️ The Bestmed Beat 1 Medical Aid Plan is a dependable and comprehensive medical aid plan that provides up to three family members with 24/7 medical emergency support and in-hospital operations. Bestmed Beat 1 Medical Aid Plan costs R2,082 ZAR.

☑️ The Bestmed Beat 1 Plan does not include Gap Cover. Bestmed provides medical emergency support 24 hours a day, seven days a week. Bestmed has a trust rating of 3.5 on the Trust Index.

☑️ All planned operations must be pre-approved by members at least fourteen (14) days before the event. In an emergency, however, the member, their authorised representative, or the hospital must notify Bestmed as soon as possible or on the first working day after admission.

☑️ Clinical processes, preferred providers, designated service providers, formularies, funding rules, and the Mediscor Reference Price (MRP) all have the potential to apply.

☑️ If a member chooses not to use a hospital that is part of a hospital network for the Beat Network benefit option, a maximum co-payment of R13,078 will apply.

3. Bonitas

Overview

☑️ Bonitas was founded in 1982, but due to its rapid growth, it has surpassed the prior market leader to become South Africa’s largest health insurance.

☑️ The Bonitas network of 4,500 doctors is dedicated to providing great care at predefined rates to their patients.

☑️ Bonitas offers two distinct solutions to help customers manage and decrease rising healthcare costs: oncology management and hospital and medicine management.

☑️ Several Bonitas plans cover dental and vision care, as well as Lasik eye surgery. Unused funds earn interest the following year and are carried over by each member from year to year.

Bonitas Hospital Standard

☑️ The Bonitas Hospital Standard Medical Aid Plan is a dependable and comprehensive medical aid plan that provides 24-hour emergency medical help as well as international coverage for up to three family members. The Bonitas Hospital Standard Medical Aid Plan costs R2,964 ZAR per month.

☑️ It covers maternity, in- and out-of-hospital care, overseas travel, PMBs, and other services.  The Bonitas Hospital Standard Plan includes Gap Coverage as well as 24-hour medical emergency support. Bonitas Medical Fund has a trust rating of 4.5, according to the Trust Index.

☑️ The Hospital Standard plan covers the 27 Prescribed Minimum Benefits listed in the appropriate formulary.  Your medication must be obtained via Pharmacy Direct, the Bonitas Designated Service Provider. You will be charged for a 40% co-payment if you do not utilise Pharmacy Direct or if you use an off-formulary drug.

4. Medihelp

Overview

✔️ For the past 117 years, Medihelp has been serving the needs of its members. With around 200 000 members, Medihelp remains one of the top five medical aid providers in the business due to their capacity to react to changing needs and evolve their service delivery by utilising cutting-edge technologies.

✔️ Medihelp’s sole objective as a self-administered medical aid is to care for members and meet their healthcare needs.

✔️ They welcome all South Africans, whether you are a student, newly employed and wishing to join a medical aid for the first time, self-employed and looking for a dependable healthcare solution for your employees or providing for a growing family.

Medihelp MedMove!

✔️ The Medihelp MedMove! Medical Aid Plan is a dependable and comprehensive medical aid plan that provides up to three family members with 24/7 medical emergency support and network GP visits.

✔️ The Medihelp MedMove! Medical Aid Plan costs R1,476 ZAR per month. Network GP appointments and follow-ups, pathology and radiology, chronic diseases and medicine, dentistry, optometry, and other services are all included.

✔️ The Medihelp MedMove! Plan does not provide Gap Coverage. Medihelp, on the other hand, provides medical emergency assistance 24 hours a day, seven days a week. Medihelp has a trust rating of 4.2 on the Trust Index.

📣 READ more about the 3 Best Hospital Plans Under R1000 in the Republic of South Africa

5. Momentum Health

Overview

📣 Momentum Health, which is administered by Momentum Medical Scheme Administrators (part of the MMI Group (Pty) Ltd), is a medical scheme that ranks among the top three largest open schemes in South Africa, covering approximately 130 000 households.

📣 With a solvency ratio of more than 31%, the Scheme is very sustainable and well positioned to meet the demands of its members now and in the future.  This optimistic prognosis is confirmed by the Scheme’s AA grade from independent Global Credit grade.

Momentum Custom

👉🏿 The Momentum Custom Medical Aid Plan is a dependable and comprehensive medical aid plan that provides up to 5 Family Members with 24/7 medical emergency support. The Momentum Custom Medical Aid Plan costs R2,149 per month.

👉🏿 It covers chronic illnesses, dentistry, optometry, in-hospital and out-of-hospital consultations, operations, and much more.  The Momentum Custom Plan includes gap coverage as well as 24-hour medical emergency support. Momentum has a trust rating of 4.3 on the Trust Index.

