Medihelp MedAdd Elect Medical Aid Plan (🇿🇦 2026)

  Overall, the Medihelp MedAdd Elect Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and in-hospital procedures to its members. The Medihelp MedAdd Elect Medical Aid Plan starts from R3 186 ZAR.    

Medihelp MedAdd Elect Plan - 11 Key Points Quick Overview

1. ☑️ Medihelp MedAdd Elect Plan Overview
2. ☑️ Medihelp MedAdd Elect Plan Contributions and Medical Savings
3. ☑️ MedAdd Elect Plan Benefits and Cover Comprehensive Breakdown
4. ☑️ MedAdd Elect Day-to-Day Benefits
5. ☑️ MedAdd Elect Benefit Table
6. ☑️ MedAdd Elect Emergency Benefits
7. ☑️ MedAdd Elect Added Insured Benefits
8. ☑️ Medihelp MedAdd Elect Plan Exclusions and Waiting Periods
9. ☑️ Medihelp MedAdd Elect Plan vs. Similar Plans from other Medical Schemes
10. ☑️ Our Verdict on The MedAdd Elect Plan
11. ☑️ MedAdd Elect Plan Frequently Asked Questions

Medihelp MedAdd Elect Plan Overview

  The Medihelp MedAdd Elect medical aid plan is one of 11, starting from R3 186, and includes a medical savings account, chronic medicine, out-of-hospital benefits and cover, care extender, extended maternity benefits, and more.   Gap Cover is not available on the Medihelp MedAdd Elect 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:  

• ✅ MediHelp Medprime
• ✅ MediHelp MedPrime Elect
• ✅ MediHelp MedPlus
• ✅ MediHelp MedElite
• ✅ MediHelp MedVital
• ✅ MediHelp MedVital Elect
• ✅ MediHelp MedSaver
• ✅ MediHelp MedMove Student
• ✅ MediHelp MedReach
• ✅ MediHelpMedAdd
• ✅ MediHelp MedAdd Elect

Medihelp MedAdd Elect Plan Contributions and Medical Savings

Contributions

 

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Medical Savings Account

 

MedAdd Elect Plan Benefits and Cover Comprehensive Breakdown

MedAdd Elect Accumulative Unused Savings Contributions

  Each month, a portion of your contributions equal to 15% is allocated to a savings account:

• ☑️ These amounts to R480 per month or R5 760 per year for the principal member.
• ☑️ Adult dependents receive R372 per month or R4 464 per year.
• ☑️ Child dependents receive R168 per month or R2 016 per year.

  These savings are intended to cover daily medical expenses.  At the start of each year, the entire year’s contributions to the savings account become available as a credit facility. Any funds that are not used are carried forward to the following year.  The remaining portion of your monthly contributions is used to fund your comprehensive core and insured benefits.  

How Medihelp pays claims on MedAdd Elect

• ✅ Except for services relating to prescribed minimum benefits (PMB), qualifying claims are paid from the savings account first until the account is empty.
• ✅ Claims are then reimbursed until the insured’s daily benefits are exhausted. PMB services are paid from day-to-day benefits until they are depleted, then from core benefits without limitation.

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MedAdd Elect Day-to-Day Benefits

Benefits are first paid from the available Medical Savings Account.  Once funds are depleted, the following limits apply to day-to-day benefits.   MedAdd Elect offers a 15% savings account per year, equaling:  

• ✅ R5 760 per main member
• ✅ R4 464 per adult dependant
• ✅ R2 016 per child dependant
• ✅ All claims are paid up to 100% of the Medihelp Tariff (MT).
• ✅ Main Members – limited to R2,100 per year after savings are depleted.
• ✅ Family – limited to R4,200 per year after savings are depleted.

MedAdd Elect Consultations

• ✅ GP appointments and follow-up appointments
• ✅ Specialists (35% co-payment if not referred by a network primary care physician or not pre-authorized)
• ✅ Telemedicine, virtual consultations, and visits from nurses at network pharmacies.
• ✅ Pharmacies providing primary care and emergency units, including primary care drug therapists, in terms of consultations and follow-ups.
• ✅ Physiotherapy, including material and treatment.

