Medshield MediCore Medical Aid Plan (🇿🇦 2026)

  Overall, the Medshield MediCore Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and comprehensive hospital cover to up to 3 Family Members. The Medshield MediCore Medical Aid Plan starts from R4 278 ZAR.    

Medshield MediCore - 9 Key Point Quick Overview

1. ☑️ Medshield MediCore Plan Overview
2. ☑️ Medshield MediCore Plan Contributions
3. ☑️ Medshield MediCore Plan Benefits and Cover Comprehensive Breakdown
4. ☑️ Medshield MOM Program and Benefits
5. ☑️ MediCore SmartCare Services and Benefits
6. ☑️ MediCore Plan Exclusions and Waiting Periods
7. ☑️ Medshield MediCore Plan vs. Similar Plans from other Medical Schemes
8. ☑️ Our Verdict on The MediCore Plan
9. ☑️ MediCore Plan Frequently Asked Questions

Medshield MediCore Plan Overview

The Medshield MediCore medical aid plan is one of 10, starting from R4 278, and includes comprehensive hospital cover, Virtual GP consultations, SmartCare benefits, a Medshield Mom maternity program, chronic medicine, ambulance services, and more.   Gap Cover is not available on the Medshield MediCore Plan. However, Medshield offers 24/7 medical emergency assistance. According to the Trust Index, Medshield has a trust rating of 2.4 from hellopeter.   💙 MedShield has the following medical aid plans to offer:  

• ✅ MedShield MediCurve
• ✅ MedShield PremiumPlus
• ✅ MedShield MediValue Prime
• ✅ MedShield Value Compact
• ✅ MedShield MediSaver
• ✅ MedShield MediPlus Prime
• ✅ MedShield MediPlus Compact
• ✅ MedShield MediPhila
• ✅ MedShield MediCore
• ✅ MedShield MediBonus

Medshield MediCore Plan Contributions

 

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MediCore Plan Benefits and Cover Comprehensive Breakdown

MediCore Hospital-At-Home

• ✅ Medshield offers a Hospital-at-Home service delivered by Quro Medical.
• ✅ The Hospital-at-Home service offers an alternative to hospitals as the center of patient care and management.
• ✅ Hospital-at-Home provides active treatment at home instead of a general hospital ward for a specified period without compromising the quality of care.
• ✅ Patients more vulnerable to hospital-acquired infections and developing new health complications may benefit from care at home.
• ✅ Patients who usually need admission to a general hospital ward are eligible for Hospital-at-Home.
• ✅ Quro Medical works with each patient and their treating doctor to develop a personalized treatment plan to deliver at home.
• ✅ Treatment plans are amended accordingly if a patient’s medical needs change during treatment.
• ✅ The clinical team at Quro Medical arranges routine home visits customized to the individual’s specific needs that may occur daily or more frequently to provide the necessary treatment and care.
• ✅ Other channels allow patients to access advice and support outside of home visits.

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MediCore Major Medical Benefits In-Hospital

 

MediCore Oncology Benefits

 

MediCore Chronic Medicine Benefits

 

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MediCore Chronic Disease List

1. Addison’s disease
2. Asthma
3. Bi-Polar Mood Disorder
4. Bronchiectasis
5. Cardiac failure
6. Cardiomyopathy
7. Chronic renal disease
8. Chronic obstructive pulmonary disease
9. Coronary artery disease
10. Crohn’s disease
11. Diabetes insipidus
12. Diabetes mellitus type 1
13. Diabetes mellitus type 2
14. Dysrhythmias
15. Epilepsy
16. Glaucoma
17. Hemophilia
18. Hyperlipidemia
19. Hypertension
20. Hypothyroidism
21. Multiple sclerosis
22. Parkinson’s disease
23. Rheumatoid arthritis
24. Schizophrenia
25. Systemic lupus erythematosus
26. Ulcerative colitis
27. Depression

MediCore Dentistry Benefits

 

MediCore Maternity Benefits

• ✅There will be benefits during pregnancy, after birth, and following delivery. However, pre-authorization with the applicable Managed Healthcare Program is required before hospital admission.
• ✅Unless otherwise specified, benefits are allocated for each pregnancy subject to the Total Yearly Limit.
• ✅A complimentary baby bag from Medshield can be obtained during the third trimester.

