Overall, the Medihelp MedReach Medical Aid Plan is a trustworthy and comprehensive medical aid plan well suited for employees of corporate companies offering 24/7 medical emergency assistance and care extender benefits. The Medihelp MedReach Medical Aid Plan starts from R3 360.
| 👤 Main Member Contribution | R3,360 |
| 👥 Adult Dependent Contribution | R2,634 |
| 🍼 Child Dependent Contribution | R1,092 |
| 📉 Annual Limit | Unlimited Hospital Cover |
| 🏥 Hospital Cover | Unlimited |
| 🏠 Home Care | ☑️ Yes |
| 💶 Prescribed Minimum Benefits | ☑️ Yes |
| 💻 Screening and Prevention | ☑️ Yes |
| 💳 Medical Savings Account | None |
| 🦷 Advanced Dentistry | ☑️ Yes |
The Medihelp MedReach medical aid plan is one of 11, starting from R3 360. It includes cover for several day-to-day benefits for the entire family, care extender benefits, optometry, dentistry, and more. Gap Cover is not available on the Medihelp MedReach Plan.
However, Medihelp offers 24/7 medical emergency assistance. According to the Trust Index, Medihelp has a trust rating of 4.2.
💙 MediHelp has the following 11 plans to choose from:
| 👤 Main Member | 👥 +1 Adult Dependent | 💙 +1 Child Dependent |
| R3,360 | R2,634 | R1,092 |
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Paid up to 100% of the Medihelp Tariff (MT). The following are available for day-to-day medical expenses:
The following is paid from day-to-day benefits:
Acute and non-PMB chronic medicine (prescribed or issued by a network Doctor and obtained from a network pharmacy). 20% co-payment if not purchased from a network pharmacy or prescribed by a network physician.
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| 💊 Self-Medication (non-prescribed medicine) | Covered up to 100% of the MT. Subject to the annual day-to-day benefit with the following limits: Main Member – R525 per year Family R2,100 per year |
| 💉 PMB Chronic Medicine | Pre-approval and registration on Medihelp’s PMB drug management program are required. Covered up to 100% of the MHRP. The unlimited cover is provided. There is a 30% co-payment if services are obtained from a non-network pharmacy or dispensing GP. |
| Consultations and follow-up Consultations | Covered 100% of the MT, following limits apply: M = R2 400 per year M+1 = R4 450 per year M+2+= R5 150 per year Subject to overall annual limit, shared with benefit for clinical psychology. GP network and specialist referral by network GP apply. |
| 👨⚕️ Out-of-Network GP Consultations Consultations, follow-ups, and emergency unit visits Surgery and anesthesia Material and discretionary medicine used during service, except vaccines/medicine for chronic conditions and immunizations. | Out-of-network GP consultations 80% of the MT, following limits: M = R1 470 per year M+ = R2 940 per year Subject to overall annual limit. GP network and specialist referral by network GP apply. |
| 🚑 Other Medical Services in and Out-of-Hospital: – Occupational Therapy | Occupational therapy shared with benefit for physiotherapy in and out of hospital, and a referral from a network GP applies. |
| 🔁 Care Extender: Additional GP Consultation | One additional GP consultation is activated for the family per year once a beneficiary claims for a Pap smear, mammogram, prostate test, faecal occult blood test (FOBT) or bone mineral density test |
| ➡️ Care Extender: R1000 for Self-Medication (Network Pharmacy) | Additional R1000 will be activated for the family to use for non-prescribed medicine once a beneficiary claims for the combo health screening. |
| 🔎 Oxygen – In and out of hospital | Covered up to 100% of the MT (Medihelp tariff). Unlimited cover. A 35% co-payment applies if not authorized. Benefits for oxygen out of hospital are subject to pre-authorisation, clinical protocols, and a prescription by medical doctor. |
| 🤓 Optometry | Subject to pre-authorization by a PPN (Preferred Provider Negotiators). Services must be via a PPN provider. There is a limit of 1 composite consultation, including refraction test, tonometry, and visual field test per 2-year cycle. Covered up to 100% of the MT. Eye examination at a non-network optometrist limited to R420 per beneficiary per 24-month cycle. |
| 👓 Spectacles or Contact Lenses | Spectacles: – Frames and/or lens enhancements (at a PPN network optometrist) – R655 per beneficiary per 24-month cycle. – Frames and/or lens enhancements (at a non-network optometrist) – R490 per beneficiary per 24-month cycle. – Lenses at a PPN network optometrist One pair of standard clear lenses – Single vision or bifocal lenses (multifocal lenses paid at the cost of bifocal lenses) per beneficiary per 24-month cycle. – Lenses at a non-network optometrist One pair of standard clear lenses – R225 for single vision lenses R480 for multifocal/bifocal lenses per beneficiary per 24-month cycle. – Contact lenses – R865 per beneficiary per 24-month cycle. |
