Makoti Medical Aid Scheme (🇿🇦 2025)

 

Overall, the Makoti Medical Aid Scheme is a trustworthy and comprehensive medical aid that offers 24/7 medical emergency assistance, Primary and Comprehensive plans to its members. The Makoti Medical Aid Scheme starts from R406 ZAR.

 

Makoti Medical Aid Scheme has two options namely

Makoti Comprehensive Option and Makoti Primary Option

 

🔎 The average number of members	10,000+
1️⃣ Number of Markets	1
👤 Number of Employees	150+
3️⃣ Average Customer Rating	3.1
🔟 Average Number of Reviews	<10
📉 Market Share	<1%
2️⃣ Number of plans offered	2
➡️ Number of Hospitals in Network	100+
↪️ Medical Claims Portal	☑️ Yes
💙 Customer Support Operating Hours	Monday to Friday from 8 am to 5 pm
🟦 Chronic Illness Benefits	☑️ Yes
🔵 Number of PMB Diagnoses	271
⬇️ Number of PMB Chronic Conditions	41
⬆️ Maternity Benefit	☑️ Yes
💶 Medical Aid Contribution Range (ZAR)	R406 – R3,744 per month
➡️ Average Waiting Period	3 to 12 months
↪️ Late-joiner penalties charged	☑️ Yes

 

💙 Download the Makoti Full Benefit Guide for 2025

 

 

 

 

Makoti Medical Aid – Analysis of Medical Aids’ Main Features

 

1. ☑️ Makoti Medical Scheme Plan Overview
2. ☑️ Makoti Medical Scheme – Advantages over Competitors
3. ☑️ How to apply for Medical Aid with Makoti Medical Scheme
4. ☑️ How to Submit a Claim with Makoti Medical Scheme
5. ☑️ How to Submit a Compliment or Complaint with Makoti Medical Scheme
6. ☑️ How to Switch my Medical Aid to Makoti Medical Scheme
7. ☑️ Makoti Medical Scheme Customer Support
8. ☑️ Makoti Medical Scheme vs Notable Competitors – A Comparison
9. ☑️ Makoti Medical Scheme Recent User Reviews
10. ☑️ Makoti Medical Scheme Pros and Cons
11. ☑️ Our Verdict on Makoti Medical Scheme
12. ☑️ Makoti Medical Scheme Frequently Asked Questions

 

 

Makoti Medical Scheme Plan Overview

 

🔎 Plan	💶 Contributions Range (Main)	💶 Contributions Range (+Adult)	💶 Contributions Range (+Child)
1️⃣ Primary Option	R406 – R1,118	R406 – R870	R273 – R400
2️⃣ Comprehensive Option	R2,738 – R3,744	R2,359 – R3,209	R910 – R1,218

 

 

Medical Aid Makoti Medical Scheme – Advantages over Competitors

 

Makoti Medical Scheme offers a range of benefit options that cater to the different healthcare needs of its members. The options include the Primary and Comprehensive options. Therefore, members can choose a plan that suits their budget and healthcare needs. Other advantages include:

 

• Generous Cover: Makoti Medical Scheme offers generous cover for a wide range of healthcare services, including hospitalization, chronic medication, and preventative care. The Comprehensive option, for example, covers in-hospital treatment according to the scheme rate, chronic medication up to a certain limit, and a range of preventative care benefits.
• Affordable Contributions: Makoti Medical Scheme’s contributions are designed to be affordable and competitive. The scheme offers a range of contribution options that allow members to pay according to their budget and financial situation.
• Value-Added Benefits: Makoti Medical Scheme offers a range of value-added benefits, including a wellness program, telemedicine services, and access to a network of healthcare professionals. These benefits promote members’ health and well-being and improve their healthcare experience.

 

Makoti Medical Scheme has a strong financial position, with a solvency ratio well above the minimum required by law. This means that the scheme can meet its financial obligations to members and providers and provide sustainable healthcare coverage in the long term.