   

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Medshield MOM Program and Benefits

To support women on their journey to motherhood, Medshield MOM has launched a dedicated website that provides information and resources for all stages of pregnancy, birth, and postpartum.   This website is an easily accessible hub of valuable health, fitness, nutrition, motherhood, babies, toddlers, and more content tailored to the pre-and post-partum phases.         As a Medshield member, you can take advantage of the pregnancy-related benefits. The Medshield MOM website will ensure you are fully informed of your options.   Some of the features and advantages include, but are not limited to, the following:  

• ✅ A guide for your journey from start to finish.
• ✅ Convenient, dependable, and easily accessible pregnancy resources.
• ✅ A toddler benefit includes information on child immunization, child nutrition, a nurse helpline available 24/7, and digital/online kid yoga.
• ✅ Advice formulated by professionals.
• ✅ Reminders through email to arrange doctor’s appointments, request hospital pre-authorizations, etc.
• ✅ Emails containing updates on your unborn child’s growth and development.
• ✅ Mothers can register and enter the specific week of their pregnancy journey. Then, they will begin getting content based on that time and continuing ahead.
• ✅ The Medshield MOM bags are made locally utilizing recyclable, eco-friendly materials. These distinctive bags are filled with excellent Bennetts products for your child.

MediCore SmartCare Services and Benefits

SmartCare gives access to Videomed and telephone plus video consultations through a select group of healthcare professionals. SmartCare is a developing healthcare benefit aiming to provide members with convenient care access.   SmartCare services include the following:

• ✅ Acute Consultations – Infections of the chest and upper respiratory tract, urinary tract, eyes, ears, etc.
• ✅ Chronic Consultations – Medication and refills for hypertension, diabetes, excessive cholesterol, etc. Then, members are advised to utilize the Medshield Chronic Medication Courier Service DSP to have their chronic medication delivered directly to their home or place of business.

MediCore Day-to-Day Benefits

 

MediCore Wellness Benefits

Medshield’s Wellness Benefit program empowers members to proactively manage their health by undergoing preventative tests and procedures. The company strongly advises its members to schedule the necessary tests at least once per year.   Medshield members must use pharmacies included in their benefit options’ Pharmacy Network to access the Wellness Benefits. Members must note that benefits are subject to the Overall Annual Limit.   Once that limit has been reached, the benefits will be subject to the Day-to-Day limit. However, consultations for specific services are excluded from these limits.    

Wellness Benefits – Child Immunisations

This benefit and immunization program as per the Department of Health Protocols according to these age groups:    

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MediCore Ambulance and Emergency Services

A 24-hour Hotline will be available to members and their registered dependents. In addition, members can dial 086 100 6337 to reach the Ambulance and Emergency Services, provider.    

MediCore Prescribed Minimum Benefits

Medshield members are entitled to cover Prescribed Minimum Benefits (PMBs), regardless of their chosen benefit option.   Medshield assumes the cost of PMB treatments if they are provided by one of Medshield’s Designated Service Providers (DSPs) in compliance with the Scheme Rules.  The Medical Schemes Act 131 of 1998 mandates that all medical plans must cover the costs associated with the following:  

• ✅ Any potentially fatal medical emergency
• ✅ A set of 26 Chronic Disease List (CDL) diseases that are well-defined
• ✅ 271 DTP PMB diagnoses.

   

MediCore COVID-19 Benefits and Access to Care

COVID-19 PCR Test or Antigen Tests - Features and Conditions

• ✅ The First COVID PCR or antigen test is covered in the Overall Annual Limit (OAL).
• ✅ Depending on the option, the Second and subsequent tests are covered by daily limits or a medical savings plan. If these benefits are not available, members must pay for the tests.
• ✅ The second and subsequent positive PCR or Antigen tests are covered first from Day-to-Day benefits or Savings and then from OAL if PMB applies.
• ✅ Risk will reimburse the pathology test as a PMB after emailing the positive results to Medshield. Risk
• ✅ Benefits require a PMB Application form, and Clinical Protocols apply.
• ✅ Travel and non-symptomatic COVID-19 tests are excluded from this benefit.
• ✅ Scheme risk gives members the Day-to-Day restriction. Therefore, PMB COVID-19 treatment will pay from a Day-to-Day benefit until it is gone and then from Risk (OAL).

MediCore Plan Exclusions and Waiting Periods

MediCore Exclusions

MediCore does not cover the following:  

• ⛔ Surgical periodontics, which includes gingivectomies, periodontal flap surgery, tissue grafting, and aesthetic tooth hemisection
• ⛔ Perio chip positioning
• ⛔ Exclusions established by the Schemes Dental Management Program Lucentis, Eylea, and Ozurdex for the treatment of Vitreoretinal diseases are not excluded unless otherwise specified in Annexure B (DSP applies)
• ⛔ Trastuzumab for the treatment of HER2-positive early breast cancer more than the dose and duration of the ICON protocol’s 9-week regimen (unless PMB level of care, DSP applies)
• ⛔ Trastuzumab for the treatment of metastatic breast cancer (unless PMB level of care or included in the ICON protocol applicable to the member’s option, DSP applies)
• ⛔ Medications that are not included in a prescription from a medical practitioner or other Healthcare Professional who is legally authorized to prescribe such medicines (save for scheduled medications)
• ⛔ Tonics, evening primrose oil, fish liver oils, multi-vitamin preparations or trace elements or mineral combinations, unless pre-authorized by the relevant Managed Healthcare Programme; Smoking cessation and anti-smoking preparations, unless pre-authorized by the relevant Managed Healthcare Program
• ⛔ Epilation - hair removal treatment (excluding Ophthalmology)
• ⛔ Hyperbaric oxygen therapy, except for life-threatening anaerobic infections, Diagnostic Treatment Pairs (DTP), and certain conditions pre-authorized by the applicable Managed Healthcare Programme and at a specific DSP
• ⛔ Conservative back and neck treatment; healthcare procedures (including scans and scopes) that should be performed outside of the hospital and do not require hospitalization