MedAdd Elect Medication

• ✅ The medication is obtained through the Medihelp Preferred Pharmacy Network and prescribed or given by a physician.
• ✅ Acute and non-PMB chronic medication and self-medication, including emergency room drugs and immunizations.
• ✅ Generic medicine – 100% of the MMAP Original medicine if no generic equivalent – 80% of the MT.
• ✅ 70% of the MMAP comprises original medication taken willingly when a generic alternative is available.
• ✅ Homeopathy, naturopathy, and osteopathy account for 25% of the possible daily benefit.

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MedAdd Elect Benefit Table

MedAdd Elect Care Extender

 

Allied Medical Services (Out-of-Hospital)

Allied Medical Services (Out-of-Hospital), include the following:  

• ✅ Occupational and speech therapy
• ✅ Dietitian services
• ✅ Audiometry
• ✅ Podiatry
• ✅ Massage
• ✅ Orthoptic
• ✅ Chiropractic
• ✅ Homeopathic
• ✅ Herbal and naturopathic
• ✅ Osteopathic
• ✅ Biokinetic services

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MedAdd Elect Standard Radiology

Pathology and Medical Technologist Services (via Ampath as the contracted DSP)    

MedAdd Elect Dentistry

 

External Prostheses and Medical Appliances

 

MedAdd Elect Hospitalization and Advanced Treatment

 

Emergency Transport Services via Netcare 911

 

MedAdd Elect Hospitalization

(Only MedAdd Elect hospital and day procedure network can be used)    

MedAdd Elect Childbirth

Subject to pre-authorization, protocols, and case management:  

• ✅ Unlimited Cover.
• ✅ Covered up to 100% of the MT.
• ✅ If not pre-approved, a 20% co-payment applies.

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

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Radiology, Pathology, and Medical Technologist Services

• ✅ In-hospital cover only.
• ✅ Subject to clinical protocols and approved hospital admission.
• ✅ Members must use Ampath as the contracted Pathology DSP.

     

MedAdd Elect Oncology

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.
• ✅ Unlimited Cover.
• ✅ 20% co-payment on non-DSP treatment.
• ✅ 20% co-payment for deviating from protocol.

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Non-PMB Cases

• ✅ Covered up to 100% of the MT.
• ✅ Limited to R273,000 per family per year.
• ✅ 20% co-payment on non-DSP treatment.
• ✅ 20% co-payment for deviating from protocol.

MedAdd Elect Alternative Hospitalization Services

   

MedAdd Elect Emergency Benefits

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:  

• ✅ Emergency admissions must be reported to Medihelp on the following business day by 086 0200 678.
• ✅ If you visit an emergency facility but are not hospitalized, the care you receive will be covered by your regular plans.
• ✅ Facilities costs are not included.

Emergency Transport Services via Netcare 911

   

MedAdd Elect Added Insured Benefits

• ✅ With a strong emphasis on preventative care, early diagnosis of potential health problems, and maternity benefits and childcare, these benefits are offered annually in addition to your insured benefits unless otherwise specified.
• ✅ Protocols and item codes may be applicable.
• ✅ Members can look for network provider information on Medihelp’s website or app using the provider search option.
• ✅ You can also sign up for HealthPrint, a free online health and fitness program offered by Medihelp, to activate the specified benefits.

Women’s Health

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 R170 per month and up to R2,310 per beneficiary.

• ✅ Intra-uterine devices for women up to 50 years
• ✅ Every 60 months.
• ✅ Covered up to R2,730 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

• ✅ 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

Additional GP visit

• ✅ Once your increased insured benefits pay for a Pap smear, mammography, prostate test, FOBT, or bone mineral density test, the family will receive a one-time GP visit benefit.
• ✅ Test protocols will apply to this benefit.

Self-Medication (R1000)

• ✅ Once your enhanced insured benefits pay for a combo health screening (blood glucose, cholesterol, BMI, and blood pressure), the family will receive a one-time R1000 for self-medication.