| 🦷 Conservative Dental Services | Benefits are subject to Dental Risk Company (DRC) protocols, contracted to Medihelp as a DSP. Benefits are subject to protocols and are limited to certain item codes. |
| 🪥 Dentistry: Routine Check-ups | One in 365 days per beneficiary from date of service |
| 😊 Oral Hygiene | – Scale and Polish Treatments 12 years: One in 365 days from date of service (<12 years – item code 8155 and >12 years – item code 8159) |
| 📌 Dentistry: Fillings | Four fillings per beneficiary, one filling per tooth in 12 months from date of service for resin restorations in anterior and posterior teeth. |
| 📍 Tooth Extractions and Root Canals on permanent teeth in the Dentist’s chair | Covered up to 100% of the MT. Unlimited Cover. Pre-authorisation is required for more than 4 fillings per year, 2 fillings on front teeth per visit and 4 extractions per visit. Root Canal Treatments: Two per beneficiary per year. |
| 🙂 Laughing Gas (Dentist’s Chair) | Covered up to 100% of the MT. Unlimited Cover. |
| ☑️ Dentistry under conscious sedation (Dentist’s chair) | Removal of impacted teeth (third molars) and extensive dental treatment for children younger than 12 years Covered up to 100% of the MT 35% co-payment for no authorization. |
| 💤 Dentistry under general anesthesia in a day procedure facility, including the removal of impacted teeth | Covered up to 100% of the MT. R2 330 co-payment per admission. 35% co-payment for procedures not performed in a day procedure network. 20% co-payment for no authorization. Includes Extensive dental treatment for children younger than seven years (per beneficiary yearly) |
| ✳️ Special Needs Patients – dentistry under general anesthesia in a day procedure | Covered up to 100% of the MT. Unlimited Cover. 35% co-payment for procedures not performed in a day procedure network. 20% co-payment for no authorization. |
| 🅰️ Plastic Dentures | This plan does not cover this service |
| 🅱️ X-Rays | – Intra-Oral X-Rays: Covered up to 100% of the MT. Limited to 4 per beneficiary yearly. Pre-authorisation for more than six per year. – Extra-Oral X-Rays: Covered up to 100% of the MT. Limited to one per beneficiary per year every three years. |
| 🔁 Specialized Dentistry | Covered up to 100% of the MT. Subject to DRC protocols and pre-authorisation. |
| 😊 Maxillofacial Surgery and Oral Pathology | Only PMBs are covered. Subject to pre-approval by Medihelp and the necessary clinical protocols. |
| 🦵 External Prostheses and Medical Appliances Services in and out of the hospital, including fitting, cost of repairs, maintenance, spares, accessories, and adjustments on the following: – Wheelchairs – Medical Appliances – Glucometers every 5 years. | 100% of the cost PMB only |
| 🦾 External Prostheses and Medical Appliances – Stoma Components/Incontinence Products or Supplies | 100% of the cost PMB only |
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| 💊 Chronic Illness and PMB | Diagnosis, treatment, and care costs of 271 PMB and 26 chronic conditions on the CDL DSPs and specialist network apply |
| ⚠️ Trauma Benefits This applies to major trauma requiring hospitalization, for example: Motor Vehicle Accidents Stab Wounds Gunshot Wounds Head Trauma Burns Near-drowning | Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff. |
| 😷 Post-Exposure Prophylaxis (HIV/AIDS) | Subject to authorization, PMB protocols, and case management. Covered up to 100% of the cost or the contracted tariff. |
| 🚑 Emergency Transport Services via Netcare 911 In the Beneficiary’s Country of Residence (RSA, Lesotho, Eswatini, Mozambique, Namibia, Zimbabwe, Botswana), including road and air transport. | Unlimited Cover. Covered up to 100% of the MT. |
| 🏥 Emergency Transport Services via Netcare 911 Outside the beneficiary’s Country of Residence | Road Transport: Covered up to 100% of the MT. If not pre-approved, a 50% co-payment applies. Limited to R2,600 per case. Air Transport: Covered up to 100% of the MT. If not pre-approved, a 50% co-payment applies. Limited to R17,700 per case. |
| ➡️ Hospitalization (Only MedReach hospital and day procedure network can be used): – Intensive Care and high-care wards – Ward Accommodation – Theatre fees – Treatment and medicine in the ward – In-hospital consultation with GPs and specialists – Surgery – Anesthesia | Unlimited Cover. Hospital network. Covered up to 100% of the MT. If not pre-approved, a 20% co-payment applies. A 35% co-payment will apply if members are admitted to non-network hospitals or day facilities. Additional co-payments on certain procedures may apply. Subject to pre-authorisation, protocols, and case management. |