👉🏿 This benefit covers hospitalisation as well as certain specialised procedures/treatments. There is no yearly limit for hospitalisations. Other specialists are covered up to 100% of the Momentum Medical Scheme Rate, whereas associated specialists are fully covered.

6. KeyHealth

Overview

👉🏿 KeyHealth offers inexpensive medical aid and healthcare management services in an open and client-centred environment.

👉🏿 KeyHealth’s high-quality product solutions are well-suited to a wide range of markets. Members can take advantage of KeyHealth’s in-depth understanding of and insight into their members’ demands, which is based on real-time, trustworthy, and accessible health data and lifestyle insights. All members have constant access to KeyHealth.

KeyHealth Essence

👉🏿 The KeyHealth Essence Medical Aid Plan is a dependable and comprehensive medical aid plan that provides up to three family members with 24/7 medical emergency assistance and limitless coverage in private and state hospitals.

👉🏿 The KeyHealth Essence Medical Aid Plan costs R1,990 ZAR per month. It provides limitless coverage in private and public hospitals, organ transplants, cancer, palliative care, and other services.

👉🏿 The KeyHealth Essence Plan includes Gap Coverage as well as 24-hour medical emergency help. KeyHealth has a trust rating of 4.1 on the Trust Index.

👉🏿 The plan also includes the Smart Baby Programme, which gives expectant mothers and fathers with general health and well-being advice and support throughout their pregnancy, ensuring peace of mind.

👉🏿 Exclusions in the plan include hospitalisation coverage for particular operations and waiting periods for new members. Overall, KeyHealth Essence provides complete medical coverage at affordable pricing for individuals and families.

7. Fedhealth

Overview

👉 Fedhealth has been servicing the medical needs of South Africans since its inception in 1936. Much has changed throughout the years, but their dedication to providing low-cost, high-quality medical treatment has not.

👉 Fedhealth continues to operate as a cooperative run by and for its members, and as such is always looking for new ways to meet its members’ health-care requirements in an ever-changing world.

👉 Fedhealth places a premium on customization, so as a member, you may have a say in the type of healthcare coverage you receive. Fedhealth, as a membership association, prioritises its members’ needs.

👉 Because of the Scheme’s strong financial position, it has been able to keep its AA- Global Credit Rating for the past 14 years while also providing for its members in times of need by setting aside more than the statutory 25% reserve.

Fedhealth FlexiFED Savvy

👉 The Fedhealth FlexiFED Savvy Medical Aid Plan is a dependable and comprehensive medical aid plan that provides 24-hour medical emergency help as well as cost-effective chronic benefit coverage for up to three family members. The Fedhealth FlexiFED Savvy Medical Aid Plan costs R965 ZAR per month.

👉 Fedhealth FlexiFED Savvy is a comprehensive medical assistance plan that provides its members with a variety of perks and features.

👉 This plan’s benefits include adjustable alternatives to fit diverse budgets and healthcare demands, no total yearly limit, and a choice of hospital networks. Chronic ailments, day-to-day medical expenses, and emergency medical treatment are also covered under the plan.

👉 The plan’s disadvantages include the likelihood of increased out-of-pocket costs, limited coverage for certain medical procedures and treatments, and a waiting time for some benefits.

👉 Overall, Fedhealth FlexiFED Savvy is a versatile and comprehensive medical aid plan that can give members with financial stability and peace of mind in the event of unforeseen medical bills.

8. Medshield

Overview

✅ Medshield is a healthcare fund in which all members contribute monthly to cover medical expenses should the need arise.

✅ Medshield has been in business since 1968, making them one of South Africa’s most experienced, competent, and dependable medical aid schemes.

✅ Each of Medshield’s options provides reasonably priced benefits. The scheme is constantly reviewing and improving the range of benefits in each option in order to deliver you what you actually need – quality healthcare at an affordable price and a variety of plans that meet your personal, individual needs.

✅ For the 12th year in a row, Medshield obtained the prestigious AA- with a stable outlook Global Credit Rating for their capacity to pay their members’ claims.

Medshield MediCore

✅ The Medshield MediCore Medical Aid Plan is a reliable and comprehensive medical aid plan that provides up to three family members with 24/7 medical emergency assistance and comprehensive hospital coverage. The Medshield MediCore Medical Aid Plan costs R3,474 ZAR per month.

✅ The Medshield MediCore Plan is a comprehensive in-hospital coverage that provides up to 200% extended benefits on specific treatments, oxygen therapy, alternative and allied healthcare services, GP and specialist consults, and more.