Medihelp MedAdd Elect Plan Exclusions and Waiting Periods

Medihelp MedAdd Elect Exclusions

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 MedAdd Elect plan excludes several items, including but not limited to the following:  

• ✅ Restorative fillings for teeth injured by toothbrush abrasion, attrition, erosion, and fluorosis
• ✅ Resin bonding for restorations is billed separately from the restoration.
• ✅ The polishing of restorations
• ✅ Gold foil embellishments
• ✅ Ozone therapy Diagnostic dentures and laboratory fees
• ✅ Snoring aids and accompanying laboratory expenses
• ✅ Provisional dentures and corresponding laboratory fees
• ✅ Implants for third molars
• ✅ Dolder bars and accompanying implant abutments, including laboratory costs
• ✅ Fees for laboratory delivery
• ✅ Cosmetic orthodontic treatment and accompanying laboratory expenses
• ✅ Orthodontic treatment for those aged 18 and older
• ✅ Surgical periodontics, including gingivectomies, periodontal flap surgery, tissue grafting, and tooth hemisection.
• ✅ Placement of perio-chip
• ✅ Appointments missed
• ✅ The plan of treatment finished
• ✅ Electrognathographic recordings, pantographic recordings, and similar electronic examinations
• ✅ Tests for caries susceptibility and microbiology
• ✅ Pulp tests
• ✅ The price of mineral trioxide
• ✅ Enamel micro-abrasion
• ✅ All biological, biosimilar, and other drugs excluded by Medihelp’s drug exclusion list
• ✅ Advanced medical techniques, surgical instruments, and medications
• ✅ Blood-derived pharmaceuticals, including autologous blood serum eye drops, and more.

Medihelp MedAdd Elect Waiting Periods

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:  

• ✅ The general waiting period is up to three months from the date of membership. During this time, you will not be eligible for benefits other than the minimum prescribed benefits (PMB). During this waiting period, the Scheme will not pay any claims you file.
• ✅ From the day you join, a condition-specific waiting period of up to 12 months applies. During this period, you will not be eligible for benefits related to a specific ailment for which you get medical advice, a diagnosis, care, or treatment (this excludes PMB).

Medihelp MedAdd Elect Plan vs. Similar Plans from Other Medical Schemes

   

Our Verdict on The MedAdd Elect Plan

Medihelp MedAdd Elect is a medical aid plan offered by Medihelp, a South African medical scheme. The plan complements Medihelp’s core medical aid plans by providing additional cover for day-to-day medical expenses.   Members of the plan pay a monthly contribution, with 15% of that amount being allocated to a savings account that can be used to cover daily medical expenses. At the start of each year, the entire year’s contributions to the savings account become available as a credit facility.   Any unused funds are carried forward to the following year.  In addition to the savings account, Medihelp MedAdd Elect also provides comprehensive cover for various medical services, including chronic medication, dentistry, optometry, and hospitalization.   Overall, Medihelp MedAdd Elect appears to be a comprehensive medical aid plan that offers a good balance of cover for day-to-day medical expenses and more serious medical events.   However, the specific suitability of the plan will depend on an individual’s unique medical needs and budget. Therefore, potential members should carefully review the plan’s terms and conditions and compare it to other available medical aid plans before deciding.   You might also like to read more about the Best Hospital Plans for Students and Young Adults

MedAdd Elect Plan Frequently Asked Questions

What is Medihelp MedAdd Elect?

Medihelp MedAdd Elect is a medical aid plan offered by Medihelp, designed to provide additional cover for day-to-day medical expenses that Medihelp’s core medical aid plans may not cover.  

What types of medical expenses are covered by Medihelp MedAdd Elect?

Medihelp MedAdd Elect covers a range of medical expenses, including chronic medication, dentistry, optometry, and hospitalization. The plan also includes a savings account that can be used to cover day-to-day medical expenses.  

How does the savings account work?

Members of Medihelp MedAdd Elect pay a monthly contribution, with 15% of that amount allocated to a savings account. At the start of each year, the full year’s contributions to the savings account become available as a credit facility that can be used to cover day-to-day medical expenses. Furthermore, any unused funds are carried forward to the following year.  

Is Medihelp MedAdd Elect suitable for everyone?

The suitability of Medihelp MedAdd Elect will depend on an individual’s unique medical needs and budget. Furthermore, some might find that the co-payments involved with MedAdd do not suit their budget or that the savings account is insufficient to cover day-to-day expenses.  

How do I join Medihelp MedAdd Elect?

To join Medihelp MedAdd Elect, you will need to become a member of Medihelp and select the MedAdd Elect plan as an add-on to your core medical aid plan. Then, you can visit the Medihelp website or contact their customer service team.  

What happens if I don’t use all the funds in my savings account?

Any unused funds in the savings account are carried forward to the following year. The full year’s contributions to the savings account become available as a credit facility at the start of each year. This means that you will have access to the unused funds and the new contributions.