| ✳️ Hospitalization (Only MedReach hospital and day procedure network can be used): – Day Procedures (Including Ophthalmological, endoscopic, ear, nose, and throat procedures, dental procedures, removal of skin lesions, circumcisions, and procedures as pre-authorized) | Unlimited Cover. Covered up to 100% of the MT. If not admitted to a hospital/day procedure facility in the network, a 35% co-payment applies. Additional co-payments on certain procedures may apply. Subject to pre-authorisation, clinical protocols, and services rendered in a day procedure facility. |
| 🅰️ Hospitalization (Only MedReach hospital and day procedure network can be used): Hospital Medicine upon Discharge | Covered up to 100% of the MT. Limited to R440 per admission. Excludes PMB/chronic medicine. |
| 🏠 Home Delivery Includes the following: – Professional Nursing Fee – Equipment – Material and Medicine | Covered up to 100% of the MT. Limited to R17,100 per event. If not pre-approved, a 20% co-payment applies. |
| 📈 Radiography | Covered up to 100% of the MT. Limited to R1,365 per family yearly. Subject to clinical protocols and on request of medical doctor. |
| 📉 Specialized Radiology | Angiography, MRI and CT scans Covered up to 100% of the MT. Cover limit of R22 000 per family per year Member pays the first R1 900 per examination in hospital and out of hospital. Subject to pre-authorisation, clinical protocols, and on request of a specialist. MedVital Elect, MedAdd Elect, and MedReach – prescribed by a specialist on referral by network GP. |
| 📊 Clinical Technologist Services | Covered up to 100% of the MT. Unlimited Cover. |
| ❤️ Organ Transplants – PMB Only | Covered up to 100% of the cost. Subject to pre-authorization and clinical protocols. Cornea implants: Covered up to 100% of the MT. Limited to R37,600 per implant yearly. Subject to pre-authorisation and clinical protocols. |
| ⚕️ In-hospital Oxygen | Covered up to 100% of the MT. Unlimited Cover. |
| 🔎 Renal Dialysis Acute Renal Dialysis Chronic/Peritoneal Renal Dialysis | Covered up to 100% of the MT. Unlimited Cover. Subject to pre-authorization and clinical protocols. 20% co-payment if not pre-approved. 30% co-payment if not obtained from DSP. |
| 🔍 Post-Hospital Care Speech therapy, occupational therapy, and physiotherapy 30 days after discharge | Accessible day-to-day benefits cover prescription medication and medical equipment. Covered up to 100% of the MT. Limited to the following: Main Member – R2,300 per year. Main Member + Dependents – R3,300 per year. |
| 📌 Other Medical Services Dietitian services, physiotherapy, and occupational therapy Speech therapy Audiometry and orthoptic services Podiatry | In-hospital protocols might apply. Covered up to 100% of the cost. PMB Only. Unlimited Cover. |
| 📍 Physiotherapy and Occupational therapy | Pre-approval required. An attending doctor must request it. Covered up to 100% of the MT, but these limits apply: Main Member – R2,600 per year. Main Member + Dependents – R4,095 per year. Network GP or specialist, on referral by a network GP, must refer the beneficiary to a physio- or occupational therapist to avoid a 35% co-payment for out-of-hospital services. |
| ☑️ Psychiatry Psychiatrist-provided hospital and outpatient treatments General ward accommodations Institution-supplied medication Outpatient consultations | Covered up to 100% of the MT. Hospitalisation and professional psychiatric services: Limited to R25,200 per beneficiary per year, with a limit of R38,200 per family per year. Treatment of depression out of hospital, subject to registration on Mental Health programme: Limited to R3 150 per beneficiary per year. Medicine: Limited to R100 per beneficiary per month, subject to the in-hospital limit and annual mental health limit. Subject to pre-authorisation, protocols, and services rendered in an approved or network hospital/facility and prescribed by medical doctor. 20% co-payment per admission if not pre-authorised. 35% co-payment for voluntary admission to non-network hospital (network plans only) . |
| Oncology: PMB and non-PMB cases | Pre-authorization and Medihelp Oncology Program registration are required. Protocols, a DSP, and the MORP apply. Covered up to 100% of the MT. Limited to R336 000 per family per year. Deviation from protocols may result in a co-payment. 20% co-payment if not pre-authorised. 30% co-payment for voluntary use of non network services. |
| 💊 Alternative Hospitalization Services: Hospice Services | Covered up to 100% of the cost. PMB Only. Subject to pre-authorisation, programmes, and protocols. Services rendered in an approved facility and prescribed by medical doctor. 20% co-payment per admission if not pre-authorised. |
| 💉 Alternative Hospitalization Services: Palliative care | Covered up to 100% of the MT. 20% co-payment if not pre-authorized Limited to R22,700 per family per year. |
| 😷 Alternative Hospitalization Services: Subacute Care Facilities & Private Nursing | Covered up to 100% of the MT. Limited to R27,900 per |