MediCore Waiting Periods

Often, there is a waiting period for pre-existing conditions. This is to prevent new members from abusing medical insurance for a short period to finance pricey procedures and then canceling their membership shortly after.   💙 According to the Medical Schemes Act No. 131 of 1998, the following waiting periods may apply:

• ✅ A 3 (three) 3-month general waiting time for all benefits.
• ✅ A maximum 12 (twelve) month exclusion for a previous ailment.
• ✅ A late joiner contribution penalty.

MediCore Plan vs. Similar Plans from Other Medical Schemes

   

Our Verdict on The MediCore Plan

The Medshield MediCore Plan is a comprehensive in-hospital cover that offers extended benefits of up to 200% on certain treatments, oxygen therapy, alternative and allied healthcare services, GP, specialist consults, and more.   The plan has several advantages, including excellent in-hospital cover, access to a wide range of medical services, and the flexibility to choose between healthcare providers. Moreover, it provides peace of mind for individuals requiring extensive medical treatment. However, the plan also has some drawbacks that potential policyholders should be aware of.   One of the main drawbacks is that it does not offer any out-of-hospital benefits, meaning that individuals must pay out-of-pocket expenses for day-to-day medical treatment and services.   Additionally, the plan has strict conditions on treatments in-hospital, which may limit the treatment options available to policyholders. Furthermore, another drawback is that the plan does not offer a medical savings account, which can be helpful for individuals who want to manage their healthcare expenses.   Overall, the Medshield MediCore Plan can be an excellent option for individuals seeking comprehensive in-hospital cover. However, potential policyholders should carefully consider the advantages and drawbacks of the plan before deciding.   Additionally, individuals who require extensive out-of-hospital medical treatment may need to consider alternative healthcare plans that offer broader coverage.   💙 You might also like the Best Medical Aids under R1000

MediCore Plan Frequently Asked Questions

What is the Medshield MediCore Plan?

The Medshield MediCore Plan is a comprehensive medical cover that provides in-hospital cover, extended benefits cover, and access to various medical services.  

What does the Medshield MediCore Plan cover?

The MediCore Plan covers in-hospital treatments, extended benefits cover specific treatments, oxygen therapy, alternative and allied healthcare services, GP and Specialist consults, and more.  

What are the advantages of the Medshield MediCore Plan?

The advantages of the MediCore Plan include excellent in-hospital cover, access to a wide range of medical services, and the flexibility to choose healthcare providers.  

What are the drawbacks of the Medshield MediCore Plan?

The drawbacks of the MediCore Plan include no out-of-hospital benefits, out-of-pocket expenses for day-to-day medical treatment and services, strict conditions on treatments in-hospital, and no medical savings account.  

Can I choose my healthcare provider under the MediCore Plan?

Yes, you can choose your healthcare provider under the MediCore Plan.  

Is there a waiting period for the MediCore Plan?

Yes, there is a waiting period of up to 3 months for specific treatments under the MediCore Plan.  

Are pre-existing conditions covered under the MediCore Plan?

Pre-existing conditions are not covered under the MediCore Plan for the first 12 months of membership.  

Is emergency medical treatment covered under the MediCore Plan?

Emergency medical treatment is covered under the MediCore Plan, subject to the terms and conditions of the policy.  

Can I add family members to my MediCore Plan?

Yes, you can add family members to your MediCore Plan at an additional cost.  

Can I upgrade or downgrade my MediCore Plan?

Yes, you can upgrade or downgrade your MediCore Plan at any time, subject to the terms and conditions of the policy.  

Are alternative and allied healthcare services covered under the MediCore Plan?

Yes, alternative and allied healthcare services are covered under the MediCore Plan, subject to the terms and conditions of the policy.  

Can I use my MediCore Plan for out-of-country medical treatment?

No, the MediCore Plan does not cover medical treatment outside South Africa.  

Does the MediCore Plan cover dental treatment?

Yes, MediCore offers basic dentistry but only in-hospital for beneficiaries <6 years and only for extensive dentistry.  

Is maternity cover included in the MediCore Plan?

Maternity cover is included in the MediCore Plan, subject to the terms and conditions of the policy.  

How do I claim the MediCore Plan?

You can claim the MediCore Plan by submitting a claim form and supporting documents to Medshield. The claim will be assessed and paid out subject to the terms and conditions of the policy.