 

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How to apply for Medical Aid with Makoti Medical Scheme

 

Medical Aid Quote Makoti Medical Scheme process:

 

To apply for Medical Aid through Makoti Medical Scheme, you must:

 

• ☑️ Visit the Makoti Medical Scheme website (https://makotihealth.co.za/) and click the “Join” button on the homepage.
• ☑️ You will be directed to a page that lists the available benefit options. Select the benefit option that best suits your healthcare needs and budget.
• ☑️ Once you select your desired benefit option, click the “Apply Now” button.
• ☑️ You will then be directed to a registration page where you must provide your details, such as your name, ID number, contact information, and employment details.
• ☑️ After completing the registration page, click on the “Next” button to proceed to the application form.
• ☑️ Fill in all the required information on the application form, including your medical history, chronic conditions, and any pre-existing conditions.
• ☑️ Review your application form to ensure that all the information provided is accurate and complete.
• ☑️ Once satisfied with your application, submit it online by clicking the “Submit” button.
• ☑️ You will then receive a confirmation email from Makoti Medical Scheme acknowledging receipt of your application.

 

Your application will be reviewed and processed by Makoti Medical Scheme. You will be notified and issued a membership certificate and other relevant documents if your application is approved.  You can start using your Makoti Medical Scheme membership to access healthcare services once your membership has been activated.

 

Get a Makoti Medical Aid quote from our Dedicated Medical Aid Specialists Broker

 

 

How to Submit a Claim with Makoti Medical Scheme

 

Here are step-by-step instructions on how to submit a claim with Makoti Medical Scheme:

 

• ✅ Obtain the claim form from the Makoti Medical Scheme website or a healthcare provider.
• ✅ Fill in the claim form with all the relevant details, including your personal information, the healthcare service or treatment received the healthcare provider’s information, and the claim amount.
• ✅ Attach all supporting documents required, such as medical invoices, receipts, and a doctor’s certificate, to the completed claim form.
• ✅ Submit the completed claim form and all supporting documents to Makoti Medical Scheme
• ✅ If the claim is approved, you will receive payment for the covered amount directly from Makoti Medical Scheme or the healthcare provider, depending on the nature of the claim.

 

If the claim is rejected, Makoti Medical Scheme will provide a reason for the rejection and advise you on how to proceed.

 

 

How to Submit a Compliment or Complaint with Makoti Medical Scheme

 

To submit a complaint or compliment, members can contact the Makoti Medical Scheme customer service department through the following channels:

 

• ✅ Telephone: Members can call the customer service department on 0861 200 400 or 010 206 1000.
• ✅ Email: Members can email [email protected] to submit a complaint or compliment.
• ✅ Online contact form: Members can submit a complaint or compliment using the contact form on the Makoti Medical Scheme website.

 

When submitting a complaint to Makoti, the following must be noted:

 

• ✅ When submitting a complaint, members should provide details of the issue, including any relevant documentation or information, such as dates, times, and names of individuals involved.
• ✅ Makoti Medical Scheme’s customer service department will acknowledge receipt of the complaint and investigate the matter. The department will respond to the member within a reasonable time.
• ✅ If a member is dissatisfied with the response from Makoti Medical Scheme, they can escalate the complaint to the relevant regulatory authority, such as the Council for Medical Schemes.

 

Furthermore, to submit a compliment, members can use the above channels to provide details of their positive experience with the Makoti Medical Scheme.

 

 

 

How to Switch my Medical Aid to Makoti Medical Scheme

 

To switch your medical cover to Makoti, you can follow these steps:

 

• ✅ Research and compare Makoti Medical Scheme with your current medical aid provider to ensure that Makoti offers the benefits, cover, and services you require.
• ✅ Once you have decided to switch to Makoti Medical Scheme, contact their customer service department via email, telephone, or contact form.
• ✅ Inform Makoti Medical Scheme that you would like to switch to their medical aid scheme and provide them with details of your current medical aid provider.
• ✅ Obtain a cancellation form from your current medical aid provider and complete it, providing details of your intention to cancel your membership.
• ✅ Submit the completed cancellation form to your current medical aid provider.
• ✅ Contact Makoti Medical Scheme and complete the necessary application forms to apply for membership with them. You can download the application forms from the Makoti Medical Scheme website or obtain them from the customer service department.
• ✅ Once you have completed the application forms, submit them to Makoti Medical Scheme, along with any supporting documents required, such as copies of your ID or passport and proof of income.
• ✅ Await confirmation of your acceptance into the Makoti Medical Scheme, which may take up to 30 days to process.