| 📍 Prostatectomy: Conventional or Laparoscopic Procedure | Member pays the first R8,240 per admission. Covered up to 100% of the MT. Subject to pre-authorisation. |
Subject to pre-authorization, protocols, and case management:
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A medical emergency is a sudden and unexpected occurrence that necessitates quick medical or surgical treatment to safeguard a patient’s health. Failure to offer medical or surgical treatment would result in severe impairment of bodily functioning or severe dysfunction of a bodily organ or portion or jeopardize the individual’s life.
Netcare 911 is the designated service provider for Medihelp’s emergency transport services, and you must contact them in an emergency. Phone 082 911. Furthermore, you may also seek assistance at the nearby hospital’s emergency room. However, the following conditions apply:
| 🚑 In the Beneficiary’s Country of Residence | Unlimited Cover. Covered up to 100% of the MT. If not pre-approved, a 50% co-payment applies. |
| 🚑 Outside the beneficiary’s Country of Residence | Road Transport: Covered up to 100% of the MT. If not pre-approved, a 50% co-payment applies. Limited to R2,600 per case. Air Transport: Covered up to 100% of the MT. If not pre-approved, a 50% co-payment applies. Limited to R17,700 per case. |
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| ☑️ Mammogram | For women 40 – 75 years old. Every two years. A medical doctor must request it. |
| ✅ Pap Smear | For women 21 – 65 years old. Every three years. A medical doctor must request it. |
| ☑️ Flu Vaccines | Once yearly. It must be done at network pharmacy clinics. |
| ✅ Contraceptives | – Oral, injectable, or implantable contraceptives: Female beneficiaries up to 50 years. Covered up to R160 per month and up to R2,205 per beneficiary. – Intra-uterine devices: Every 60 months. Covered up to R2,500 per beneficiary. |
| ☑️ Enhanced Maternity Benefits HealthPrint’s Maternity and Infant program registration will activate these additional benefits per family per year. | Ten prenatal and postnatal consultations with a midwife, general practitioner, or gynecologist. However, a recommendation from a network GP to the gynecologist is not required. Two prenatal and postnatal visits to a lactation consultant, dietician, or antenatal classes. Two 2D ultrasound imaging. |
| ✅ Child Benefits | Babies <2 years receive two additional visits to a general practitioner, pediatrician, or ear, nose, and throat specialist. However, a network Physician reference is not required to see these specialists. In network pharmacy clinics, the full series of regular child immunizations are covered for up to seven years. Vaccination of children against influenza at network pharmacy clinics. |
| ☑️ Routine Screening and Immunization | A combo test, including blood glucose, cholesterol, BMI & blood pressure measurement. Individual tests, including blood glucose or cholesterol. HIV testing, counseling & support A tetanus vaccine A flu vaccination Two HPV vaccinations for girls and boys between 10 – 14 years or three between 15 – 26 years |
| ✅ Men’s Health | A prostate test (PSA level) was requested by a physician for men aged 40 to 75. Flu vaccination is administered at network pharmacies. |
| ☑️ Screening and Immunization for beneficiaries 45> | An FOBT test for recipients 45-75 years Women aged 65 and older can access one bone mineral density test every two years if requested by a physician. A Pneumovax vaccine on a 5-year cycle for each 55-year-old with asthma or COPD who is registered. |
| ✅ Wellness Support | One Back Treatment – this benefit covers back therapy at a DBC facility as an alternative to surgery for eligible patients. Moreover, treatment is a precondition for spinal surgery. One dietitian consultation with each registered HealthPrint member whose BMI is greater than 30 and whose BMI was determined by a BMI test. An oncology schedule is provided in conjunction with Independent Clinical Oncology Network oncologists (ICON) HIV program – Presented in partnership with LifeSense Disease Management |
| ☑️ Care Extender Benefit | • One additional GP consultation – the first of either a Pap smear, mammogram, prostate test, faecal occult blood test (FOBT) or bone mineral density test activates a one-off GP consultation for the family for the year. • Self-medication dispensed at a network pharmacy – an additional R1 000 will be activated for the family to use for non prescribed medicine once a combo health screening has been claimed from the added insured benefits. |
As medical research advances, new medical services are introduced each year. However, Medihelp covers life-saving medical treatment first. The Medical Schemes Act requires medical schemes to cover the diagnostic, treatment, and care costs of the mandated minimum benefits (PMB) without co-payments or limits.