✅ The plan has various benefits, including great in-hospital coverage, access to a large choice of medical services, and the ability to choose between healthcare providers. Furthermore, it gives individuals who require extensive medical treatment peace of mind.

✅ However, there are some disadvantages to the plan that prospective policyholders should be aware of. One of the biggest disadvantages is that it does not provide any out-of-hospital benefits, which means that individuals must pay for day-to-day medical treatment and services out of pocket.

⚠️ READ more about the 5 Best Hospital Plans with Savings Accounts

9. Genesis Medical Aid Scheme

Overview

☑️ Genesis has been delivering great value-for-money medical aid cover and peace of mind as a premier medical scheme in South Africa since 1995.

☑️ Genesis membership is open to everyone who is a South African citizen or who is permanently residing in South Africa.

☑️ Foreign students who desire to study in South Africa and wish to apply for membership in order to obtain a visa are not eligible for Scheme membership.

☑️ Genesis, like all medical aid schemes, is owned by all of its members. Members elect Trustees to represent them. The Trustees serve as the Scheme’s management body and are elected to work in the best interests of all members.

☑️ Every medical scheme has a fund that is utilised to pay claims. The ability of a scheme to maintain that pool of funds at a level sufficient for its members’ claims is critical to the success of any plan, as mandated under the Medical Schemes Act.

Genesis Med 100

☑️ The Genesis Med-100 plan is a reliable and complete medical aid plan that provides up to three family members with 24/7 medical emergency support and in-hospital operations. The Genesis Med-100 Medical Aid Plan costs R1,530 ZAR per month.

☑️ Genesis Medical Scheme’s Med-100 is a comprehensive medical aid plan. The plan covers in-hospital treatment in full, including specialists and doctors, with no co-payments necessary.

☑️ Members also receive out-of-hospital benefits such as chronic pharmaceutical coverage, basic dental, and maternity care. The strategy, however, has several flaws. For example, certain out-of-hospital cancer benefits are only available in public/state hospitals, which may disadvantage people who prefer private healthcare.

☑️ Furthermore, the plan imposes waiting periods at the Scheme’s discretion, which may be inconvenient for some members.

☑️ Overall, MED-100 is a comprehensive plan that provides excellent in-hospital and out-of-hospital benefits. Potential members should, however, carefully analyse its limitations and restrictions before joining.

10. SureMed Health Medical Aid

Overview

✔️ Suremed Health is financially sound, with reserves far exceeding the required 25% of yearly contributions. It also boasts one of South Africa’s longest track records, having been created in August 1976.

✔️ Suremed Health focuses on offering its members a a comprehensive selection of medical aid solutions to ensure that you obtain the most appropriate and cost-effective medical care for your specific situation.

Suremed Health Shuttle

✔️ The Suremed Health Shuttle Medical Aid Plan is a dependable and comprehensive medical aid plan that provides 24-hour medical emergency help as well as improved major medical benefits to up to three family members. Suremed Health Shuttle Medical Aid Plan is priced at R1,150 – R2,465 ZAR.

✔️ Suremed Health’s Shuttle Plan is a medical aid plan that covers members for in-hospital treatment, chronic medicine, day-to-day medical expenses, and preventative care.

✔️ The plan includes a number of features and benefits designed to make healthcare more inexpensive and accessible to members.  One of the Shuttle Plan’s primary benefits is that it covers a wide range of medical expenses for participants.

✔️ Members get access to in-hospital treatment coverage, which includes lodging, theatre expenses, and medicines.  Some plans also provide coverage for chronic medications, day-to-day medical expenses, and preventative care.

✔️ The Shuttle Plan is intended to serve a diverse variety of individuals and families with varying incomes and healthcare demands.

Frequently Asked Questions

How should I choose a hospital plan?

There are some steps to take before choosing a hospital plan, which include:

• 👉🏾 Check your health needs
• 👉🏾 Assess your finances
• 👉🏾 Check the scheme’s payment record
• 👉🏾 Check the scheme’s solvency ratio
• 👉🏾 Scrutinise the benefits

Should I take out a hospital plan or a medical aid?

📣 A hospital plan covers treatment and medical expenditures incurred while the insured is in the hospital, but a comprehensive medical aid plan covers hospital charges as well as other private medical needs such as specialist consultations, GP visits, and further tests or procedures.

Do hospital plans cover surgery?

📣 A hospital plan will cover any medical operations conducted in a private hospital, such as if you are in an accident and require an emergency surgery.

Is there a waiting period for a hospital plan?

✅ Yes, each hospital plan will have its own waiting period

Do hospital plans have co-payments?

✅ Some hospital plans provide more benefits and require fewer co-payments, whilst others impose stricter limitations, exclusions, and limits.

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