 

Once your application has been approved, you will receive a membership certificate and other relevant documents.  Begin using your Makoti Medical Scheme membership to access healthcare services.

 

New Members 35 years or older may be subject to late-joiner penalties on Makoti Medical Aid Plans.

 

 

Makoti Medical Scheme Customer Support

 

You can contact Makoti Medical Scheme customer support using any of the following channels:

 

• ☑️ Telephone: You can call the customer support team on 0861 002 400.
• ☑️ Email: You can email [email protected] to reach the customer support team.
• ☑️ Contact Form: You can also fill out a contact form on the Makoti Medical Scheme website. Go to the “Contact us” page and fill in your details and message.
• ☑️ Postal Address: You can send a letter to Makoti Medical Scheme at the following postal address: PO Box 612, Johannesburg, 2000.

 

 

Makoti Medical Scheme vs Notable Competitors – A Comparison

 

🔎 Medical Aid	🥇 Makoti Medical Scheme	🥈 GEMS	🥉 Sizwe Hosmed
📌 Years in Operation	Since 1976	Since 2005	35 Years
📍 Average # Members	10,000+	1.8 million+	63 577 members 152 421 beneficiaries
📈 GCR Rating	–	AA	A+
📉 Number of Employees	150+	500+	500 – 1,000
📊 Market Share	<1%	>10%	<5%
🟥 Market Coverage	South Africa	South Africa	South Africa
🟧 Customer Rating	3.1	3	–
🟨 Number of reviews	<10	1,700+	<1,000
🟩 Mobile App	No	Yes	Yes
🟦 Contribution Range (ZAR)	406 – 3,744 ZAR	1,456 – 7,852 ZAR	2,636 – 9,788 ZAR
🟪 International Travel Benefit (ZAR)	No	Scheme Rate – Members pay and claim back from GEMS	100% of the Scheme Rate

 

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Makoti Medical Scheme Recent User Reviews

 

Positive Experience.

My experience thus far with Makoti has been exceptionally positive. The consultants are patient and accommodating and provide comprehensive explanations, ensuring I fully comprehend my queries without the inconvenience of prolonged waiting times or tedious music. – Carl van Tonder

 

Great Support.

I recently became a member of Makoti Medical Aid. I was pleasantly surprised by the 100% service and support received from the Makoti team. – Steve Rikhotso

 

Very Happy.

It is a delight to consult with Makoti. The consultants exude high professionalism, courtesy, and amicability and willingly go beyond to assist. – Robert Botha

 

 

Makoti Medical Scheme Pros and Cons

 

✅ Pros	❎ Cons
Affordable contribution rates	Limited geographic coverage
Comprehensive benefit options	Limited online resources and tools
Personalized service	Some benefit options may have restrictions or exclusions
Speedy claims processing	Limited member perks or discounts

 

Poll: 5 Best Comprehensive Medical Aid Plans

 

 

Our Verdict on Makoti Medical Scheme

 

💙 Makoti Medical Scheme is a South African medical aid scheme offering affordable healthcare coverage to individuals and families. The scheme provides a range of benefit options to suit different healthcare needs and budgets, including comprehensive coverage for hospitalization, chronic conditions, and day-to-day medical expenses.

 

💙 Makoti Medical Scheme’s unique selling points include its personalized service, speedy claims processing, and competitive pricing. However, the scheme has limited geographical coverage, as it only operates in specific provinces within South Africa.

 

💙  In summary, Makoti Medical Scheme is a reliable and cost-effective medical aid scheme for those who live in its operational areas and require comprehensive healthcare coverage.