Furthermore, services must follow legislation’s PMB treatment algorithms and Medihelp’s managed healthcare guidelines, which may include pharmaceutical formularies. Medihelp will cover the cost of a substitute treatment if a protocol or formulary drug is ineffective or hazardous.
However, the Medihelp MedReach plan excludes several items, including but not limited to the following:
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During waiting periods, members are eligible for membership but not for benefits. For example, Medihelp could implement either a general or condition-specific waiting period as follows:
| MediHelp MedReach (2026) | Discovery KeyCare (2026) Based on income levels | Bonitas BonEssential (2026) | |
| 👤 Main Member Contribution | R3,360 | R1,184 – R3,687 | R2,747 |
| 👥 Adult Dependent Contribution | R2,634 | R1,184 – R3,687 | R2,030 |
| 💙 Child Dependent Contribution | R1,092 | R713 – R 986 | R888 |
| 📉 Annual Limit | Unlimited Hospital Cover | None | Several limits and sub-limits |
| 💶 Prescribed Minimum Benefits (PMB) | ✅ Yes | ✅ Yes | ✅ Yes |
| 📊 Screening and Prevention | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 💳 Medical Savings Account | No | No | No |
| 🍼 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
| 🏠 Home Care | ☑️ Yes | ☑️ Yes | ☑️ Yes |
👉 Medihelp’s MedReach plan is a comprehensive medical aid plan that offers its members a wide range of benefits. One of the standout features of this plan is its unlimited hospital cover, which means that members are covered for all hospital-related expenses, including accommodation, theatre, and specialist fees.
👉 In addition, the plan offers generous benefits for chronic medication. Furthermore, it covers day-to-day medical expenses such as GP consultations, dentistry, and optometry.
👉 One drawback of the MedReach plan is that it is relatively expensive compared to other Medihelp plans and may not be suitable for individuals or families on a tight budget. Additionally, the plan may not offer as much flexibility or customization options as some other Medihelp plans.
👉 Overall, the MedReach plan is a great choice for employees of corporate companies, self employed individuals or families looking for comprehensive medical aid coverage and willing to pay a premium. However, those on a tight budget may want to consider some of the other more affordable options Medihelp offers.
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The MedReach plan is a comprehensive medical aid plan offering unlimited hospital cover, generous benefits for chronic medication, and day-to-day medical expenses such as GP consultations, dentistry, and optometry.
The Medihelp MedReach medical aid plan is one of 11, starting from R3 360.
Yes, the MedReach plan does cover pre-existing medical conditions. However, waiting periods may apply.
Waiting periods for the MedReach plan may vary depending on the specific benefit. Generally, waiting periods range from three to 12 months.
No, there is no limit on the amount of chronic medication covered by the MedReach plan.
Yes, the MedReach plan does cover maternity benefits, including antenatal care, delivery, and postnatal care.
No, there are no network restrictions with the MedReach plan. Members are free to choose any healthcare provider, hospital, or pharmacy.
The MedReach plan covers dental and optical benefits, including routine check-ups, fillings, and eyeglasses.
No, the benefits of the MedReach plan are fixed and cannot be customized.
The MedReach plan is one of the premium plans offered by Medihelp. It offers more comprehensive coverage than lower plans such as MedSaver, MedVital, and MedAdd. However, it is more expensive than other plans and may not suit those on a tight budget.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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