 

👉 You might also like: Makoti Comprehensive Option
👉 You might also like: Makoti Primary Option

 

 

Makoti Medical Scheme Frequently Asked Questions

 

What is Makoti Medical Scheme?

Makoti Medical Scheme is a medical aid scheme in South Africa that offers comprehensive healthcare coverage to its members.

 

What benefit options are available with Makoti Medical Scheme?

Makoti Medical Scheme offers a range of benefit options, including hospital plans, chronic condition cover, and day-to-day medical expense cover.

 

How much do I have to pay to join Makoti Medical Scheme?

The contribution rates for Makoti Medical Scheme start from R406 per main member and depend on the income bracket of the main member, which option they choose, and how many dependents they add.

 

How long does it take for claims to be processed by Makoti Medical Scheme?

Makoti Medical Scheme is known for speedy claims processing, with most claims processed within 5 working days.

 

How can I contact customer support at Makoti Medical Scheme?

You can contact Makoti Medical Scheme customer support by telephone, email, online chat, contact form, or postal address.

 

What geographic areas does Makoti Medical Scheme operate in?

Makoti Medical Scheme operates in specific provinces within South Africa, including Gauteng, Limpopo, Northwest, and Mpumalanga.

 

Does Makoti Medical Scheme cover chronic conditions?

Yes, Makoti Medical Scheme offers comprehensive coverage for chronic conditions, subject to certain terms and conditions.

 

Are there any restrictions or exclusions to the benefit options offered by Makoti Medical Scheme?

Depending on the specific benefit option chosen, some benefit options may have restrictions or exclusions.

 

What online resources and tools are available on the Makoti Medical Scheme website?

The Makoti Medical Scheme website provides information on benefit options, contribution rates, claims procedures, and contact details.

 

Does Makoti Medical Scheme offer any member benefits or discounts?

While Makoti Medical Scheme does not offer many member benefits or discounts, it does offer affordable contribution rates and comprehensive healthcare coverage.

 

What are the contact details for Makoti Medical Scheme?

You can contact Makoti Medical Scheme by telephone at 0860 002 400, by email at [email protected], or through the online contact form on their website.

 

What are the benefits and cover options for Makoti Medical Scheme in 2025?

Makoti Medical Scheme offers a range of benefit options for 2025, including hospital plans, chronic condition cover, and day-to-day medical expense cover. Furthermore, prospective members can view the Member Benefits brochure on the Makoti website.

 

How can I join Makoti Medical Scheme?

To join Makoti Medical Scheme, complete an online application form on their website or contact their customer service department for assistance.

 

Can I choose my doctor with Makoti Medical Scheme?

Yes, Makoti Medical Scheme allows members to choose their doctors, subject to certain terms and conditions.

 

What is the Makoti Medical Aid website?

The Makoti Medical Scheme website is https://makotihealth.co.za/.

 

How can I find a doctor who accepts Makoti Medical Aid?

You can use the Makoti Medical Scheme website to search for healthcare providers who accept Makoti Medical Aid or contact their customer service department for assistance.

 

What is the customer service hotline for Makoti Medical Aid?

The customer service hotline for Makoti Medical Scheme is 0860 002 400.

 

What documents do I need to provide to join Makoti Medical Scheme?

You must provide a copy of your ID or passport, proof of income, and any other documentation required by the Makoti Medical Scheme. Contact their customer service department for more information.

 

How do I add a Beneficiary to Makoti Medical Scheme?

If you want to add a child or adult dependent, you can log into your Makoti Medical Scheme profile and obtain the necessary forms from the Makoti Medical Scheme website or the customer service department.

 

How do I Downgrade my Plan with Makoti Medical Scheme?

Notify Makoti Medical Scheme of your intention to downgrade your benefit option by contacting the customer service department. You can do this via email, telephone, or by visiting the Makoti Medical Scheme website and using their online chat or contact form.  Complete and submit the required forms to request the downgrade. The forms can be downloaded from the Makoti Medical Scheme website or the customer service department.